http://www.kpbs. org/news/ 2009/jul/ 06/hepatitis- c-epidemic- more-widespread-
hiv/

Hepatitis C: An Epidemic More Widespread than HIV
By Kenny Goldberg
Monday, July 6, 2009

There's a chronic liver disease that's ten times more infectious than HIV, and
more widespread. Hepatitis C is a virus that's spread through IV drug use, like
HIV. Left untreated, hepatitis C can cause life-threatening complications,
including liver cancer. In this first of a four-part series, KPBS Health
Reporter Kenny Goldberg takes a look at the epidemic of hepatitis C.
In 1997, Charlie Navarro began to feel tired and lethargic. He went to his
primary care doctor, who recommended a blood test.
Navarro was diagnosed with hepatitis C.
He thinks he became infected back in his college days, when he experimented with
shooting drugs.
"This was before we went to a concert, it wasn't in the back of an alley, or it
wasn't 50 or 60 times," Navarro remembers. "I was never addicted. All I tried
was once, or twice. And unfortunately, with the crowd I was with, we shared
needles."
Getting a transfusion or an organ transplant used to be major risk factors for
becoming infected with hepatitis C. But since 1992, all blood and blood products
in the U.S. have been screened for the virus.
"And that's why now, IV drug use is the main risk factor for contracting
hepatitis C," says Dr. Tarek Hassanein, liver specialist at UCSD. "And most of
the patients that we see now, are infected because of history of IV drug use,
even once or twice in their life", he says.
Hepatitis C is the most common blood-borne infection in the U.S. -- about four
million Americans have it. In San Diego County, more than 4,000 people are
infected.
The virus often doesn't cause symptoms, so it can linger undetected for years.
Hassanein says once a person becomes infected with hepatitis C, the virus
replicates and survives in the liver.
"The ongoing fight between the virus and the immune system leads to injury to
the liver," Hassanein points out. "We call it chronic injury because it’s
happening every day for 20, 30 years. The liver has the ability to regenerate.
But in the process of the fight, the liver needs to heal with scar tissue. That
scar tissue within 20, 30 years leads to what we call cirrhosis."
Once cirrhosis sets in, it's very difficult to reverse. That's why early
detection and treatment are crucial.
"So welcome to the hepatitis C instruction class. The purpose of this class
today is to educate you on what the disease is. We're gonna talk about how we
treat hepatitis C."
At UCSD Medical Center in Hillcrest, nurse practitioner Lisa Richards offers a
primer on the disease with a class of 12 patients.
All of them have the virus, and they're about to start up to 48 weeks of
treatment. The potential cure consists of taking two medications -- one by
mouth, and one that's self-injected.
The treatment causes painful, flu-like side effects. But about half of all
hepatitis C patients who complete treatment are cured. For those that aren't,
their liver slowly deteriorates. About one in five will need a liver transplant.
Nikki is among the unlucky ones. The Oceanside woman recently developed type 2
diabetes, because the hepatitis C also attacked her pancreas.
"I didn't know that I had hepatitis all these years, so I didn't know that I was
damaging another part of my body," Nikki says.
Nikki has been on a waiting list for a liver transplant for two-and-a-half
years.
Dr. Ajai Khanna is UCSD's director of abdominal transplantation. He says people
who need a new liver don't always get one in time.
"The number of patients waiting for liver transplantation with end stage liver
disease, they far outnumber the number of donors available," says Dr. Khanna.
"So, therein lies the problem. And that's why we lose patients on the waiting
list."
Khanna says even if someone does get a donated liver, the operation can cost
more than a quarter of a million dollars.
In contrast, there's a really cheap way to prevent the spread of hepatitis C.
We'll find about it in part 2 of this series.

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