Panel warns of explosion in hepatitis C deaths
Current treatment 'disappointing,' federal panel says
March 26, 1997
Web posted at: 9:30 p.m. EST
WASHINGTON (CNN) -- Nearly four million Americans, and 200 million people worldwide, are infected with hepatitis C, a blood-borne virus that might someday scar their livers so badly that they'll need a transplant to survive.
Trouble is, most of the people who are infected don't even know it. Even if they did, current treatments are not effective for most patients. And over the next 20 years, the number of deaths attributable to hepatitis C in the United States will triple, to an estimated 24,000 a year, unless more effective treatments are found.
That cautionary assessment came Wednesday from a National Institutes of Health panel, convened to evaluate the current understanding, diagnosis and treatment of hepatitis C.
"There is a large reservoir of patients with chronic [hepatitis C] disease who will become ill, require liver transplants or die," said Dr. D.W. Powell of the University of Texas Medical Branch at Galveston, who chaired the panel.
The panel concluded that current methods of treating the disease have been "disappointing" because only one out of five patients who develop the chronic phase of the disease can be cured. They called for more research into drugs to combat the virus.
Intravenous drug use spreads infection
Hepatitis C is spread most commonly by needle sharing among intravenous drug users. Snorting cocaine and having multiple sex partners are also considered risk factors. But there are a number of other methods of transmission involving more mainstream activities.
For instance, Constance Petrides, a 38-year-old woman infected with the virus, says she believes she was infected by having an ear pierced.
Theoretically, hepatitis C can also be spread to recipients of blood transfusions. In the U.S. though, this route of transmission has become very uncommon because of a blood test that detects the disease in donors.
Edith Jackson Thomas, 45, thinks she got the disease more than 20 years ago when she was a lab technician.
"We did not use gloves because we were not aware of the existence of hepatitis C," she said.
Vaccines are available to protect against two other common strains of hepatitis, hepatitis A and B. But there is currently no vaccine for hepatitis C.
Symptoms include fatigue, nausea, loss of appetite
After infection, hepatitis C can appear benign, with few visible signs of illness for years or even decades. Symptoms, when they do occur, include extreme fatigue, loss of appetite, nausea and abdominal pain. About 15 percent of those infected recover completely without medical intervention.
The rest develop a chronic liver infection. And while the health of most of these people may not be seriously affected, they remain carriers of the virus, able to infect others.
For about 20 percent of people infected with hepatitis C, the consequences are more serious. They will develop chronic liver diseases, the leading reason for liver transplants in the United States. Many develop cirrhosis of the liver, which is often fatal.
Principal method of treatment
The principal drugs used to treat hepatitis C are all based on interferon, an immune system protein produced by the body to fight viral infections. Treatment requires injections three times a week for six months to a year.
The NIH panel found that the longer course of treatment seems to be more effective. Perhaps as many as 30 percent of patients could be cured if they stayed on interferon for a year, the panel concluded.
Because of the limited efficacy of current treatment, the panel called for limiting use of interferon therapy only to patients who have signs of progressive cirrhosis.
Correspondent Eugenia Halsey contributed to this report.
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