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Johns Hopkins Hospital Walk-in Program a Lifesaver for Hepatitis C Patients

Johns Hopkins Hospital Walk-in Program a Lifesaver for Hepatitis C Patients

The outlook for people infected with the hepatitis C virus has improved dramatically.

Margaret Renea says her life was in a downward spiral. In 2016, the 54-year-old South Baltimore native’s drinking was out of control. Her marriage was in trouble, and her hepatitis C was only making matters worse.

Then, in just 12 weeks, Renea gained a new future. Renea is one of the approximately 4,242 patients who have been cured of hepatitis C at The Johns Hopkins Hospital.

The hepatitis C virus attacks and inflames the liver and can lead to cirrhosis, liver failure and liver cancer. Prior to 1992, before donated blood was screened for the hepatitis C virus, blood transfusions could transmit the disease. Today, it is spread mainly via shared needles. Most people infected with the virus show no symptoms until they sustain liver damage, which can take decades.

But in the past five years, the outlook for people infected with the hepatitis C virus has improved dramatically. In October 2014, the U.S. Food and Drug Administration approved new drugs that inhibit the virus’ ability to reproduce. Since then, medications to treat the disease have gotten even better.

“As more people are cured of this life-threatening liver disease, the hope is that fewer infections will be transmitted,” says , a nurse practitioner at The Johns Hopkins Hospital’s John G. Bartlett Specialty Practice.

The practice houses a comprehensive viral hepatitis program composed of nurses, case managers, pharmacists, outreach specialists, and infectious disease and gastroenterology/hepatology specialists trained in the management of viral hepatitis, including hepatitis B and hepatitis C infections.

Brinkley says this setting provides free rapid testing for hepatitis C and HIV infections, on-site liver imaging technology, as well as a walk-in program for new patients interested in same-day services. New patient walk-ins are welcome Monday through Friday from 8 a.m. until 3 p.m.

Mark Sulkowski, medical director of the practice, says his team strives to make sure each patient’s care is paid for.

“Our staff works hard to find the dollars to cover patients’ treatments, no matter their insurance status,” he says. “While barriers still exist, we have a dedicated team that works to overcome obstacles to therapy.”

Until new medications were available, patients undergoing treatment for the hepatitis C infection endured a noxious combination of antivirals and interferon, leaving many who took it feeling sick and run-down. The treatment rarely led to a cure, aiming instead at merely tamping down the virus.

Today, says Brinkley, treatment is typically well-tolerated, adding that the Bartlett Specialty Practice’s nurse and pharmacy teams work to support patients with individualized adherence plans and treatment calendars to maximize outcomes. Their cure rates remain consistently in the 97% range for patients.

Sulkowski and his colleagues present patients’ treatment plans in manageable pieces, coaching and counseling them along the way.

“Maybe the patient has been through treatment before, unsuccessfully,” Sulkowski says of a common occurrence. “We make sure they know that this is going to be different. You’re not just going to walk out of here with a bottle of hepatitis C treatment. Through counseling, through peer groups, through our nurses and our community health workers, we’ll be with you every step of the way.”

Many cured patients remain connected to the clinic through a peer support group called The Cure Club. For example, some patients need to avoid alcohol because of compromised liver function. Others with histories of opioid abuse or drug use involving needles must avoid relapse and a risk of reinfection. The Cure Club is led by a counselor who has been through the program. It gathers cured patients and those in various stages of the medication regimen to talk about their experiences and encourage one another.

Such support begins with a patient’s first visit to the clinic. Renea says that appointment was a “life-changer.” Her doctor, , listened patiently to Renea’s story of depression and alcoholism.

“Then, Dr. Falade said something that broke me down,” says Renea. “She said, ‘I believe in you.’ I cried and cried.”

With Falade’s help, Renea’s insurance company approved her treatment, and she began an easy, once-a-day pill regimen. She reported mild nausea on the first day but no side effects after that.

Three months after taking her first pill, Renea was free of hepatitis C. She feels like herself again — cheerful and outgoing.

“I’m so grateful to my doctor and to everyone at the clinic,” she says. “Those are some very special people. They really care about me.”

For more information or to make an appointment, call 443-997-1900.

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