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target=new>http://hepcnet.net/heppopics/heprandi.gif</a> *PIC*<br><br>Check out
my Transplant Heppo made for me by <a href=http://hepcnet.net/
target=new>http://hepcnet.net/</a><br><br>Great Site lots of Heppos check it
out.<br><br>Peace/Love<br>Randi

Pegylated Interferon, Better Molecular Tools
Improve Outcomes <br><br>April 23, 2001 <br><br>Treatment
and outcomes for patients with chronic hepatitis
(HCV) continue to improve with the recent approval of
pegylated interferon. <br><br>An expert panel, convened by
the American College of Gastroenterology (ACG) on
April 6, 2001, met in Dallas, Texas, to discuss the
most recent data in the field of hepatitis diagnosis
and treatment. <br><br>With a huge expansion in
scientific knowledge relating to diagnosis and treatment of
hepatitis B and C, the ACG symposium brought together
experts on hepatitis and liver disease. The prime
objective of the symposium was to prepare treatment
approaches and recommendations, reflecting the latest
scientific advances that could be applied by individual
gastroenterologists as they encounter patients with hepatitis in
their day-to-day practice. <br><br>The panel of 16
experts presented the most recent data on a number of
recent developments relating to hepatitis. <br><br>The
recent conference compiled critical treatment data
spanning new developments: * on molecular tools to measure
response to therapy for hepatitis C (e.g., TMA diagnostic
test recently available through Bayer Diagnostics); *
on two new pegylated interferons (Roche's Pegasys
and Schering's PEG Intron); and * ways to optimize
treatment outcomes for patients treated for chronic
hepatitis C (i.e., Procrit for ribavirin induced hemolytic
anemia). <br><br>Because of the critical advances in these
new diagnostic and therapeutic advances, which it is
believed may increase success rates by at least 30%, the
results of the meeting will be sent to all 7,500 ACG
member physicians in the form of a CD-ROM, with other
follow-up educational materials in the works. <br><br>This
article was prepared by Hepatitis Weekly editors from
staff and other reports. <br><br>To see more of the
NewsRx.com, or to subscribe, go to <a href=http://www.newsrx.com
target=new>http://www.newsrx.com</a> .

Study illuminates how hepatitis C infects cells
By Emma Patten-Hitt, PhD NEW YORK, Apr 10 (Reuters
Health) - Researchers have gained new insights into the
way in which hepatitis C virus (HCV) takes over the
machinery of a host cell, which may lead to the development
of drugs that can eliminate the infection without
harming normal cells. Hepatitis C infection kills about
10,000 people a year in the United States, primarily due
to its long-term consequences: chronic liver
disease, cirrhosis, and liver cancer. Currently no cure
exists for hepatitis C, which is why finding new targets
is so important, according to Dr. Jennifer Doudna of
Yale University, New Haven, Connecticut, lead author
of the study. Like other viruses, HCV "borrows" the
protein-making machinery of the cells it infects because it is
unable to churn out viral proteins on its own. In a
recent issue of the journal Science, Doudna and
colleagues described how they gathered extremely
high-resolution images of the interaction of HCV with the
machinery of the host cell in order to study how HCV forces
the host cell to make proteins. "We were trying to
see how hepatitis C and other viruses initiate
synthesis of proteins," Doudna said in a statement, noting
that this is the first time this process like has been
visualized. "Perhaps the best known viruses using this type
of method are polio virus, foot-and-mouth disease,
and Kaposi syndrome-related herpes virus," co-author
Dr. Joachim Frank of the Howard Hughes Medical
Institute's Wadsworth Center in Albany, New York, told
Reuters Health. But he added that these viruses may act
in a slightly different manner than HCV, so drugs
would have to be designed for each type of virus. "A
long-term goal of this work is to understand the molecular
basis for protein synthesis in hepatitis," according to
Doudna. "It's already clear that hepatitis C and a number
of other viruses utilize a method for protein
synthesis that's different from the mechanism used in the
host cell. That already makes it a target for drugs
that could serve as an effective treatment for HCV."
The researchers note that in addition to providing
therapeutic targets, a deeper understanding of the changes
that occur in these types of events may offer insights
into features common to protein synthesis in general.
"This is only the first step in getting information on
how HCV interacts with the host cell," Frank said.
"The findings may pave the way toward drug
design--drugs that could bind to specific sites (on the virus).
This could be a promising way to fight the disease."
Science 2001; 291:1959-1961.

Liver Transplantation<br>Preventing Hepatitis C
Is A Factor In Stemming Organ Demand<br><br>2001 APR
16 - (NewsRx.com) -- by Sonia Nichols, staff medical
writer - A<br>Stanford University researcher says
preventing hepatitis C virus infections<br>is just one of
several ways to tackle the problem of too few livers for
too<br>many potential liver recipients.<br><br>"In the past
two years, approximately 4,500 liver transplants have
been<br>performed annually, with one-year survival rates in the
85%-90% range, while<br>the waiting list has expanded as
of November 2000 to more than 16,000<br>patients,
resulting in an increasing death rate among listed
patients," E.B.<br>Keeffe of Stanford University Medical
Center, California, said in the<br>journal
Gastroenterology.<br><br>Keeffe suggested preventing new and recurrent hepatitis
C virus (HCV)<br>infections using new
immunosuppressive therapies and exploring new<br>transplant
alternatives could address this problem.<br><br>"Over the long
term, there will be an increasing application of
novel<br>approaches to liver replacement including cadaver
split-liver<br>transplantation and adult living donor liver transplantation and
possibly,<br>in the more distant future, xenotransplantation and
hepatocyte<br>transplantation," Keeffe proposed. Xenotransplantation involves
using livers<br>obtained from animals, whereas
hepatocytes, or liver cells, could be used to<br>initiate the
growth of new livers.<br><br>Increasing prevalence of
HCV infections is one reason for a
significant<br>number of liver transplant surgeries. According to
Keeffe, preventing<br>initial HCV infections and
preventing the recurrence of HCV infections after<br>primary
liver grafts would be an effective strategy for
targeting the<br>shortage of donor livers ("Liver
transplantation: Current status and novel<br>approaches to liver
replacement," Gastroenterology, 2001;120(3
Sp.<br>Iss):749-762).<br><br>Finally, Keeffe recommended that the medical
establishment
should perform a<br>review of immunosuppressive
therapies, which are taken by most patients who<br>receive
donor livers, stating that "...movement toward
minimal<br>immunosuppression and steroid withdrawal and the development of
safer and<br>more effective drugs, is another important
factor that has the potential to<br>increase the success
of liver transplantation."<br><br>The corresponding
author for this study is E.B. Keeffe, Stanford
University,<br>Medical Center, 750 Welch Road, Suite 210, Palo Alto,
California 94304, USA.<br><br>Key points reported in this
study include:<br><br>. Preventing HCV infections would
decrease the need for liver transplants<br><br>. Novel use
of existing livers, animal livers, and liver cells
could support<br>some of the demand for donated
livers<br><br>. Better immunosuppressive therapies could increase
liver transplant success<br>rates This article was
prepared by Health & Medicine Week editors from
staff<br>and other reports. Copyright 2001, Health & Medicine
Week via NewsRx.com.

