Articles from prior issues of The Advocate

July/August 2001

Hepatitis C Virus Infects 30,000 Annually
by Lisa Self and Jeanette Hawkins, Arkansas DDS

ACCORDING TO SAN JUAN GASTROENTEROLOGIST Dr. Maribel Rodriguez, the Hepatitis C Virus (HCV)is responsible for 8,000-10,000 deaths per year in the United States and Puerto Rico. This number is expected to triple in the next 10-20 years. In San Juan, Puerto Rico alone, 300 patients are treated for Hepatitis C each week. HCV is a blood born virus transmitted primarily through direct percutaneous exposure. 4,000,000 Americans are infected with HCV and most are not even aware of it. There are 30,000 new case of HCV reported each year.

Hepatitis C is the major cause of cirrhosis and hepatic carcinoma. Once infected, it can take a person 20-30 years to develop cirrhosis. IV drug use accounts for 50% of all new Hepatitis C cases. Other risk factors include occupational exposure to infected blood, hemodialysis, intranasal cocaine use, body piercing, tattooing, high sexual activity, and co-infection of the HIV virus. HCV can stay alive 7-8 days on surfaces, so to lower your risk of infection, you should not share toothbrushes, razors, manicure materials, jewelry, etc... Awareness of risk factors is very important. Infected persons should not be blood or organ donors. Safe sex should be practiced and sexual partners of infected persons should be tested for the virus. High risk groups should also be tested. It is important to be tested early if you are in a high risk group. Many people wait to be tested after they develop serious liver disease complications. To confirm a diagnosis of Hepatitis C, a liver biopsy is recommended, especially prior to treatment.

The primary treatment goal for HCV is to slow the progression of Hepatitis C to cirrhosis and hepatic carcinoma. Patients with HCV who already have decompensated cirrhosis however, should be evaluated for liver transplant, not treatment. Three kinds of Interferon (natural proteins produced in the body) are used to treat Hepatitis C. They are Interferon Alpha 2b, Alpha 2a, and Alphacon 1. When used in conjunction with Ribavirin, the positive response rate increases by 40%. While the response to treatment with Interferon and Ribavirin is more sustained and the risk of relapse is lessened, it is not a cure. Side effects of Interferon include flu like symptoms (the most common side effect), decreased appetite, nausea, vomiting, diarrhea, dizziness, hair loss, weight loss, cough, respiratory tract infection, hypertension, and palpitations. Interferon can also increase the patient’s risk of thyroid disease and cause thyroid test abnormalities. Physical symptoms are not the only side effects of Interferon. This treatment can also cause nervousness, depression, anxiety, emotional lability, agitation, and decreased libido.