Here's a quick test:
Think of a dangerous infectious disease that has affected the
lives of countless people here in America and abroad, has
decimated entire communities and has been the subject of
highly visible fundraising efforts worldwide. I tried this on
several friends, and every one of them thought of AIDS. But
what if I told you there is a virus that is four times as
prevalent as HIV, almost as dangerous and affects between four
and six million Americans?
Well there is. And it's
called hepatitis C.
Also known as The Silent Epidemic, the
hepatitis C virus (HCV) affects at least 1.8% of Americans.
For every one person infected with HIV (the virus that causes
AIDS) there are four infected with HCV. At least four million
Americans are infected (some estimates go as high as five to
six million). Twenty percent of those infected will get
cirrhosis of the liver, and of those, more than half will die.
Frighteningly, these deaths are expected to double or triple
in the next 10 years. And in case you're thinking that
hepatitis is just for drug addicts and other fringe members of
the population, think again.
THE BASICS of
HEPATITIS
Hepatitis comes in several forms, all
viral infections, each identified by a letter (A, B, C, D and
E are best known) and transmitted in different ways.
Unlike other forms of hepatitis, HCV can
lie dormant, producing no major signs or symptoms, for
decades. Those that do have symptoms may experience jaundice,
fatigue, dark urine, abdominal pain, loss of appetite and
nausea. HCV is a blood-borne virus, spread by needles,
transfusions, exposure to blood-tinged sputum (i.e., someone
coughing blood), and, much more rarely, sex. It often results
in liver damage, which can lead to cirrhosis, liver failure
and sometimes premature death.
THOSE AT RISK FOR
HEPATITIS C
You may be at risk for HCV and
should contact your doctor for a blood test if you...
- Were notified that you received blood
from a donor who later tested positive for HCV.
- Received a blood transfusion or solid
organ transplant before July 1992.
- Have ever injected illegal drugs,
even if you experimented a few times many years ago.
- Were a recipient of clotting factor(s)
made before 1987.
- Have ever been on long-term kidney
dialysis.
- Have evidence of liver disease (e.g.,
persistently abnormal liver enzyme levels).
In addition, it's possible -- though
less likely -- to contract HCV by living with someone who was
infected with the virus. Shared razors or toothbrushes that
might have had blood on them are theoretically a transmission
route. According to the CDC, sexual transmission is rare, and
risk is even lower in long-term monogamous relationships.
There is no evidence for transmission by oral sex.
Surprisingly, there is also no evidence that the virus can be
spread by tattooing. Thanks to recent advances in screening
technology, currently the chance of getting HCV from
transfused blood is less than one chance per two million units
of blood transfused. That said, it is possible that new
strains of hepatitis may slip through the screening process in
years to come.
DIAGNOSING HEPATITIS
C
For those at risk or who are
experiencing liver problems, hepatitis is first screened for
in a liver enzyme test. According to Robert Gish, MD, medical
director of the Liver Disease Management & Transplant
Program at California Pacific University in Escondido,
California, "When there is damage to the liver cells,
enzymes are released into the blood." The enzymes
measured in a blood test include ALT and AST (formerly known
as SGPT and SGOT). "Pay particular attention to the ALT
test," he says. "While ALT and AST are both liver
enzymes, AST can be released from muscle inflammation. Statin
drugs can also cause an increase in AST." Dr. Gish
emphatically stated that if you suspect exposure, you should
not pay attention to the "lab standards" from the
local blood lab, but instead adhere to the more conservative
international standards, which are as follows: "For
women, an ALT of over 17 and for men an ALT of over 25 may
possibly indicate a potential liver problem, most likely some
form of hepatitis that may include fatty liver. This
condition, in which fat builds up in the liver, is due to a
number of factors, including inefficient fat metabolism and
insufficient processing by the liver of triglycerides and
other fats," he told me.
The liver enzyme test does not tell the
whole picture, though. It is common for persons with chronic
HCV to have a liver enzyme level that goes up and down, with
periodic returns to normal or near normal. And, to make
matters more confusing, ALT can also be raised by alcohol,
prescription drugs and even a meal containing tainted food. Net-net:
If your ALT score is high, you should be checked further for
chronic (long-term) liver disease and possible treatment.
The gold standard for pre- and
post-treatment evaluations is the liver biopsy. If hepatitis
is found via blood tests, most hepatologists will ask for the
biopsy to confirm disease progression and add confidence to
treatment efficacy.
Be sure the evaluation is done by a
health-care professional familiar with chronic HCV.
IS HEPATITIS C
CURABLE?
HCV may be curable, though it will take
some effort. Twenty percent of people or more clear the virus
on their own right after acute disease, and 60% of people live
symptom free for the rest of their lives with no treatment.
"Pegylated interferon and ribavirin
is currently the treatment of choice," Dr. Gish told me.
According to the CDC, this combination can get rid of the
virus in up to five out of 10 persons for certain strains of
the virus, and up to eight out of 10 for other strains.
"While interferon definitely has side effects including
flu-like symptoms, weakness, fatigue and depression," Dr.
Gish said, "if treatment is well managed, you can get
nine out of 10 people to stay with it."
Daily Health News contributing
editor Andrew L. Rubman, ND, adds that there are a number of
natural treatment options to help beat hepatitis. These
medications are not a substitute for conventional care.
Rather, they are best prescribed as adjuncts to conventional
care by a naturopathic physician working in tandem with the
treating hepatologist.
Equally important are lifestyle choices
that can help you live a healthy, productive, symptom-free
life even with HCV. If you have (or suspect you have) HCV...
- Do not drink alcohol.
Without question, alcohol can make liver disease worse. It
may be the single biggest stressor on the liver.
- Lose weight.
According to Dr. Gish, when you are overweight you put fat
in your liver, which puts a massive strain on the liver
and increases the risk of cirrhosis and diabetes.
Be well,
Carole Jackson
Bottom Line's Daily Health News
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