The FDA wants to know about side effects
associated with interferon and/or<br>ribavirin or other
medications, even if the patient has finished taking
the<br>medication. If you had a problem, it should be reported to
the FDA. They<br>can<br>be contacted
at<br>1-800-FDA-1088 (1-800-332-1088).<br>The number will provide a
menu of options, and you will be asked<br>to leave
your name & address so that a reporting form can be
mailed to<br>them, or you can use an on-line reporting
form. The form and more info on<br>MedWatch is
at:<a href=http://www.fda.gov/medwatch/
target=new>http://www.fda.gov/medwatch/</a><br>They also have an Office of
Special Health Issues,
which answers consumer<br>questions about the Food and
Drug Administration's activities related
to<br>HIV/AIDS, cancer and other special health issues. They
encourage<br>patient participation in medical decision making, and
invite patient<br>representatives to participate in its
Advisory Committee meetings to
discuss<br>medical<br>products for the treatment of serious or life-threatening
diseases.<br>People can contact the Office of Special Health Issues
at:<br>Office of Special Health Issues<br>Food and Drug
Administration<br>Parklawn Building, HF-12<br>5600 Fishers
Lane<br>Rockville, MD<br>301-827-4460
(Voice)<br>888-INFOFDA<br>301-443-4555 (FAX)<br>or see their website
at:<a href=http://www.fda.gov/oashi/ target=new>http://www.fda.gov/oashi/</a>

Tuesday April 17 6:58 PM ET<br>HHS Plans To Boost
Organ Donation <br><br><br>By LAURA MECKLER, Associated
Press Writer <br><br>WASHINGTON (AP) - Health and Human
Services Secretary Tommy Thompson began a campaign Tuesday
to boost organ donation with a pledge to shift
national attention from a bitter debate over distribution
into a united effort to collect more
organs.<br><br>``Let's work together. Let's solve the problem,'' said
Thompson, who as governor of Wisconsin took a hard-line
position to keep inside the state organs that were donated
in Wisconsin. ``Why can't we solve the problem
instead of creating more angst amongst
ourselves?''<br><br>His initiative includes a new partnership with
business to promote donation among employees, a national
medal to honor donor families and a new model
curriculum on organ donation for teen-age driver education
classes.<br><br>HHS also released a national donor card that backers
hope will give transplant officials a stronger case
for proceeding with donation even if the family is
reluctant.<br><br>The department will also study organ donor
registries, where people's wishes are recorded electronically
for families and hospitals to consult when the
potential donor dies.<br><br>Most of the program announced
Tuesday amounts to a public information campaign to
convince Americans that organ donation is a good idea, an
approach that so far has failed to increase donor rates
substantially. While overwhelming majorities say they support
donation, only half of the families that are approached
about donating loved ones' organs say yes.<br><br>Just
Monday, HHS announced that the number of deceased donors
rose by only 2.7 percent last year.<br><br>For now,
the debate over how distribute organs is largely on
hold. HHS has won authority to force the transplant
network to send organs to the sickest patients first, but
Thompson is unlikely to use the power.<br><br>-<br><br>On
the Net: HHS Division of Transplantation:
<a href=http://www.organdonor.gov
target=new>http://www.organdonor.gov</a><br><br>Coalition on Donation: <a
href=http://www.shareyourlife.org target=new>http://www.shareyourlife.org</a>

Georgie of course I don't mind your posting lol.
See if this site can give you some help;.
<br><br>About NFT<br><br>Many transplant candidates and
recipients find they do not have the insurance coverage or
personal savings to pay for their transplant,
pre-transplant or follow-up care and medications.<br><br>Since
1983, patients facing these problems have found help
through National Foundation for Transplants
(NFT).<br><br>"NFT's goal is that patients will not be deterred from a
second chance at life simply because they cannot afford
it."<br><br>NFT serves tissue and solid organ transplant patients
in all 50 states. Headquartered in Memphis,
Tennessee, NFT is recognized by the IRS as a 501 (c)3
tax-exempt not-for-profit organization.<br><br>Types of
Assistance<br><br>Patients Services/Fund-raising<br>NFT works with the
families and friends of transplant candidates and
recipients needing $10,000 or more for their transplant care
and medications, so they can successfully raise the
money through fund-drives in their local
areas.<br><br>A Patient Advocate provides individual fund-raising
training, advice and consultation to help volunteers reach
their financial goal.<br><br>• NFT provides detailed
instructions and materials on every step of a successful
campaign. <br>• NFT lends assistance with publicity &
places each patient's information on this web site (see
Patient Campaigns.) <br>• NFT offers a wide range of sale
items for fund raising, including cookbooks, holiday
cards, candy, t- shirts and more. <br>• NFT administers
the account, personally acknowledging all donations
of $25 or more. <br>• NFT acts as an advocate on
behalf of the patient in negotiating bills, and promptly
processes payments to hospitals, physicians, pharmacies and
other health-care providers. <br><br>If you want to
find out more about NFT assistance with fund raising,
call toll-free at (800)489-3863 and ask to speak with
Carolyn Vannucci, ext.107. To see the patients NFT is now
assisting with fund raising, visit Patient
Campaigns.<br><br>Our Mission<br>Reaching out to help those who seek a
new life through transplantation, by providing a
program of healthcare and financial support services and
patient advocacy for transplant candidates, recipients
and their families nationwide.<br><br>To see a
listing of the NFT's Board of Directors, click
here.<br><br>Still have questions? Look at our online Frequently
Asked Questions for a possible
<a href=http://www.transplants.org/ target=new>http://www.transplants.org/</a>

