Nursing PhD student leads new Hep C center at UofL Hospital

University of Louisville Hospital has opened a new center to treat hepatitis C, a particular problem in Kentucky, which has the highest infection rate in the country. The center is lead by UofL School of Nursing Ph.D. student and family nurse practitioner Barbra Cave.

A ribbon-cutting and open house marked the UofL Hospital Hep C Center’s official opening Wednesday morning, Nov. 29, with the first patients scheduled later in the day.

“While Kentucky has the highest rate of new hep C cases in the U.S., few places exist here for treatment,” said Cave, M.S.N., A.P.R.N., who specializes in gastroenterology and hepatology. “This is a much-needed service in the community.”

In the past, treating hepatitis C was difficult. It involved a triple therapy with interferons that lasted almost a year, with multiple side effects. Not everyone was a candidate for treatment. Doctors found it challenging, and some patients opted to not get treated at all.

“Many patients were scared off by treatment, knowing it was going to be hard,” Cave said. “Maybe they saw a friend go through it. But we want them to know it’s not hard anymore. We can help so many people.”

Today, treatment is one pill, once a day, for 8-12 weeks – with minimal side effects, said Ashutosh Barve, M.D., Ph.D., the center’s medical director and a gastroenterologist with the hospital and UofL Physicians. The center also uses FibroScan, which allows staff to perform a non-invasive assessment of the liver without a biopsy.

“This is truly a success story of modern medicine,” he said. “We went from discovering the basic science of the disease in the late ‘80s, early ‘90s, to finding a cure in 2014.”

While hepatitis C can cause major complications, up to half of patients who have it may not know they are infected, Cave said. The U.S. Centers for Disease Control and Prevention has recommended screening for all baby boomers.

“People may carry the disease for decades before they have symptoms,” she said.

Hepatitis C is a blood-borne illness. It may have been contracted from a blood transfusion prior to 1992, contaminated tattoo equipment or IV drug use. Older veterans are particularly at risk due to the use of the old “jet gun” vaccinators by the military and combat injuries, Cave said.

Contaminated dental equipment can also spread hepatitis C, and the disease can be passed from mother to baby.

“The virus can live on a surface for weeks, if not sterilized properly,” Cave said.

Though hepatitis C is now easily curable with proper treatment, the disease can cause major complications if left untreated. It can cause cirrhosis of the liver or liver cancer. Barve, who also directs the Liver Cancer Program at the UofL School of Medicine, said hepatitis C is a leading cause of liver transplant.

Hepatitis C may predispose those infected to diabetes and depression, and it has an association with joint pain, regardless of the amount of liver damage.

The new center will see patients every weekday, and the hospital is expecting 2,000 patient visits per year, with space to expand as volume grows. 

Nov. 29, 2017