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Silent disease an issue locally

n Free hepatitis C screenings offered.

May 15, 2008
By Jimmy Mincin,
Hepatitis C is a disease many have — though few realize it.

It’s been dubbed “the ghost virus” and the “silent stalker” because it evades media attention and even medical diagnosis, area medical practitioners say.

‘‘It’s a silent infection in that most people never know they’ve picked it up,’’ said Dr. Ralph McKibbon, gastroenterologist at Altoona Regional Health System.

‘‘Many people who have it have no recognizable symptoms. It often goes undiagnosed because it’s unsuspected — if we don’t look for it, we don’t find it. That’s why screening is so important,’’ he said.

It also is the most prevalent cause of chronic liver disease.

In an effort to increase public awareness of the disease, Altoona Regional will provide a free and confidential hepatitis C blood screening from 4 to 7 p.m. Tuesday at 501 Howard Ave. (across from the Altoona Hospital Campus) in the B Building, Room 204.

Pre-registration is preferred but walk-ins will be accommodated as time permits.

‘‘It’s a definite health problem in our area,’’ McKibbon said of the disease. ‘‘We have about 50 people under treatment right now at our offices. We’re screening it not just to identify it, but because there’s treatment for it. About 50 percent of people who undergo antiviral treatment will be cured. But the longer you wait, the harder it is to treat.’’

Hepatitis C is a bloodborne, infectious disease caused by the hepatitis C virus (HCV), he said.

It attacks the liver, causing cirrhosis or scarring, liver failure and liver cancer, and is most often contracted through sharing of needles during intravenous drug use, tattoos and body piercing, and sharing razors with someone who is infected.

Others at an increased risk of exposure include those who had a blood transfusion before 1992 (before blood screening for HCV was implemented) and health care workers and medical emergency responders who are exposed to blood.

‘‘People with tattoos and body piercings are particularly vulnerable, especially if you’ve had them done on vacation,’’ he said. ‘‘There’s some people out there who are less than honest about using new and fresh needles. They reuse needles to save money.’’

Eighty percent of individuals exposed to hepatitis C will go on to have a chronic form of the disease, according to Kathy Henderson, community outreach coordinator at Home Nursing Agency, Altoona. Seventy-five percent of the liver may become damaged before a person shows any symptoms.

‘‘Many individuals infected with HCV are not aware of their infection and are not clinically ill,’’ she said. ‘‘The consequences of chronic liver disease may not become apparent until 10 to 30 years after the initial infection.’’

HCV is not spread through casual contact such as kissing, drinking or eating after someone or through coughing and sneezing, she said, adding that only 3 percent to 5 percent of cases are caused by sexual contact. But the virus is five times easier to contract than HIV and stands as the leading cause of liver cancer and the No. 1 reason for liver transplants in the United States. It affects one in 50 Americans, she said.

There are almost 5 million people with hepatitis C living in the U.S., according to the Centers for Disease Control and Prevention. Injection drug use is now responsible for the majority of new and existing cases of the disease. Seventy to 96 percent of long-term injectors have been exposed to hepatitis C, about half of them during their first year of injecting.

Blair County is fighting the spread of hepatitis C, Henderson said. She reports that Pennsylvania is the first and only state to allocate money for the disease, and Blair is one of six counties in the state that has a hepatitis C testing program at local outpatient drug and alcohol treatment facilities.

‘‘Blair County Drug and Alcohol Services sponsors this testing program and has been proactive in providing education about the risk of contracting hepatitis C during intravenous drug use,’’ she said.

Joe Noel, program director for the Altoona Hospital School of Medical Technology/Clinical Laboratory Science at Altoona Regional, said the jury is still out on the number of HCV’s long-term, and that’s also why it’s so important to get tested.

‘‘We worry about the numbers because they’re going up — even in this area,’’ he said. ‘‘A person who tests positive needs to follow up. If left untreated, it can move on to a chronic phase, and that can lead to cirrhosis, cancer and other serious liver issues down the road.’’

Most cases are treated with antiviral drugs such as interferon and ribaviran, he said.

‘‘There isn’t yet a vaccine available for hepatitis C, like there is for hepatitis A and B — they’re still working on it,’’ he said. ‘‘Right now, there isn’t a whole lot we can do, except antiviral treatments.’’

Mirror Staff Writer Jimmy Mincin is at 946-7460.

Fact Box

Symptoms and signs
Many people with chronic hepatitis C have no symptoms of liver disease. If symptoms are present, they are usually mild, nonspecific, and intermittent. They may include
n Fatigue
n Mild right-upper-quadrant discomfort or tenderness
n Nausea
n Poor appetite
n Muscle and joint pains

The major high-risk groups for hepatitis C are
n People who had blood transfusions before June 1992, when sensitive tests for anti-HCV were introduced for blood screening.
n People who have frequent exposure to blood products. These include patients with hemophilia, solid-organ transplants, chronic renal failure, or cancer requiring chemotherapy. n Health care workers who suffer needle-stick accidents.
n Injection drug users, including those who used drugs briefly many years ago.
n Infants born to HCV-infected mothers.

Other groups who appear to be at slightly increased risk for hepatitis C are
n People with high-risk sexual behavior, multiple partners, and sexually transmitted diseases.
n People who use cocaine, particularly with intranasal administration, using shared equipment.

Maternal-Infant Transmission
Maternal-infant transmission is not common. In most studies, only 5 percent of infants born to infected women become infected. The disease in newborns is usually mild and free of symptoms. The risk of maternal-infant spread rises with the amount of virus in the mother’s blood. Breast-feeding has not been linked to HCV’s spread.

Source: The Foundation for Better Health Care (FBHC),

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