``I think this is a very feasible operation, but
I think it needs to be done in centers where there
is a strong commitment to doing this,'' Pomfret told
Reuters Health. ``It has good results, by and large it
can be done safely, but there is certainly a
possibility for major complications.'' In Pomfret's study, 15
of 66 potential donors wound up going through with
the procedure. All of the donors survived the
operation, although three cases of death among liver donors
have been reported to date in the medical literature,
Pomfret noted.<br><br>Ten of the 66 volunteers chose not
to participate after an initial consultation with
doctors describing exactly what the procedure entails.
Many were disqualified after their own health was
evaluated. The most common cause for disqualification was
having a liver that was too small. Potential donors in
the study were also disqualified after being
diagnosed with hepatitis C or other liver disorders
themselves, or for having psychological issues that seemed
problematic.<br><br>Many potential transplants did not proceed because the
ill patient died, became too sick to successfully
undergo the operation, or received an organ transplant
from a cadaver.<br><br>After the surgery, the donors
regenerated 80% of their livers within a month and 90% after
a year, Pomfret said.<br><br>However, some donors
in the study suffered side effects, including minor
complaints such as wound problems and hand numbness, and
some had a few serious complications. The researchers
originally found that about 67% of the donors suffered side
effects, however, when they looked at more patients, this
dropped to 38% of donors.<br><br>``The reason it
decreased with time was a combination of improved
techniques and post-operative care,'' Pomfret said. ''We've
been more aggressive about fixing
things.''<br><br>Despite these reassuring results for potential donors, a
large percent of potential liver donations never came
to fruition.<br><br>``The hope is that you wouldn't
have to take healthy people to have enough organs to
transplant people, but at this point, the number of cadaver
organs falls so short,'' she said. ``This appears to be
a way to transplant people who might not otherwise
receive them.''<br>Experimental techniques, such as using
pig livers or cultured liver cells, she noted, are
still ``a long way off.''SOURCE: Archives of Surgery

Monday April 16 1:16 PM ET<br>Liver Donors Can
Survive, Thrive After Transplant <br>By Melissa
Schorr<br><br>NEW YORK (Reuters Health) - It is now possible to
donate a section of liver to an individual needing a
transplant, but a new study suggests that many of those who
plan to donate are rejected--or decide not to
donate--for a variety of reasons, including their own or the
recipient's health.<br><br>Donation of a piece of the liver's
right lobe from one adult to another is a relatively
new procedure. It is increasingly being performed in
the United States, where the demand for donated
organs often outstrips the supply. However, potential
donors are strictly screened to make sure that the
procedure does as little harm as possible to their
health.<br><br>``Live donor liver transplantation has not been done
between adults because of this issue: How much liver can
you take from a person and not hurt them and still be
sufficient for the person that needs the liver?'' explained
Dr. Elizabeth Pomfret, director of live donor liver
transplantation at the Lahey Clinic Medical Center in Burlington,
Massachusetts, and the study's lead author.<br><br>Pomfret and
her colleagues examined which factors determined a
successful match between donor and recipient, and whether
the procedure is safe for donors. The results were
first reported in October 2000 at the New England
Surgical Society's annual meeting, and are published in
the April issue of the Archives of
Surgery.<br><br>People in need of liver donations include those with
livers damaged by hepatitis C, cancer, alcohol
consumption or primary biliary cirrhosis, a disease of the
liver and bile ducts. Potential liver donors are
generally limited to family members, spouses or close
friends. While an exact genetic match between donor and
recipient isn't required, blood type does need to be a
match, Pomfret said.

Hi Heprandi: I would have e-mailed you but my
e-mail website is under construction and I cant get in.
My neighbor has been listed for transplant, but we
live about 2 1/2 hrs from the hospital. He has to go
down every 4-6 weeks for one appoint. or another and
the stay is costing them about 3 to 4 hundred dollars
each time! This includes travel, food and lodging and
time off from work for the spouse. How can I help them
raise money for this expense? My idea was to possibly
set something up in care of either the liver
foundation or organ transplant awareness, so if there were
funds raised that weren't used they would automatically
go to these other organizations. If you have any
ideas please let me know. I hope you dont mind me
posting this........Hugs and Prayers.....Georgie

WESTPORT, CT (Reuters Health) Apr 10 - A new test
detects antibody to <br>hepatitis C virus in about 3
minutes and exhibits a sensitivity of 98% <br>and
specificity of 100% compared with enzyme immunoblot assay,
report <br>investigators from the University of Hong
Kong. <br><br>The SM-HCV Rapid Test (SERO-Med
Laborspezialitaten GmbH, Eichstatt, <br>Germany) is based on the
principle of sandwich enzyme immunoassay and is
<br>semiquantitative. According to the investigators, the test can be
<br>conducted with 30 to 40 µL of serum or whole blood,
individual samples <br>can be tested and no technical
expertise is required. <br><br>Dr. Ching-Lung Lai and
associates tested the SM-HCV Rapid Test using <br>serum from
100 patients who were positive for hepatitis C
according to <br>the third-generation enzyme immunoblot
assay (EIA-3, Abbott <br>Laboratories, Chicago). Also
included were 95 patients with other <br>chronic liver
diseases and 95 healthy subjects. <br><br>As reported in
the American Journal of Gastroenterology for March,
two <br>patients who tested positive by EIA-3 were
negative by the Rapid Test. <br>According to the authors,
acute hepatitis C infection in these subjects <br>had
probably resolved and antibody titers were too low to be
detected by <br>the Rapid Test. <br><br>Am J Gastroenterol
2001;96:838-841.

Cirrhosis Patients Should Be Screened For
Esophageal Varices WESTPORT, CT (Reuters Health) Apr 09 -
Contrary to practice guidelines, less than half of the
patients with cirrhosis or pulmonary hypertension who are
referred for orthotopic liver transplantation are not
being screened for esophageal varices, according to
researchers. Dr. Miguel R. Arguedas and colleagues, from the
University of Alabama at Birmingham, evaluated a random
sample of 125 patients with cirrhosis or portal
hypertension who were referred for liver transplantation. Data
regarding demographics, clinical information, relevant time
intervals, screening strategies used, and implementation of
primary or secondary prophylaxis were included in the
analysis. According to the report in the March issue of the
American Journal of Gastroenterology, 12 of the patients
were excluded from the analysis due to presentation of
variceal bleeding at the initial manifestation of
cirrhosis. Of the remaining 113 subjects, 52 (46%) had
screening endoscopy or radiologic studies to detect the
presence of varices. Primary prophylaxis with beta-blocker
therapy was initiated in 15 (29%) of the 52 patients who
underwent screening and were determined to have large
varices, according to the report. Of these, one patient
had esophageal variceal bleeding 12 months after
screening endoscopy and 14 had not experienced variceal
bleeding after a median follow-up of 20 months.
"Thirty-seven patients had a history of variceal bleeding
before referral for transplantation," the authors
explain. Secondary prophylaxis, including endoscopic
obliteration, ß-blocker therapy, or distal splenorenal shunt,
was instituted in all of these patients, they add.
"Primary prophylaxis with ß-blockers is not being
instituted in a timely manner," Dr. Arguedas told Reuters
Health. "This means that patients are at continued risk
of developing an episode of variceal hemorrhage."
"While we did not address the reasons why [the
recommendations are not being followed]," he said, "questions
regarding physician reimbursement for endoscopy performed
for screening, lack of awareness of the
recommendations, or questions regarding the appropriate timing of
the endoscopy may be playing a role." "Once bleeding
occurs, the mortality at 6 weeks may approach 30%," Dr.
Arguedas added. "Institution of primary prophylaxis may
decrease the risk of bleeding by 40% to 50%," he said.
"Therefore, in order to institute prophylaxis in patients
with large varices, screening endoscopy should be
performed." In a related editorial, Dr. Naga Chalasani, of
Indiana University School of Medicine, Indianapolis, and
colleagues agree: "It is essential that all of us who care
for patients with cirrhosis adhere to the published
guidelines for primary prophylaxis of variceal bleeding,
beginning with endoscopic screening for their detection."
Am J Gastroenterol 2001;96:623-624,833-837.

