PHA-Exchange> Hepatitis C epidemic, those with Hepatitis C still face long odds

[Claudio]

> The rate of Hepatitis C infection is very high
> ( often  > 70% ) among IV Drug users. Here is
> this article from the NY Times
>
> October 7, 2003
> PERSONAL HEALTH
> Those With Hepatitis C Still Face Long Odds
> By JANE E. BRODY
>
> There is some good news to report about a
> bloodborne virus that has infected 4 million Americans
> and 170 million people worldwide.
>
> The disease, hepatitis C, will eventually debilitate
> the livers of many of its sufferers, but new cases of
> it have declined 80 percent since the virus was
> identified in 1988 and blood banks started screening
> for contaminated donations four years later.
>
> But — and this is no small but — the annual death toll
> from the long-term consequences of this infection is
> 10,000 a year in the United States, and scientists
> expect deaths to triple by 2010 before that statistic
> begins to decline, unless new treatments are developed
> to eliminate the virus or at least keep its
> complications at bay indefinitely.
>
 Current therapies are
> lengthy, expensive and can cause devastating side
> effects. Further, they work in only slightly more than
> half the patients.
>
> Sources and Symptoms
>
> Unlike H.I.V., the hepatitis C virus is rarely
> transmitted through sexual contact. Its primary route
> to a new bloodstream has been through contaminated
> needles shared by drug users and by blood
> transfusions.
>
> Fatal cases have resulted from organs inadvertently
> transplanted from a contaminated donor.
>
> Household contacts and sexual partners in monogamous
> relationships are rarely affected. But people who
> engage in high-risk sexual behavior with multiple
> partners and people who have sexually transmitted
> diseases face increased risk.
>
> Testing is recommended for people who have had blood
> transfusions or organ transplants and those who have injected street
> drugs, even once many years ago.
>
> Not everyone infected becomes ill. Some people seem to
> eliminate the virus, and a chronic infection never
> develops.
>
> Others who remain chronically infected may be free of
> symptoms indefinitely.
>
> In most cases, however, as with H.I.V., the virus can
> linger in the body for a long time — even decades —
> before symptoms of liver damage appear.
>
> The most serious consequences are severe cirrhosis, a
> scarring of the liver, liver failure and liver cancer,
> which have made hepatitis C the leading reason for
> liver transplants.
>
> Search for Treatment
>
> No vaccine against the virus has been developed, and
> prospects for one are not promising because there are
> at least six major genetic types and more than 50
> subtypes of the virus. And, it changes rapidly. The
> possibility of a vaccine depends on finding an exposed
> part of the virus that remains stable even as its
> protein coat mutates.
>
> Two main therapies have been developed. One involves
> injections of interferon,  which is injected weekly, and
> the other an oral antiviral drug called ribavirin.
>
> The side effects can be quite miserable, at least at
> the outset. But they subside with time and disappear
> when the treatment ends.
>
30 percent to 70
> percent of infected individuals may never progress to
> cirrhosis before dying from other causes."
>
> With or without treatment, people infected with the
> virus should take steps to protect their livers from
> further damage. The steps include avoiding alcohol,
> getting vaccinated for hepatitis A and consulting
> physicians before taking any new medicines, including
> over-the-counter and herbal remedies.