WASHINGTON - Hepatitis C, an infectious disease that can go
undetected in a person for decades while slowly destroying the
liver, is emerging as one of the country's top health care
concerns, both in terms in loss of life and stress on the economy.
Like the AIDS virus, hepatitis C often is transmitted through
sexual contact, bodily fluids and sharing of intravenous drug
needles. People who had blood transfusions before 1992 also are at
risk.
Although the disease can be detected with a simple blood test,
physicians, insurers and national health officials all express
concern about its growing prevalence and that few victims know they
are infected:
-- The American Medical Association, which represents
physicians, says hepatitis C likely will become ``a high public
health priority as the number of people who die from the disease
and those requiring liver transplants are expected to dramatically
increase in the coming decade.''
-- The National Institute of Allergy and Infectious Diseases, a
division of the government's National Institutes of Health, has
ominously warned that ``without better therapies, the number of
deaths is expected to triple by the year 2015 - higher than the
current annual death rate for AIDS.''
-- A leading insurance industry group, the Downers Grove,
Ill.-based Alliance of American Insurers, calls hepatitis C an
``emerging epidemic.''
-- The American Liver Foundation, an advocacy group based in New
York, says that hepatitis C is the leading cause of liver
transplantation in the United States. Demand for livers, which
already far outstrips supply, is expected to rise dramatically over
the next 20 years.
The disconcerting statistics may be rooted partly in high-risk
behavior. Sixty percent of new infections are due to the sharing of
needles, according to the Centers for Disease Control and
Prevention (CDC) in Atlanta.
Government and industry officials are concerned about the impact
on the nation's economy. The government estimates that the disease
already costs the nation some $600 million annually, in 1991
dollars, in medical costs and loss of work time. The sum, however,
excludes the costly expense of liver transplants.
But the actuarial firm of Milliman & Robertson, which tracts
healthcare trends, says the costs actually are much higher.
``People with (hepatitis c) currently consume at least $15 billion
per year for all their medical care. Without effective curative
treatment, total health care costs for patients infected with
hepatitis C will peak at an estimated $26 billion per year in about
2021,'' the company predicts in a recent report.
The CDC says hepatitis C is the most common chronic blood-borne
infection in the United States, with about 4 million people
infected, or 1.8 percent of the population. Of the total, about 2.7
million people are considered chronically infected - a stage in the
disease when liver damage has occurred or is imminent. Moreover,
hepatitis C leads to chronic liver disease and possible death in 7
out of 10 people it infects.
Hepatitis C far surpasses AIDS, another major blood disease, in
total infections. According to the CDC, the total reported cases of
people infected with the AIDS virus in the United States is
733,374. Hepatitis C kills nearly as many U.S. citizens each year
as AIDS. About 10,000 people died last year from it, while AIDS
claimed 10,200 lives, according to government figures.
Chronic liver disease, which includes hepatitis c, is the No. 10
cause of death in the United States. Heart disease is the No. 1
killer, taking the lives of more than 725,000 people annually.
The liver is one of the body's most essential organs. It is a
warehouse for storing sugars, fats, vitamins and nutrients; it
destroys toxins in the body such as alcohol; it filters out waste
products from the blood; and it acts as a kind of overall regulator
for the body, ensuring there is a proper balance of chemicals in
the system. When the liver malfunctions, the body is vulnerable to
secondary infections and general organ failure.
Hepatitis C is often confused with two much less deadly strains
of hepatitis, known as A and B, which can be prevented with
vaccination.
Hepatitis A is transmitted mainly by contaminated food and
water, which is why international travelers often get infected.
While it can spark severe fever and impede liver function resulting
in jaundice - a yellowish pallor to the skin and the whites of the
eyes - it rarely leads to chronic liver disease.
Most all people recover without lasting problems. Nearly
one-third of all Americans have been infected at some point in
their lives. The CDC estimates that there are 125,000, to 200,000
new infections annually.
Hepatitis B is blood-borne like hepatitis C, spreading through
contact with infected blood, semen and vaginal fluid. Having sex
with an infected person or sharing drug needles spreads the
disease. Symptoms include jaundice, fatigue, abdominal pain and
vomiting.
Still, most all recover, with only 2 percent to 6 percent of
those stricken develop serious liver damage. The CDC estimates
140,00 to 320,000 new infections of this strain annually.
With 36,000 new infections annually, hepatitis C can be
transmitted by sexual contact, drug use with needles, even sharing
a razor or toothbrush with an infected person. Scientists believe
there are other possible risk factors that bear further study, such
as tattooing or body piercing in unsanitary conditions.
The CDC says recipients of blood transfusions before 1992, when
the national blood supply was purged of tainted blood, are also at
risk.
Hepatitis C is particularly disconcerting for health care
workers because there is no vaccine and in only a relatively small
portion of newly diagnosed cases, perhaps 25 percent, does the
patient exhibit any symptoms, which are similar to those of
Hepatitis B. Most new cases occur in young adults, aged 25 to 40.
Unless a person requests a simple blood test to check for the
antibody indicative of infection, hepatitis c can stay hidden for
years.
According to Dr. Peter Somani, former director of the Ohio
Department of Health, ``most people have no idea they have
hepatitis C until it has reached the chronic phase and the damage
to their liver is severe.''
Once a person is treated with the leading course of drugs - a
combination of two medicines, Interferon-Alfa and ribavirin, the
disease can be kept at bay but rarely cured.
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(Distributed by Hearst News Service. The Hearst Newspapers Web
site is at http://www.hearstcorp.com/news.html.)