This is a very delicate topic. Ido not agree 100%
with this article in the sense that some who are on
life support from trauma injuries have been known to
suddenly come out of the states. I had a case of a woman
who was hit by a car in Alaska and flown down to
Seattle. She was pronounced braindead after 2 days and her
sister called the Priest at our Monastery and asked me
to go see what I was able to do as I had bragged how
I helped a woman in a similiar case come out of a
come who was pregnantand in an auto accident some time
before. (she did come out, it took 32 days to happen) and
she gave birth to her son and the picture was in the
paper. I never contacted the family about the
vibrational work I had been doing at home in my healing
studio to monitor her from a distance as to her brain
activity. I had only her picture to work with. She showed
heat on both sides of her brain and thus I continued
for up to 3 to 4 hours after work each night to help
her as I was taught in this situation. I had told my
co-workers at the City of Seattle of this situation and they
found it interesting but felt I was crazy to be doing
this. I felt a change one evening and went off to work
and when I arrived my supervisor had a cake for me
and said " the woman came out of the coma this
morning" <br>The other woman in the trauma case from
Alaska had a sister who heard of this from our priest
and I went there (I had 6 days before leaving for
pilgrimage for India) I tested her as I had been taught, the
nurses were in amazement at what I did, she showed
vibrational activity from the stem of her brain to the tips
of her footsys. I talked and prayed into her ear,
told her how beautiful she looked, that I understoond
she wanted to be with her children and that she had
been hit by a drunk driver. I talked to the staff a
lot, the husband despised me and decided to "pull the
plug" on her on Saturday at noon as they found no
activity in her brain. I was talking to the nurse on
Thursday and she gave me the big clue, she was allergic to
every drug they had, even tylenol. I went home and
meditated on Lisa and a giant orange appreared in my vision
during meditation. It was Friday the day before they
were to unhook her and I called her sister Linda and
said Linda we must go to the hospitol NOW! I took the
orange with me and peeled a bit and put it under her
nose and she sneezed, the alarms went off and she
fluttered her eyes the first time and held Linda's finger.
So I want organ donation as much as anyone as I may
need one soon, but this article is a bit ambigious to
me. The crazy nun (given a new title of lama after
this incident and others) : hepbegone

US DOD: Lower Military Hepatitis C Virus
Infection Risk Found <br><br><br>April 11, 2001
<br><br><br>The Department of Defense, in collaboration with the
Centers for Disease Control and Prevention (CDC) and the
Department of Veterans Affairs, announced today that it has
completed and published a peer-reviewed epidemiological
study that has found that military personnel are at
three to five times lower risk of hepatitis C virus
infection than the civilian population. The study is one of
the largest epidemiological studies of hepatitis C
virus infection ever conducted. <br><br>The results,
just published last weekend in the "American Journal
of Epidemiology," found that among 10,000 active
duty personnel, a low percentage (0.5 percent) were
found to have been infected with the hepatitis C virus.
Men and women had the same rate of infection. Among
adults in the general population, 3.7 percent of males
and 1.6 percent of females (2.6 percent overall) have
been found by the CDC to be infected with the
hepatitis C virus. <br><br>The research evaluated 21,000
military personnel serving in 1997. Blood samples stored
in the DoD Serum Repository were used to test for
antibody to hepatitis C virus infection. The study was
directed by the Naval Medical Research Center, Silver
Spring, Md. <br><br>In this study, most hepatitis C virus
infections were concentrated in older military personnel.
"Among troops less than 35 years of age, only 0.1
percent (1 out of 1,000 troops) had been infected" said
Dr. John Mazzuchi, deputy assistant secretary of
Defense for Health Affairs. "Likewise, among 2000
military recruits, two (0.1 percent) had previously been
infected with the hepatitis C virus." In addition to
general active duty personnel and recruits, the study
evaluated 2,000 reservists, 2,000 troops about to retire,
1,000 health care personnel, 1,000 troops who had been
serving since before 1974 (the Vietnam War era), and
3,000 over-sampled demographic groups. Importantly,
reservists were found to have the same level of hepatitis C
virus infection as troops on active duty.
<br><br>Health care personnel and Vietnam era veterans were not
at increased risk of infection. <br><br>Based on the
results of this study, military personnel greater than 34
years of age and separating or retiring from military
service are now being offered testing for this viral
infection. "Because this age group includes 80 percent to 90
percent of troops with hepatitis C virus infection, we
have implemented this program to screen the military
population at highest risk," said Mazzuchi. "In addition, we
have implemented an extensive program to identify
patients who may have been infected with the hepatitis C
virus through a blood transfusion before scientific
research had developed an accurate test for this disease."
The low risk of hepatitis C virus infection in
current members of the military matches findings from the
largest epidemiological study of the civilian population.
In a study of the general population, the CDC found
a lower risk of hepatitis C virus infection among
military veterans compared to individuals who had not
served in the armed forces. <br><br>"The very low level
of hepatitis C virus infection in today's military
can be attributed to infrequent injection drug use,
which is the most common source of hepatitis C virus
transmission in the United States," said Mazzuchi. Illicit
drug use is rare in the U.S. military because of
mandatory drug testing of new recruits and because of
random drug testing of military personnel throughout
military service. <br><br>The "American Journal of
Epidemiology" is a journal published by The Johns Hopkins
University School of Hygiene and Public Health.

Brain Dead Means Dead <br>by Kristen Philipkoski
<br><br>2:00 a.m. Apr. 9, 2001 PDT <br> <br> If someone is
brain dead, the person is dead, period. <br><br>This
fact can be hard to accept, particularly when a
patient might look very much alive to family members.
Brain dead people often still have a heartbeat, and
their chests may rise and fall with the help of a
ventilator, sometimes giving hope to grieving families that
the person may suddenly wake up. <br><br>This false
hope, some experts believe, prevents people from
donating organs. People fear that their organs, or those
of their loved ones, might be taken before they're
actually dead. Some suspect a doctor might "pull the plug"
prematurely to harvest their organs.

