ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Tuesday, January 28, 1997 TAG: 9701280112
SECTION: EXTRA PAGE: 3 EDITION: METRO
COLUMN: Personal Health
SOURCE: JANE BRODY
HIV, the virus that causes AIDS, is hardly the only virus that can invade the body and wreak havoc for years without the person even knowing it is there.
Another insidious and perplexing organism, already present in more than 3.5 million Americans, is the virus that causes hepatitis C. When it first infects a person, it may produce no discernible symptoms. But while still in hiding, it can disrupt vital functions of the liver, and in the long run it may severely damage the liver, causing cirrhosis, organ failure and even cancer.
Although most Americans are far more familiar with hepatitis A, transmitted through contaminated food and water, and hepatitis B, transmitted through infected blood and semen, it is the more recently identified hepatitis C, transmitted mainly through blood, that is responsible for more deaths than the other two versions combined.
As with HIV, no treatment exists that is certain to squelch the virus permanently. Even when treated with a virus-suppressing drug soon after it is acquired, the hepatitis C virus is likely to result in a chronic liver infection.
Organ damage caused by the virus is one of the leading reasons for needing a liver transplant. The virus is rarely responsible for failure of the transplant but nearly always invades the new liver, sometimes within a few weeks, and damages it.
With nearly 1.5 percent of the population already infected with hepatitis C virus, the eventual effects of chronic infection make it a growing and costly problem for public health as well as the individual.
That is the bad news about hepatitis C. The good news is that though there is no vaccine to prevent it, recent measures have greatly reduced the risk of infection, and there are steps everyone can take to protect against it.
Hepatitis C is not spread through casual contact, sneezes or coughs, food or water. In the past, the main route of infection was through transfusions of contaminated blood and blood products.
But since May 1990, when screening of blood supplies for the virus began, there has been a sharp decline in the risk of infection from transfusions. In 1981, 10 percent to 13 percent of transfusions resulted in transmission of hepatitis C; by 1992, the risk was down to less than 1 percent - three cases per 10,000 units of transfused blood.
Now, intravenous drug use with unclean needles is the most common known mode of transmission. Needle exchange programs could in theory reduce the likelihood of this infection as well as that of HIV infection.
About one case in 20 can be traced to infection through sexual intercourse with a virus carrier, exposure to contaminated saliva or other forms of intimate contact with an infected person. Those known to be infected should always practice safe sex; that is, use a latex condom.
The risk of acquiring hepatitis C is highest in people with multiple sex partners. Other protective measures to be taken by an infected person include never sharing a toothbrush or razor with another person, taking care to bandage all open cuts carefully and never donating blood, plasma, body organs or sperm.
In about 40 percent of cases, the source of the infection is unknown. Some experts believe that a fair portion of these cases may result from activities like tattooing, body-piercing and even manicures, says Dr. John D. Hamilton, an infectious disease specialist at Duke University Medical Center in Durham, N.C.
Anyone pursuing such activities should be sure the practitioner follows strict hygienic measures. If the equipment is previously unused or sterilized at high temperatures or by bathing it in special sterilizing fluids, there is no danger of acquiring the virus.
Pregnant women who are infected with hepatitis C sometimes pass the infection to their fetuses, but it is not known to be transmitted through breast milk. A few cases among health care workers have resulted from being accidentally jabbed by a needle.
Each year, as many as 180,000 new cases of hepatitis C are diagnosed in this country. If the infection causes immediate symptoms, they are likely to resemble the flu: loss of appetite, nausea, extreme fatigue, fever and abdominal pain.
Severe cases result in jaundice, a yellowing of the skin and eyes that results from malfunction of the liver. But more often than not, hepatitis C is first discovered in its chronic, symptom-free state through a routine liver-function test.
Anyone with any form of hepatitis is advised to abstain from alcohol, which can aggravate the virus-induced liver damage.
A vaccine against hepatitis C is not likely to be available in the foreseeable future, in part because the virus has many genetic variants and is forever changing. The current goals, therefore, are to prevent infection and to find treatments that are less toxic and better able to eliminate the virus.
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