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Importance of Pre-Treatment Screening

With recent events in the news about people not being treated with appropriate drugs for their liver disease status, and what I am hearing from the affected community, it is something that needs addressing by the community affected as well as the treating medical community.

I am aware of several people having minimal testing and screening prior to their treatment. As we know there is no drug or regimen/protocol that fits every genotype, fibrosis level, -cirrhotic, non-cirrhotic, treatment naïve vs. treatment experienced, and to include people who have relapsed and null responders. There are other considerations such as resistant variants and genetic barriers, and perhaps some I have not included.

The issue here is about proper screening both at diagnosis and before embarking on treatment. Assessing the overall health of a patient is key, and this should include an appropriate evaluation of their mental and physical health, not only the health of their liver. In some cases people will need a referral to a social worker or mental health professional, or perhaps another specialist as in diabetes. Accompanied illness or “comorbidity” as they are called, is important and can impact what course of action should be taken. I cannot stress enough how important these things can be.

I know of people who have had minimal screening, and this is not acceptable in my opinion.

I am not going to go into exactly what should be done because I am not a physician, or scientist, but I will say that any person who is diagnosed with HCV, and I mean Chronic Hepatitis C, needs to have a complete and appropriate level of screening.

There is another issue that I have experienced myself, which is about the level of understanding people have about their diagnosis, and what the test results mean. In the moment it is often difficult for people to understand what the physician is saying about our condition. Much of the language is foreign to us and if there is only a cursory explanation we are less likely to get the information we can use in our own self-guided care. It is hard to make good decisions about what is the best care or treatment if we do not understand the ramifications of decisions we make, or our physician makes for us and about us. We need to have a reasonable understanding at the very least.

Evaluation and assessment are key components with any illness or disease, and HCV is no exception. If the healthcare provider is not doing the complete job it puts patients at risk for a number of things. Some may be minor while others can be very serious and impact on whether the person can achieve SVR cure status. This is after all the goal with treatment, even if the ultimate goal is an improved quality of life.

It is never my intention to scare or cause undue alarm. We have seen frightening news from time to time, over the years. Fears about this thing or that thing are commonplace in our modern world. Fear and doubt is not my go to place despite my deep concerns for the health of you and me. We need to approach HCV like we do any other serious illness, and the people who are providing us with care need to do the same.
Most do, some do not.

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