<a href=http://www.wyeth.com/products/neumega.asp
target=new>http://www.wyeth.com/products/neumega.asp</a><br><br>Neumega®
(Oprelvekin) is a platelet growth factor that can
help prevent<br>extremely low platelet counts caused
by chemotherapy. Treatment with<br>Neumega may help
reduce the need for platelet transfusion and may
help<br>cancer patients avoid changes in their overall
chemotherapy plan.<br>Platelets are disk-shaped cells that are
found in the blood. They tend to<br>stick to uneven or
damaged parts of blood vessels. Because they are able
to<br>stick (clot) and block small breaks in blood vessels,
platelets can prevent<br>severe bleeding.<br><br>Platelets
are formed in bone marrow. Chemotherapy drugs can
affect their<br>formation in the bone marrow and cause a
large decrease in the number of<br>platelets. Low
platelet counts may necessitate changes in chemotherapy
dose<br>and schedule.<br><br>Neumega is a growth factor
(protein) that stimulates certain cells in the<br>bone
marrow to make platelets. Stimulating platelet
production can help<br>maintain platelet counts, which, in
turn, may help minimize the possibility<br>of having to
change chemotherapy dosing or timing because of low
platelet<br>counts.<br><br>Neumega is indicated for the prevention of severe
thrombocytopenia and the<br>reduction of the need for platelet
transfusions following myelosuppressive<br>chemotherapy in
patients with nonmyeloid malignancies who are at high
risk<br>of severe thrombocytopenia. Efficacy was
demonstrated in patients who had<br>experienced severe
thrombocytopenia following the previous chemotherapy<br>cycle.
Neumega is not indicated following myeloablative
chemotherapy.<br><br>In randomized studies, most adverse events
associated with Neumega were<br>mild or moderate in
severity, associated with fluid retention,
and<br>reversible after discontinuation of dosing. The most common
adverse events<br>associated with Neumega included
peripheral edema, dyspnea, tachycardia,<br>and conjunctival
redness. Neumega should be used with caution in
patients<br>with congestive heart failure (CHF), at risk of
developing CHF, or with a<br>history of heart
failure.<br><br><br><br><a
href=http://www.centerwatch.com/patient/drugs/dru346.html
target=new>http://www.centerwatch.com/patient/drugs/dru346.html</a><br><br>Drugs
Approved by the FDA<br>Drug Name: Neumega<br>The
following information is obtained from various newswires,
published<br>medical journal articles, and medical conference
presentations.<br><br><br><br>Company: Genetics Institute<br>Approval Status:
Approved
November 1997<br>Treatment for: platelet
deficiency<br><br><br><br>General Information<br>Neumega (Oprelvekin) has been
approved to promote the production of the<br>body's supply
of platelets in cancer patients with solid tumors or
lymphoma<br>who are undergoing chemotherapy. By significantly
reducing the incidence of<br>severely low platelet levels
(thrombocytopenia), a serious side effect<br>which often delays
chemotherapy administration, Neumega may give some<br>cancer
patients a better chance of receiving the treatment they
need to<br>fight their disease.<br><br>Clinical
Results<br>In clinical trial involving 170 patients, Neumega
reduced the incidence of<br>severe chemotherapy-induced
platelet depletion, reduced the need for<br>platelet
transfusions, and reduced the number of platelet
transfusions<br>required.<br><br>Side Effects<br>The most common adverse effects
associated with Neumega treatment included<br>peripheral
edema, dyspnea, tachycardia, and conjunctival redness.

} Biochemical markers useful for predicting
fibrosis in hepatitis C<br>patients<br> 6th April,
2001<br> Lancet 2001;357:1069-75 - Abstract (free reg.
req.) - Full text<br>(subscr. req.)<br><br>A
prospective study of a group of biochemical markers used
together as a<br>predictive score in patients with
isolated hepatitis C found cutoffs under<br>which liver
biopsy could be avoided. Dr, Thierry Poynard and
colleagues at<br>the Hospitalier Pitie-Salpetriere and the
Universite Rene Descartes, in<br>Paris, France, writing in
the April 7 issue of the Lancet, found a
score<br>using levels of the 6 most informative markers could
reduce by up to 46 %<br>the number of liver biopsies
needed to assess need for therapy for
hepatitis<br>C.<br>Patients without concomitant HIV, hepatitis B or other
liver disease were<br>excluded from analysis leaving a
total of 339 who were evaluated for levels<br>of
biochemical markers drawn just prior to biopsy. Forty percent
of the<br>group were found to have clinically
significant fibrosis on biopsy.<br>Statistical analysis was
done by logistic regression,
receiver-operating<br>characteristic curves and neural networks.<br><br>The
authors
found six basic biochemical markers for fibrosis with
high<br>positive or negative predictive value. These were, in
descending rank:<br>alpha2-macroglobulin, haptoglobin, GGT,
gamma globulin, total bilirubin and<br>apolipoprotein
A1. Using a fibrosis index based on values of these
markers,<br>Poynard and group identified 13 of 119 to be false
negatives with a low<br>score of 0.2 or less,. If treatment
was initiated without biopsy in patients<br>with a
fibrosis score of 0.8 or higher, only 5 of 50 would have
been false<br>positives, and the authors note that 3
of these had biopsy evidence of<br>moderate activity
despite significant fibrosis and would have
been<br>candidates for treatment anyway.<br><br>Although the results
obtained were similar with both logistic regression
and<br>neural network analysis, the authors preferred
regression because "with the<br>neural connection the weight
accorded to each factor is not certain."<br>Because
sampling variation could miss fibrosis in early stages
when unevenly<br>distributed, use of the biochemical
markers, particularly longitudinally,<br>"might provide a
more accurate description of fibrogenic events that
occur<br>across the whole liver," write Poynard et al who caution
against using the<br>fibrosis score with comorbid
conditions such as alcoholic liver disease and<br>renal
dysfunction.<br><br>Poynard and associates conclude with a call for studies
comparing their<br>fibrosis index to other algorithms for
fibrosis diagnosis. They plan to use<br>the index to help
in treatment decisions in those patients with
refusing<br>biopsy or with contradindications and also plan a
prospective<br>cost-effectiveness analysis.<br><br>-- F. Wayne van Saun, M.D.,
Newsrounds

