A recent congressional squirmish over the expensive price tag attached to Solvadi, a breakthrough hepatitis C drug, has brought that disease into the spotlight. And that’s an excellent thing for everyone but Gilead Sciences, manufacturer of Solvadi. Since 2007, the number of Americans dying from Hep C, as it is commonly referred, has been increasing yearly and now surpasses those dying from HIV/AIDS. But how many doctors test for or even discuss this disease, which can lie dormant for years, with their patients?

Hepatitis C, which results from infection with the hepatitis C virus (HCV), is a contagious liver disease. Mainly, it is spread through contact with the blood of an infected person. People can become infected with the virus by sharing needles, syringes, or other equipment to inject drugs, by needlestick injuries in health care settings, by being born to a mother with the virus, and (less commonly) by sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes, and by having sexual contact with an infected person. It is also possible to become infected during tattooing or piercing.

Doctors describe hepatitis C as either acute or chronic. The acute form of infection means short-term illness occuring within the first six months of exposure to the virus. For most people, though, acute infection leads to chronic infection, which is a long-term illness that can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer. According to the Centers for Disease Control and Prevention, most people with chronic hepatitis C do not have any symptoms, until liver problems have developed.

The New York City Department of Health and Mental Hygiene, according to City Limits, estimates four million people infected with HCV nationwide — almost four times the number believed to be infected by HIV/AIDS — while 85 percent may be chronic carriers of the virus. Worse, nearly 80 percent of infections go unnoticed for decades; not only does this mean a person can be unknowingly transmitting the virus but also the virus may be doing more damage to a carrier’s liver. Because it has been difficult to treat chronic infections, Solvadi — which has a cure rate of 90 percent compared to 65 percent to 75 percent cure rates for other Hep C drugs — was hailed as a significant scientific advancement. Additionally, the drug worked on a wide range of people, including those unable to tolerate other treatments (a frequent occurrence) and those whose infections came back after an original treatment. Yet it’s $1,000-a-pill cost ($84,000 for a total course of treatment per patient) means insurance companies are balking at covering the cost in plans.

“Because Hepatitis C is ‘concentrated in low-income, minority patients,’ the affordability problems are likely to be particularly acute for state Medicaid programs and those patients served by these programs,” wrote Congress in its letter to Gilead.  Clearly, a drug can only be effective when it is available to the people who need it… including those who understand what they need. Is it time you asked your doctor about being tested for hepatitis C?