The Importance of Following Up and Monitoring

Follow-up monitoring after successful hep C treatment is hit-and-miss for most people I have talked to, whether they were treated 6 months ago or six years more.

Having had a fibro scan recently, I was happy to learn that I have no fibrosis now, years after being cured. Recently a CT scan revealed there had been no change in the size of some lesions found 14 years ago, and that was super comforting, as we know we are considered to have a higher risk of developing Hepatocellular Carcinoma (HCC).

Extrahepatic manifestations

HCC, like other cancers, is best found earlier rather than later and provides us with more effective treatment options.

There are several hep C and hep B-caused extrahepatic manifestations (EHM). Due to the possible implications of a chronic condition, I suspect it is not common at all for hep A, not being a chronic infection.

I hear how some people don’t ever get their all-clear from 12 weeks post-treatment, with some not getting tests done. With SVR/cure rates at nearly 100%, some will argue just how important that SVR test is.

One of the problems is that for people who do not have secure housing or have resources and support to help them to get the blood work and necessary follow-up care, not to mention a list of health issues.

This is a massive problem for a growing population of people with hep C, typically younger and engaged in current substance use and/or addiction. The options for care are limited, which speaks to health equity and the social determinants of health that are barriers to care.

Overdose epidemic

The resources available for some people/populations who are in this group vary vastly. Some of the largest cities, but not all, have NGO and public health programs that are helpful but variable in many towns and cities/counties.

Rural and more remote areas, which have what some would suggest are big city problems, are dealing with most of the same issues in the smaller communities.

Don’t get me wrong, as successes and good work are being done by some dedicated peers and staffers. Covid made delivering harm reduction materials and services a challenge, and many workers experienced burnout or trauma.

The overdose epidemic continues, and, in many locations, it is growing in the number of lives lost.

Recovery and treatment

Recovery and treatment for people facing a list of barriers to care are taking an awful toll on people, families, and communities all over. In the inner city, suburbs, and small towns, unless we see adequate funding and redoubled efforts to address the issues better, we will see more illness and death, sadly.

This is the reality I see in populations who live on the margins of society, and they are our brothers, sisters, fathers, and mothers. We cannot ignore this thing as a society.

Surely, we can no longer ignore it.