Hepatitis C Not Necessarily a Death Sentence, but There’s Still No Cure
(HealthDay News) -- Of the three types of hepatitis, hepatitis C may be the one that can be most easily prevented.
But that hasn’t happened yet. As many as 10,000 Americans die from the disease each year, while the side effects of drug treatment can be devastating.
Yet, those who suffer from hepatitis C do have options of living with the infection that can reduce the uncomfortable consequences. In fact, many people infected with the liver disease go for decades without symptoms, experts say, and those who do become ill can turn to antiviral drug treatments that can be effective.
"Not everyone who gets hepatitis (C) dies from it. In fact, most people don't," says Frank Myers, an epidemiologist with Scripps Mercy Hospital in San Diego. Fifteen percent of hepatitis C patients actually get better on their own as their bodies eliminate the virus from their blood.
However, hepatitis C can ravage the liver and cause other symptoms. Hepatitis C is a blood borne virus, like HIV, which causes AIDS. However, unlike AIDS, hepatitis C seems to be much easier to transmit through shared needles and much harder to spread through sex.
There are three major types of hepatitis -- A, B and C. All affect the liver, which acts a kind of clearinghouse for cholesterol, nutrients, blood-clotting products and other substances, says Dr. Kenneth Gould, an infectious disease consultant with the Southern California Permanente Medical Group in Los Angeles.
Hepatitis C is most often transmitted from person-to-person by blood from an infected person entering the body of a person who is not infected. This is most common among drug users who share needles injecting drugs, but it can also occur from any sharp object that may be job-related or from an infected mother to her baby during birth. Transmission by sexual contact is not considered to be a risk factor for hepatitis C.
An estimated 4.5 million Americans are infected with hepatitis C, and it kills 8,000 to 10,000 people a year.
Treating hepatitis C is costly. A study late in 2005 found that hepatitis C-related hospitalizations, hospital days, total charges and deaths increased by more than 20 percent per year. That's three times higher than all-cause hospitalizations. The largest increases were seen in patients in their 40s and 50s, who spent more time in a hospital, incurred greater costs, and died more often than HCV patients in other age groups.
The chances of HIV infection through a contaminated needle stick are estimated to be one in 333, while they're 1-in-50 for hepatitis C, Myers says.
Viruses try to survive by developing different ways of infecting people, he explains.
"Each virus develops its own niche strengths and weaknesses," Myers says. "I don't think we know enough to know what hepatitis C gained by designing itself in a way that does not allow itself to easily be sexually transmitted."
Once a person is infected with hepatitis C, the prognosis can vary. It's possible to live for 20 to 30 years without encountering symptoms, Gould says. In some cases, infected people aren't diagnosed until their blood is tested for some other reason.
"Many times, it's serendipitously found," he says.
Even if someone doesn't notice any signs of infection, hepatitis C is usually still at work. Often, Myers says, "the liver is slowly attacked by the virus, but (the patients) die of something else before the virus destroys their liver."
Hepatitis C scars and inflames the liver, potentially blocking circulation within the organ, Gould says. Liver cancer is also a possibility.
Only a few years ago, there was no treatment for hepatitis C. Now, doctors use antivirals such as interferon and ribavinin.
However, drug treatment can make patients feel like they have the flu and even cause anemia, so it's generally limited to those whose livers are already damaged, Gould says. The treatment typically takes six to 12 months.
"Most people don't opt for therapy because it's prolonged and somewhat difficult," he says.
There's also a risk that treatment may not vanquish the virus, Myers says. While blood levels of the virus disappear in nearly half of people on drug treatment, hepatitis C returns in about half of them.
One study in 2005 indicated that using the vaccine for hepatitis A might be beneficial to those with hepatitis C. But not many patients have been vaccinated. Of almost 1,200 patients with chronic hepatitis C virus infection -- which can lead to fatal liver disease -- only 94 had been vaccinated against hepatitis A, according to researchers with the New York University School of Medicine.
Hepatitis A vaccine has been available since 1995. But using the hepatitis A vaccine will not prevent or cure hepatitis C.
Despite the limitations, Gould says, the future for hepatitis patients is much brighter than it was just a few years ago.
"We have improved knowledge, and there are options for therapy that weren't available previously," Gould says.
On the Web
For more information about hepatitis C and how to prevent it, go to the CDC Web site.
SOURCES: September and December 2005 issues of Hepatology ; Frank Myers, M.A., CIC, clinical infectious disease epidemiologist, Scripps Mercy Hospital, San Diego; Kenneth Gould, M.D., consultant, infectious disease, Southern California Permanente Medical Group, Los Angeles
Publication date: August 1, 2006
Author: Randy Dotinga, HealthDay Reporter
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