Hepatitis C has been in the news lately with the rise of advertisements for vaccines or screening for the baby boomer generation. Millions are at risk for the slow and potentially fatal damage the virus does to the liver, requiring liver transplants that are often in short supply and very costly, attaching with it a life time of anti rejection medication and medical treatment. Hepatitis B while less advertised in the media is just as deadly and attacks the liver in a similar way.
Due to Hepatitis B & C being considered more as a sexually transmitted disease, while Hepatitis A tends to be contracted by living in areas with poor sanitation or unclean drinking water, we’ll only address B & C in this article. For educational purposes, there’s also a Hepatitis D and E, with D requiring a co-infection of B and E only being temporary, allowing for a full recovery.
So just how wide-spread is Hepatitis B & C? How many are infected? According to a study released by the World Health Organization (WHO), infection rates are concentrated in the Eastern and African part of the world, with the West being on the lower end.
However, this isn’t to say that the West is in the clear of risking contraction. Recently, reports have come out showing a rise in hepatitis C rates among young Californians, with rates having increased by 55% for men and 37% for women 20-29 years of age between 2007 to 2015. IV drug use is being blamed as the sole reason for the spread, which has a higher risk of transmission than unprotected sex.
“Two groups are top priority for hepatitis C testing – young people who inject drugs and baby boomers,” CDPH Director and State Public Health Officer Dr. Karen Smith said. “Drug users may be at high risk for transmitting hepatitis C to others if they are not being treated, and baby boomers may be at risk for developing serious liver disease, even if they have no symptoms.”
Hepatitis B can be transferred in many ways:
· Sex with an infected partner
· Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
· Birth to an infected mother
· Contact with blood or open sores of an infected person
· Needle sticks or sharp instrument exposures
· Sharing items such as razors or toothbrushes with an infected person
While Hepatitis C is transferred normally through sharing of needles and receiving blood or organs contaminated with the virus. Neither of the two viruses can transferred via food or water, but both can be passed to a newborn by an infected mother. One important note is Hepatitis B can survive outside the body for over a week and still infect a person.
Symptoms of someone infected with Hepatitis B and C include:
30% of those infected with either virus will show some signs of infection, most commonly jaundice, with symptoms taking 90 days on average for Hepatitis B and 30-90 days for Hepatitis C.
As for long-term health risks, each virus works in separate ways. Hepatitis B is seen as the less lethal virus, due to only 25% of those affected after the age of five developing chronic liver disease according to the CDC. Hepatitis C however develops to chronic liver disease in 75%-85% of every 100 cases, as seen below:
· 75–85 will go on to develop chronic infection
· 60–70 will go on to develop chronic liver disease
· 5–20 will go on to develop cirrhosis over a period of 20–30 years
· 1–5 will die from the consequences of chronic infection (liver cancer or cirrhosis)
Hepatitis B vaccines in the West have been recommended to infants since 1991. Long term studies of 10-22 years have shown the vaccine to have protected recipients from being infected, with only a few rare cases when the person’s immune system was weakened.
Hepatitis C currently has no vaccine available in the US. Simple education on avoiding the sharing of needles is the current method of reducing the spread of infection.
Studies have shown that the sooner a person is treated post exposure the better. Hepatitis B immunoglobulin injections and the initial 3 injections of the hepatitis B vaccine are the recommended treatment for someone who believes they’ve come in contact with the virus within the first 1-2 weeks.
Depending on whether you develop long-term chronic Hepatitis B or C symptoms, the goal then becomes to slow the damage of the liver. Anti-viral medications are usually given to the patient to help keep the virus from multiplying. A 6 month follow-up Complete Metabolic Panel and Thyroid blood tests are recommended by physicians to monitor the health of the liver and Thyroid, as hepatitis C can also disrupt healthy thyroid function.
In 2014, Gilead Science announced a treatment for Hepatitis C had been developed and was now available in the United States.
There is however, a small (expensive) catch: the cost for a 12-week treatment is $84,000.
At this rate, it would cost Medicaid $360 million to provide treatment to its beneficiaries, so as a result they’ve been selective as to who gets it.
While the debate raged over the ethics of making such a drug more accessible, one man took it upon himself to look outside the country to treat his ailment. He discovered that the same company who was pricing it at $84,000 in the US had struck a deal with India to market the drug in a region of 103 million infected residents for only $1500 dollars. An Egyptian company is also claiming to soon be releasing a $300 version of the drug.
Let me just be clear, I’m not advocating for anyone to bypass state laws and purchase medications online. Aside from the legal issues, the quality of the medication can be difficult to guarantee.
The landscape for prevention and treatment is currently being shaped in treating a virus that once could only be treated with a liver transplant and a lifetime of anti-rejection medications. Contracting the virus seems less likely for people who avoid drug use involving needles. Education on the safety of clean needle use in cities like New York for example, have reported a decrease in Hepatitis rates from 80% to 59% among IV drug users. Understanding the risks associated with such behavior as well as how to protect oneself from becoming infected will in the long run lead to a better quality of life.
Until next time,