Cases of hepatitis C have declined by nearly a third in Alaska, according to the most recent data from the state’s Health Department. This mirrors a national trend, says a bulletin published by the Alaska Department of Health’s epidemiology section last week.
While the bulletin said that the reason for the decline isn’t clear, it suggested two factors.
One potential reason for the decline is an increase in screenings and treatment efforts, the bulletin said. For example, the number of reported tests from Alaska Native Tribal Health Consortium increased throughout the study period, with the consortium administering more than 10,000 tests annually, according to the bulletin.
But Dr. Brian McMahon, a hepatologist and senior consultant to the consortium’s liver disease program, said increased screening can also result in the state finding more cases.
“The more active you are in screening, the more you’re going to find,” he said.
American Indian and Alaska Native people had the highest rate of reported chronic hepatitis C infection in the state, with 223 infections per 100,000 people. McMahon said that may be an overrepresentation in data because of the frequent screening.
“We can’t say for sure that it’s skewing the results, but it’s definitely making the numbers in Alaska Native people much higher than in other populations, because the Alaska tribal organizations are so aggressive about doing screening,” McMahon said.
The percentage of chronic hepatitis C first identified in a correctional setting in Alaska increased from 15% during 2016-2019 to 20% during 2020-2023. The bulletin linked this increase to expanded testing and treatment by the Alaska Department of Corrections since 2020. The bulletin also noted that hepatitis C testing and treatments have been offered to all incarcerated people in Alaska starting in late 2023.
Unlike hepatitis A and hepatitis B, hepatitis C has no vaccine. However, antiviral therapy is available after an infection occurs.
“I’ve been a doctor for sixty years and it’s almost a miracle,” said McMahon about the treatment, which has over a 90% cure rate, according to the CDC.
People with chronic hepatitis C can remain asymptomatic for decades, the bulletin also said, meaning that people are often unaware that they are infected.
From 2016 to 2023, there were 5,352 new cases of chronic hepatitis C reported in the state.
The bulletin suggested another reason for the statewide decline in infections: more people are smoking drugs than injecting them. The virus, which causes liver disease, is spread through contact with infected blood. According to the Center for Disease Control and Prevention, transmission is most common through needles, such as sharing contaminated needles to inject drugs. According to recent data from the CDC, Americans across the nation are shifting away from injecting drugs and toward smoking them. As a result, the transmission of hepatitis C through contaminated needles is potentially mitigated.
According to the bulletin, most of the reports of infection were in adults aged 18-39 years old. Males account for 66% of chronic hepatitis C cases reported to the state. The Southeast, Gulf Coast, and Matanuska-Susitna regions of the state had the highest rates of hepatitis C, which has been consistent since at least 2003.
The bulletin also referenced recent analysis from the CDC, which estimated that 34% of people with hepatitis C in Alaska between 2013 and 2022 achieved “viral clearance” or were essentially cured. This is similar to the national rate, but falls short of the 58% target set by the U.S. Department of Health and Human Services.
The bulletin recommended that everyone 18 years old or older be tested for hepatitis C at least once in their lifetime. Pregnant women should be screened during each pregnancy, and people who inject drugs should be tested periodically.
