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Hepatitis C: Are You a Silent Carrier?

Posted Aug 24 2008 1:49pm
ANNOUNCER: Hepatitis C is often referred to as a "silent epidemic". It is largely overlooked by the general public, although many physicians and sufferers of hepatitis C view the virus as a public health threat on par with HIV.

EMMET KEEFFE, MD: The total amount of people in the US that have hepatitis C is about 4 million individuals.

ANNOUNCER: Hepatitis C can present in individuals in two ways. A few days after being infected, a patient may experience an acute, or short-term, illness with flu-like symptoms that usually goes away by itself.

EMMET KEEFFE, MD: Now, some patients will have some subtle symptoms of fatigue or easy tiredness or some mild aching, but those are quite nonspecific symptoms and don't usually lead them to seek out their physician or their health care provider. So many are asymptomatic.

ANNOUNCER: An acute hepatitis C infection may progress into a chronic, or long-term, infection. Patients often have no symptoms and are unaware that they carry the virus.

EMMET KEEFFE, MD: We don't see very much acute hepatitis C. Chronic hepatitis C is far more common. In fact, there was a recent survey conducted by the Centers for Disease Control that showed that 1.8 percent of the adult population have an antibody to hepatitis C. That's huge. That means nearly 2 percent of the U.S. population at some time has been exposed to that virus.

ANNOUNCER: The hepatitis C virus is found in blood and certain body fluids and can be commonly spread in a number of ways.

EMMET KEEFFE, MD: If you had blood transfusions before 1990, you're at risk that you have acquired hepatitis C. If you ever used IV drugs, even on a few occasions as a young college student experiment, you may have picked up hepatitis C, and you also need to be tested.

Now, one of the peculiarities about hepatitis C that's different in terms of its spread compared to hepatitis B is that hepatitis C is not easily spread by sexual contact. So the CDC does not recommend that monogamous partners, husbands and wives or steady partners, need to change their sexual practices, because it's quite rare to have the virus be spread by that mode of contact.

ANNOUNCER: Hepatitis C can also often infect health care workers, through accidental needle sticks. People who live with an infected person and share personal items, such as razors or toothbrushes, are also at risk. Unfortunately, there is no vaccine for hepatitis C.

EMMET KEEFFE, MD: There's active research underway, but there's been a number of obstacles to vaccine development, because hepatitis C is a very tricky virus. There's a lot of mutations that occur, a lot of different flavors of the virus, if you will. So we don't have a vaccine for C.

ANNOUNCER: If a person does become infected, several treatments are available.

EMMET KEEFFE, MD: Once hepatitis C is identified, that individual should consult a physician with expertise in hepatitis C, because they may be a candidate for antiviral therapy. The first drug that was made available for hepatitis C was interferon in 1992, and the results were modest, maybe 10 percent, up to 15 percent had the virus eradicated. But beginning in 1998 with combination therapy, with interferon and ribavirin, 40 percent of patients had the virus eradicated. And by that I mean, on a long-term follow up the virus does not reappear.

Today, beginning over the past two or three years, we use a more potent interferon called pegylated interferon plus ribavirin, and we now have a 50, maybe up to 55 percent cure rate.

ANNOUNCER: If left untreated, hepatitis C can lead to several long term health problems, including cirrhosis, or scarring, of the liver, liver cancer and even liver failure.

EMMET KEEFFE, MD: So if you have chronic hepatitis C with cirrhosis, you then enter into a risk for liver cancer. We then ask those individuals to undergo every six months routine testing for the presence of a small tumor, If we're going to find tumor, we want to find it when it's small, when we can do something about that.

If the chronic hepatitis C leads to liver failure, then those individuals we refer to liver transplant centers, and liver transplantation can be lifesaving. Even though the virus returns after the transplant, in the initial five to seven years so far, these individuals do quite well. And we're hoping that over time industry and research will bring us new antivirals for hepatitis C that we can effectively use after transplant.

ANNOUNCER: Although we now have treatments that can effectively fight hepatitis C, myths and the stigma of the disease prevent many at risk from getting diagnosed and tested. Diagnosis is often coincidental and usually happens in the later stages.

EMMET KEEFFE, MD: In the case of hepatitis C, if you've been diagnosed, you've usually been diagnosed already when it's chronic, and you need to explore treatment options if you have hepatitis C.

So the bottom line is, you need to consult a physician, most typically a gastroenterologist or a hepatologist, someone with expertise in liver disease who can give you the right advice about what's going to happen to you and whether or not you're a candidate for antiviral therapy.

ANNOUNCER: The good news for people who are infected with hepatitis C is that research is continuing and the future looks bright.

EMMET KEEFFE, MD: Some of my patients say, "Doc, is this glass half-full or half-empty?" Because we have made progress, but we only eradicate, let's say, 50 percent of our hepatitis C patients. But I predict in the next five or ten years we're going to be eradicating many more individuals who are infected.

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