The hepatitis C virus (HCV) has become the new, ugly epidemic in this country, but it’s not showing up in the headlines. What’s up with that? There are 3.5 million Americans chronically infected with HCV. At least 80 percent of the cases are blood borne. The experts seem uncertain about the origin of the other 20 percent. The blood supply wasn’t screened for HCV until 1990. Liver failure due to chronic HCV infection is the leading cause of liver transplants in this country. Many people have the disease but don’t know it and are unwittingly giving it to others!
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Here is a quote from Matthew Dolan’s book, The Hepatitis C Handbook: “HCV is a relentless and baffling pathogen which frequently defies classification. Patients are definitely suffering from a serious, frightening illness whose consequences can no longer be minimized. The fact that the symptoms vary from one patient to the next, that they can take decades to emerge, and the increasing evidence of the existence of a sinister but unpredictable pattern of severe related illnesses, means that it is difficult to face the future without a feeling of apprehension.”
Question of priorities. What’s more important, the next plague or Monica Lewinsky? In fairness, hepatitis C hasn’t been ignored; the amount of coverage has increased in the last year or two. But the seriousness of the disease still hasn’t registered with most people, possibly because of the name. Hepatitis? Hepatitis has been around forever, right? Wrong. Six types of hepatitis have been identified so far; they’re completely different viruses whose only common feature is that they affect the liver. Hep C is caused by a newly discovered virus that wasn’t fully identified until 1989. And HCV is tough to get a handle on. Is the problem getting better or worse? Does it threaten everybody or just a few high-risk groups? Not even the experts can give us a straight answer.
The good news is that the HCV epidemic is probably not getting worse. The number of new cases reported annually–currently around 150,000 a year–has been declining, largely because screening has eliminated infections due to transfusions and such. Needle-exchange programs conceivably could reduce the staggeringly high incidence of HCV among drug users. The real problem will be treating those who currently have HCV but haven’t yet shown any symptoms. A lot of people got this bug years ago, but the real cost lies ahead.