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Education Campaign<br> Bethesda, MD <br> 310/654-2635<br>
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Foundation <br> <br> Newsletter "HepNews"<br> The Hepatitis
Education Project (mainly Hep C)<br> Seattle, WA<br>
206/447-8136<br> <a href=http://www.scn.org/health/hepatitis
target=new>http://www.scn.org/health/hepatitis</a><br> Hepatitis
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Grove, NJ<br> 1-800-891-0707<br>
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Hi: I just came from delphi and posted a message
about the show, sorry I didn't know it was cancelled!!
But you have such a great attitude. I know its not
healthy to be pestimistic, but I dont know how you do it,
I would be sooo angry w/ them especially well, I'll
save it for an e-mail.<br>Your a fighter and I'm glad
your in our corner.<br>Hugs and prayers ......Georgie

Tuesday April 03 01:45 AM EDT <br>FDA Eyes
Tougher Labels for Acetaminophen<br>By Fran
Berger<br>HealthScout Reporter<br><br>THURSDAY, March 29 (HealthScout)
-- Take only as directed. <br><br>That's the
consistent message from the Food and Drug Administration
(news - web sites) (FDA), from the makers of
acetaminophen products, and from researchers, who've linked
excess amounts of the analgesic to liver failure and
injury. <br><br>That connection has prompted the FDA to
begin further investigations into the drug/liver link
and to investigate a possible need for more explicit
warning labels. <br><br>The FDA action was triggered in
part by data presented by Dr. William Lee, professor
of internal medicine at the University of Texas
Southwestern Medical Center, when he spoke at a workshop of
the Pharmaceutical Researchers and Manufacturers of
America and the American Association for the Study of
Liver Disease. <br><br>In both a study now under way,
and one conducted in l999, Lee's research team linked
high levels of acetaminophen with liver injury and
failure. <br><br>Although Lee would not comment on the
specifics of his as-yet unpublished current study, his
previous research found acetaminophen overdose was the
most common identified cause of liver failure,
effecting 60, in a group of 295 patients. That study was
published in the January l999 issue of Liver
Transplantation and Surgery. <br><br>Are stronger labels needed?
Perhaps, says Susan Cruzan, an FDA spokeswoman.
<br><br>"We have seen reports linking toxicity, some
associated with unintentional overdoses. And because of that
and Dr. Lee's data presented at this meeting, the FDA
has decided to get another look at this," Cruzan
says. <br><br>"One of the things the FDA is looking at
is whether people are taking the drug for too long a
time, of if they are mixing up products -- for example
taking cold and flu medication and adding an analgesic
-- or taking more than the recommended doses in one
24-hour period," Cruzan says. <br><br>Tylenol: Our labels
are fine <br><br>Dr. Anthony Temple, vice president
of medical affairs for McNeil Consumer Healthcare,
the makers of the acetaminophen product Tylenol, says
he and his company are confident the labeling is
fine and the product is absolutely safe. <br><br>"If
someone takes a massive overdose, you can have liver
injury. Our message to consumers is if they take it as
directed, they can be confident they can take it without
difficulty." <br><br>But, Larry Sasich, a pharmacist with the
Public Citizen Health Research Group, a Washington,
D.C.-based consumer advocacy organization, says just talking
about labeling changes once a linkage is made is not
enough. "There should be better ways of tracking adverse
drug reactions than the voluntary system which now
exists," Sasich says. <br><br>"Unless you have some kind
of active system of looking for serious drug adverse
reactions, you can go for years and miss them. Even if the
reactions are rare, based on the numbers of people who
might take that drug, they can cause a lot of damage.
It took 60 years to find out cigarettes cause lung
cancer." <br><br>Unfortunately, Sasich adds, "Congress has
not seen fit to adequately fund the FDA to be able to
do more active surveillance. These are the funds
Congress should come up with in short order. There's no
reason for underfunding our most important consumer
protection agency." <br><br>The results of the FDA's further
investigations could take several months, or longer. So for now,
Cruzan adds, "follow the label directions." <br><br>What
To Do <br><br>Read all labels of all medications
carefully. Make sure you're not mixing and matching drugs
that cannot be safely combined. If you accidentally
overdose call the poison control center immediately.
<br><br>Not sure which painkiller's best for you? Read about
the alternatives at yourhealth.com. <br><br>Learn
more about acetaminophen from Medlineplus. <br><br>You
can also read more HealthScout stories on
ac

It is about time more attention is getting out
about tattoos. HCOP has done several investigations in
the past couple of years on this issue. It sure takes
time to trickle down into the media though and the
tattoo'd of the world really rebel about this issue but
hey that is one of the most common transmission
routes in prison along with IV issues and youth is
really involved in body piercing and tattoos, I love to
look at them but actually cringe when I go by those
spots in the mall who use this solution to kill germs
inbetween piercings. They say the ends are changed but I
still get crawly skin when I think of it.<br>We have
started weekly TV spots here in Seattle and I am happy to
be involved, we did touch on tattoos a bit
yesterday. I am learning to take articles and scientific
abstracts with me to show where these statements come from
otherwise it is like spreading folk lore tales or they make
ut seem as such. HA, I am going armed in the future.
We are adding a call in time to the next session
which is this coming Friday the 13th. Good Friday.
hepbegone of Frontline

Yikes in the butt? Oh, what about the Pooping
reflex involved with this type of entry? A not too
pleasant thought but really it figures they would give it
to us in the butt. Useless druggies that we are.
lol<br>Good research Randi! Japan seems up on the latest as
is Italy. I have a friend who does the national list
and government backed Italian web but I cannot read
Italian. Darn. hepbegone

Hi I would like to have a Hepper Friends album on
my site - click on photos on left had side under our
pages. Look for that album and click add pic. Also
started an memorial hepper album, if you have friends and
or family that have lost their fight to the dragon
if you'd like please post. <br><br>Thanks<br>Hope
your day is going well.<br><br>Peace/Love<br>Randi

