When a hepatitis C (“hep C”) infection is left untreated, it damages the liver over time, causing illnesses like cirrhosis and liver cancer. The good news is that hep C is curable.
Despite advances in hep C treatment that make it easier to use and prescribe, each year we still see more people in King County diagnosed than cured from hep C, as shown in the data on new hep C data dashboard. We sat down with Dr. David Sapienza, a physician with Public Health who treats patients with hep C, to learn more.
Dr. Sapienza, how does hep C spread?
Dr. Sapienza: Hep C spreads when the blood from a person infected with hep C virus gets into the body of a person who is not infected. More specifically, hep C spreads through blood contact, such as sharing needles and other drug use supplies such as cottons and cookers, receiving tattoos from equipment that has not been properly cleaned, sharing personal items like razors that have blood containing the hep C virus on them, from a birth parent to their baby during childbirth, and, though rare, through sexual contact.
Today, the most common way that people in the US become infected with hep C is through injection drug use.
What are the symptoms of hep C?
Often, people with hep C don’t feel sick and don’t even know they’re infected. Those who do develop symptoms may have fatigue, nausea, loss of appetite, and skin and eyes turning yellow.
Even though most people with hep C don’t have symptoms, the virus may be causing long-term damage to their liver. In fact, hep C is the number one cause of liver cancer.
So, it sounds like getting tested for hep C is important?
Yes. Because you can be infected with hep C without even knowing it, everyone should be tested for hep C at least once in their lifetime.
Some folks should test more frequently, including people:
- who inject drugs
- who are on hemodialysis
- who are pregnant, even if they were tested the last time they were pregnant
The test is a simple blood test that your doctor can order. It’s covered by most insurance, including Apple Health/Medicaid.
Hep C is curable. What does treatment involve, and how available is it here in King County?
Yes! The hep C cure is a lifesaving development.
The treatment is pretty simple. For most people it involves taking one to three pills a day for eight to 12 weeks.
In King County, you can get medication through your regular doctor or at Public Health clinics, like the Robert Clewis Center or the King County Sexual Health Clinic at Harborview Medical Center.
Most insurance, including Apple Health/Medicaid, covers the full cost of treatment. For people who don’t have insurance or who have large co-pays, there are also assistance programs that will help cover the cost of the medications.
What is the patient experience like? Are there many side effects?
Treatment is usually easy. Most people either don’t notice side effects, or experience just mild tiredness or a headache. After finishing the pills, a simple blood test shows if you’re cured. On average, 95% of people who complete the treatment are cured.
This is a newer treatment, introduced about 10 years ago. Earlier hep C treatments required a much longer course of medicine, had more side effects, and were less effective. Hep C treatment has really improved since then.
I also want patients to know that they don’t have to be sober to receive treatment for hep C. I know some patients may still be using drugs while also receiving treatment for hep C. Treating hep C – even if you’re still using drugs – not only helps protect your health but also helps prevent you from spreading hep C to others. Some people with hep C were denied treatment in the past if they were using drugs. The recommendations are clear now that people who use drugs should have their hep C treated, and there are many providers in the community who will offer them treatment.
If you know you have hep C, or if you have risk factors for hep C, such as previous or current injection drug use, talk to your doctor about hep C testing and treatment, or visit our Robert Clewis Center or the Sexual Health Clinic.
How many people have hep C? And how have these numbers changed since the introduction of a cure?
About 2.4 million people are living with hep C in the US and about 5,000 people are living with untreated hep C infection in King County. In 2024, 760 people were newly diagnosed in King County.
The good news is that the rate of new hep C infections in King County has been decreasing in recent years, and many people have been successfully treated. In 2015, about 74 people per 100,000 were newly diagnosed with hep C; in 2024, that rate was 32 people per 100,000. Since Public Health started collecting data in 1989, we estimate that over 10,000 King County residents have been cured of their hep C. Over 500 King County residents were cured last year.
The challenging news, however, is that we’re still seeing more people in King County each year newly diagnosed with hep C than cured leading to an increase in the number of people living with hep C.
We still see more new hep C infections than cures in King County. Why is that?
The hep C treatment is simple, but people’s lives aren’t always simple.
People who have hep C are more likely to be dealing with factors such as unstable housing, substance use disorder, and poverty. These factors can make it more difficult to seek medical care and complete eight to 12 weeks of medication.
Stigma and lack of access to medical care also make it hard for people with hep C to get care. We need more medical providers in our area to incorporate hep C treatment into their practices. In earlier years, there were a lot of hoops for doctors to jump through to prescribe hep C treatments. That’s not the case anymore, but many providers haven’t caught up with these changes.
That’s why I wanted to do this interview. I want to help spread the word about hep C treatment, and to help break down the stigma surrounding the disease. I want to encourage more people to talk to their doctors about testing and care and encourage more doctors and nurses to incorporate hep C treatment into their practices.
From a provider’s perspective, why should doctors and nurses include hep C testing and treatment in their practice?
Prescribing hep C treatment is so much easier than it used to be.
Working with hep C patients is a very rewarding part of my work. I can offer patients a cure for something that used to be a lifelong disease. Testing is easy to add into routine care, and treatment is usually straightforward. It changes lives and makes a huge impact on our community.
Resources
- Explore the local data on hep C on our new hep C data dashboard and our recently published 2024 Hepatitis C data report .
- Hep C treatment training and resources for providers
- Public Health’s Hep C 2024 Epidemiology Report and Hep C Data Dashboard
- Get hep C testing and treatment at:
- Public Health’s Robert Clewis Center – no appointment needed, walk-ins welcome
- Public Health’s Sexual Health Clinic at Harborview Medical Center – appointments preferred, but walk-ins welcome
Originally published October 3, 2025.