Friday April 6 1:30 PM ET<br>Tattoo Parlors
Linked to Spread of Hepatitis C <br><br>By Merritt
McKinney<br><br>NEW YORK (Reuters Health) - Tattooing may be an
overlooked source of hepatitis C infections, Texas
researchers report.<br><br>In their study, which was
conducted in the early 1990s, people who received tattoos
at a commercial tattoo parlor were more than six
times as likely to have hepatitis C than people who did
not have tattoos.<br><br>Nearly 4 million Americans
have hepatitis C, making it the most common chronic
viral infection in the US. Chronic inflammation of the
liver develops in about 70% of infected patients, and
about 20% of people with hepatitis will develop
cirrhosis, a severe and possibly fatal scarring of the
liver. Cirrhosis increases the risk of liver
cancer.<br><br>Hepatitis C is spread through contact with blood and other
body fluids, but the route of transmission remains
undetermined in a substantial percentage of
infections.<br><br>Commercial tattooing is an important ``missing risk factor''
in the spread of hepatitis C, Dr. Robert W. Haley of
the University of Texas Southwestern Medical Center
in Dallas told Reuters Health in an
interview.<br><br>Haley and his co-author, Dr. R. Paul Fischer of
Presbyterian Hospitals of Dallas, conducted a study of 626
patients seeing a physician for spinal problems. Each
patient was asked about a number of potential risk
factors for hepatitis C. After the interview, the study
participants were screened for the virus.<br><br>Writing in
the March issue of the journal Medicine, the
researchers report that 18% of all patients had at least one
tattoo. Twenty-two percent of patients with tattoos were
infected with hepatitis C, compared with only 3.5% of
patients without tattoos. The hepatitis C rate was about
33% in patients who had been tattooed at a commercial
tattoo parlor rather than at home or at another
location.<br><br>The risk for hepatitis C was even higher in patients
with more complicated or more colorful tattoos, the
authors note.<br><br>According to Haley, hepatitis C can
be transmitted if a tattoo artist does not properly
sterilize needles or other equipment. And, he added, some
of the equipment used is extremely difficult to
sterilize thoroughly. Haley pointed out that regulation of
tattoo parlors varies widely from place to place, with
no regulations in place in about one third of
states.<br><br>The researchers conclude that in the face of the
potential risk of tattooing, regulations on commercial
tattoo parlors should be strengthened.<br><br>Several
previous studies have detected a link between tattoos and
an increased risk of hepatitis C, the report
indicates. Not all research has supported the connection,
however.<br><br>Besides tattoos, other major risk factors for infection
were injection-drug use, certain hospital jobs (for
men only) and heavy beer drinking. Haley explained
that drinking alcohol does not transmit hepatitis C,
but heavy drinking can make the liver more
susceptible to the virus.<br><br>The researchers did not
detect an increased risk of hepatitis C in patients who
had had blood transfusions, which can spread the
virus, or in patients with multiple sexual
partners.<br><br>SOURCE: Medicine March 2001.

HCV Advocate<br>March 6,2001<br>Alternate Methods
of Administering Interferon
<br><br>Suppositories<br>At the 51st annual meeting of the AASLD, Japanese
researchers reported<br>that the administration of interferon
alpha (INF) suppositories to<br>HCV-infected
individuals suppressed HCV replication. <br>Fourteen patients
with chronic HCV were treated with one IFN
suppository<br>(1000 units of lymphoblastoid INF alpha) a day for 24
weeks. The<br>researchers reported that serum HCV levels
were significantly decreased<br>from 4 weeks to 20
weeks compared with before the treatment.
The<br>scientists concluded that the rectal administration of the
low dose INF<br>suppressed HCV replication and should
be considered as a different form<br>of
administration from INF injection. This report did not list
side<br>effects. <br>Source: Yoshimichi Haruna and others, AASLD,
abstract 844 <br><br>Nasal <br>Nastech Pharmaceutical
Company, Inc., announced a Phase I clinical trail<br>in
the US to evaluate the nasal administration of
interferon. The<br>objective of this Phase I clinical trial
is to determine nasal<br>absorption, tolerance, and
safety of interferon alpha in healthy<br>volunteers.
<br>Source: PRNewswire <br><br>Oral<br>Amarillo Bioscience is
currently developing an oral formulation of<br>low-dose
interferon alpha (INF) for treating hepatitis C.
Amarillo<br>believes that an oral form of INF will not cause the
severe side effects<br>associated with interferon by
injection, and can be stored at room<br>temperature and
would cost less than the current form of interferon.
<br>Source: Company press release

Abdominal pain is one of the most frequent
complaints of Hep C patients, and one taken less than
seriously by many doctors, because "the liver cannot feel
pain".<br><br>HEPATITIS & LIVER PAIN<br>Many chronic hepatitis C patients
have expressed their frustration when it comes to
describing and sharing the experience of various abdominal
pains and discomforts with their physicians.
Frequently, these acute or chronic pains are dismissed as
having little or nothing to do with chronic liver
disease. What do physicians know about abdominal
pain?<br><br>Read the following and learn about the mechanisms of
abdominal pain in general and the types of pain that result
from diseases of some specific
organs.<br><br>Abdominal organs are unresponsive to many stimuli that
normally would elicit severe pain.<br><br>For example,
cutting or crushing of abdominal organs does not result
in a recognizable sensation. The pain fibers in the
viscera (large interior organs) are generally sensitive
only to stretching or increased wall tension. The
causes of stretching or tension vary. In hollow organs
such as the intestine or gallbladder, nociceptive
fibers are located in the muscular wall. Afferent
(conveying towards a center) impuses travel along the
sympathetic nerves.<br><br>In solid organs such as the liver
and kidney, such fibers supply the capsule and react
to capsular stretching. An inflammatory reaction to
microbes or toxins produces organ pain (visceral) through
the elaboration of tissue hormones or metabolites
(substances produced by metabolism). Four different
mechanisms give rise to abdominal pain: (1) visceral; (2)
referred; (3) parietal peritoneal; and (4)
psychogenic.<br><br>VISCERAL PAIN<br><br>Pain resulting from stimulation of
sensory afferent nerves innervating abdominal
organs.<br>The pain is often difficult to describe (usually as
cramping or aching), dull in nature, and poorly localized
to the midline from the upper (epigastrium) to the
lower abdominal area.<br>The pain may be accompanied by
nausea, vomiting, sweating, pallor, and
restlessness.<br>Patients often move about in bed, occasionally finding
relief with a change in position.

REFERRED PAIN<br><br>Visceral pain may be
referred to a remote area of the body, where it is
perceived as cutaneous pain (sensation of pain in the skin)
in an area supplied by the same spinal cord level as
the affected abdominal organ. Referred pain is
usually well localized and appears when noxious visceral
stimuli become more intense. Thus, swelling of the liver
capsule by a hematoma (swollen blood vessels) after liver
biopsy is first perceived in the abdomen but may be
referred to the right shoulder.<br><br>PARIETAL PERITONEAL
PAIN <br>When the parietal peritoneum (abdominal
membrane that encloses that body cavity) becomes involved
as a result of abdominal pathology (disease
process), nerves supplying the area are stimulated and
generally produce pain that is more intense and more
precisely localized than is visceral pain. The classic
example is the localized pain of acute appendicitis.
Parietal pain is often aggravated by movement; hence the
patient's desire to lie completely still.<br>PSYCHOGENIC
PAIN This is obviously abdominal pain that is
perceived but without any local cause.<br>Unfortunately,
this may be a pain mechanism that some physicians
choose to attribute to some chronic hepatitis patients'
episodes of pain. However, as cited above, physicians
should take the time to explain and concede that there
are valid causes for different types and intensities
of abdominal pain that arise from our internal
organs due to inflammation and toxic conditions.
<br>FURTHERMORE.... When the hollow structures of the gallbladder and
biliary tract dilate due to the disease process, pain is
experienced in the upper abdomen or right upper abdomen. Pain
may also be referred to the back between the shoulder
blades. Pain from the pancreas is also felt in the upper
abdomen and is often referred to the middle of the back.
In a manner analagous to the liver, gallbladder, and
biliary tract on the right, lesions in the tail of the
pancreas that involve the diaphragm, may result in
referred pain to the left shoulder.<br>Bacterial or viral
infection of any intraabdominal organ may cause abdominal
pain.<br>Interference with venous or arterial blood flow can affect the
abdominal organs. Clinically this may present as severe
abdominal pain and shock.<br><br>source: Hepatitis Central

4LIVER <br>PRESCRIPTION DRUG WEB RESOURCES
<br>Compiled by: Candi <br>PharmInfoNet Drug Information
Database <br><a href=http://pharminfo.com/drg_mnu.html
target=new>http://pharminfo.com/drg_mnu.html</a> <br>Drug
Information Database RXList-The Internet Drug Index
<br><a href=http://www.rxlist.com target=new>http://www.rxlist.com</a>
<br>RxList - The Internet Drug Index - Neil
<br>Sandow, Pharm.D. HealthTouch-Drug Information
<br><a href=http://www.healthtouch.com/level1/p_dri.htm
target=new>http://www.healthtouch.com/level1/p_dri.htm</a> <br>Healthtouch® -
Drug <br>Information
<br><br> <br>  <br> 

At one briefing for newly admitted prisoners this
week, John Romain, a peer counselor serving three years
for drug possession, did not mince his
words.<br><br>``Since I've been in this institution, quite a few
fellows have died of Hep C. Don't share needles, don't do
tattoos, don't share needles with nobody, don't share
cotton balls, don't share water, don't share
toothbrushes, don't share nothing with no one,'' he
said.<br><br>Judy Greenspan of California Prison Focus, a
grass-roots<br><br>advocacy group, said San Quentin was the exception in the
state prison system. Other facilities offered little or
no health screening and education to
inmates.<br><br>``Even if prisoners were tested, they were not always
told the results. We have people who have gotten sick
and gone back to their medical records and found they
tested positive in prison years ago. By that time, it's
too late,'' she said.<br><br>Phyllis Beck, director
of a hepatitis C awareness project in Oregon, said
hundreds of inmates within that state's prison system
desperately needed treatment but only a handful were
receiving it.<br><br>``We are seeing more and more inmates
who are being released with cirrhosis or close to
cirrhosis due to a lack of follow-up care after a positive
diagnosis has been made,'' she said.<br><br>Oregon started
counseling prisoners about hepatitis C only last year. Of
the state's 9,600 inmates, 937 requested a test of
whom 339 tested positive. Four liver biopsies have
been conducted and 9 more prisoners are in the process
of work-ups.<br><br>Degroot, who has seen two of her
patients die in prison, said treatment would be highly
cost effective for U.S. society despite the high price
tag.<br><br>``If we treat these people, nearly all of whom will be
returning to the community, we can avert public health
expenditures down the road to the tune of billions of
dollars,'' she said.<br><br>``If we aggressively treat in
the prison system, we could avoid 30 percent of the
liver transplants that will otherwise be needed,''
Degroot said.

Thursday April 5 9:59 AM ET<br>Hepatitis C
Spreads Mostly Unchecked in Prisons <br><br>By Alan
Elsner, National Correspondent<br><br>SAN QUENTIN, Calif.
(Reuters) - Hepatitis C, a silent killer that attacks the
liver, is rampant among the almost two million inmates
of U.S. prisons and jails but authorities are making
only half-hearted efforts to combat it, medical and
prison experts say.<br><br>``The prevalence of this
disease is believed to be 30 to 40 percent of the prison
population, depending on the state,'' said Anne Degroot, a
doctor who treats AIDS and hepatitis patients in the
Connecticut prison system and heads a prison health education
project at Brown University in Providence, Rhode
Island.<br><br>Hepatitis C is a virus spread through contact with human
blood and is rarely transmitted sexually. It can lead
to life-threatening liver damage by scarring the
liver (also called cirrhosis), liver cancer or liver
failure. Fewer than half of those treated are cured. There
is no vaccine.<br><br>The disease is particularly
prevalent among intravenous drug users. For example, in
Baltimore 90 percent of those seeking treatment for heroin
addiction are infected.<br><br>In total, more than 4
million Americans have been exposed to the disease, of
whom up to 15 percent can expect to become seriously
ill in the next 20 years, according to David Thomas
of Johns Hopkins University Hospital. Carriers often
have no symptoms.<br><br>Most state prison systems do
not require testing of inmates. In many systems,
testing is voluntary and in a few it is non-existent.
Prison activists charge that prison authorities do not
want to know if inmates are infected because once they
do know they are obliged to offer costly
treatment.<br><br>Diagnosis may involve giving patients liver biopsies to
determine how far the disease has progressed. Drug
treatment can cost up to $12,000 a year for each patient.
In some advanced cases, the only treatment may be
liver transplants.<br><br>``The incarcerated population
is the only population in this country that has a
constitutional right to health care,'' said Barry Zack of
Centerforce Inc, a non-profit organization that offers HIV
and hepatitis education to inmates of California's
San Quentin state prison.<br><br>``If they find
something, they have to treat it at the same standard as
that which prevails in the outside community. The
implications are enormous. People used to think that treating
prisoners with HIV would break the bank. That's nothing
compared to what treating hepatitis C would do,'' he
said.<br><br>Incidence of HIV among the prison population, although much
higher than in the community at large, is still
relatively low. A 1997 Justice Department report estimated
that 2.3 percent of state and federal prison inmates
-- just under 25,000 individuals -- were HIV
positive.<br><br>For those who are infected with both HIV and
hepatitis C, the prospects are grim.<br><br>Hep C Expensive
To Diagnose, Treat<br><br>Ted Hammett of Abt
Associates, a research and consultancy company in Cambridge,
Mass, conducted a study for the Texas prison system
which concluded it would cost $40 million a year to
diagnose and treat prisoners for hepatitis C in that
state.<br><br>``A lot of states are really gun shy about the cost
issue for pretty obvious reasons,'' he
said.<br><br>Prisoners are San Quentin are told about AIDS and hepatitis
C as they enter the prison and are urged not to do
things that could put them at risk, including tattooing,
body piercing, fighting, sharing razors, sharing
needles and engaging in homosexual sex. Prison rape puts
inmates at additional risk.