Silent Killer

The Cleveland paramedic teetered precariously between life and death, burned over 75 percent of his body when a basement filled with natural gas exploded. I was a reporter at a Cleveland television station. Covering a blood drive the paramedic's co-workers had hastily arranged, I learned my blood type was the same as his and donated. Two weeks later, the Red Cross sent me a letter. It informed me that I had hepatitis C.

Like up to 40 percent of those who have this liver disease, I had zero idea how I got it. Unlike most, I am now hep C free, thanks to a successful clinical trial that rid me of this potential killer.

The National Institutes of Health (www.nih.gov) defines hepatitis as inflammation of the liver that may cause permanent damage. Viruses, bacteria, some medications or alcohol can be the cause. Fever, jaundice and an enlarged liver are possible symptoms of hepatitis, and there are are several types.

Hepatitis C used to be called non-A, non-B hepatitis. A recently identified blood-borne virus causes Hepatitis C. The strain was discovered in 1989 and causes about 26,000 new infections in the U.S. each year.

Some 55 to 80 percent of those infected become chronic carriers of the virus and recovery is rare. Approximately a fifth of those infected with hepatitis C will become jaundiced or develop other symptoms. Seventy percent may eventually develop chronic liver disease.

Chronic liver disease due to hepatitis C causes between 8,000 and 10,000 deaths and is the leading indication for liver transplantation each year in the United States. By 2010, the number of deaths in the U.S. from hep C may top 38,000 each year.

People get hep C from contact with infected blood, during sex with an infected partner, or a baby can get it from an infected mother. Blood transfusions prior to 1992 and the use of shared needles are known transmitters of of hepatitis C.

Those at risk, according to the National Institutes of Health, include:

• children born to mothers who are infected with the virus
• people who have a blood-clotting disorder such as hemophilia and who got clotting factors before 1987
• people who need dialysis for kidney failure
• people who received a blood transfusion before 1992
• people who may participate in high-risk activities such as intravenous (IV) drug use and/or unprotected heterosexual or homosexual sexual contact

There is no vaccine for hepatitis C. Those at risk should be checked regularly for hepatitis C. Those who have it should be monitored closely for signs of chronic hepatitis and liver failure.

The NIH says symptoms may include:

• loss of appetite
• fatigue
• nausea and vomiting
• vague stomach pain
• jaundice (yellowing of the skin and eyes)
• fever
• dark yellow urine
• light-colored stools
• muscle and joint pain

Symptoms may show up two weeks to six months after exposure and may resemble other medical conditions or problems. If in doubt, see your doctor.

Besides a complete medical history and physical examination, diagnosing hepatitis C may involve:

• blood tests
• a liver biopsy

Specific treatment for hepatitis C, health officials say, will be determined by:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures or therapies
• expectations for the course of the disease
• what you want to do

Right now, a vaccine is not available for the prevention of hepatitis C. Treatment may include biological therapy with interferon.

Those who can't afford treatment may be eligible for a clinical trial. If accepted, during the course of the trial, all medications will be free. To find a clinical trial in your area, visit www.clinicaltrials.gov and search hepatitis C. Clinical trials (also called medical research and research studies) are used to determine whether new drugs or treatments are both safe and effective. Carefully conducted clinical trials are the fastest and safest way to find treatments that work. Here are a few trials currently underway:

• Study: Peginterferon alpha-2b and Ribavirin to treat Hepatitis C in HIV-Infected Patients
• Study: Pilot Studies of Gamma Interferon Therapy Chronic Hepatitis C
• Study: HALT-C Trial

If you don't qualify for a clinical trial but wish to begin treatment, those who are income eligible may be able to obtain a form of interferon called Intron-A from drug manufacturer Schering-Plough through the company's cost sharing program called "Commitment to Care." The program is designed to help those in need of interferon therapy who can't afford it. It's based on a sliding scale tied to income. The cost will range from free in some cases, to whatever the scale says you can afford. The manufacturer will first try to find programs in your state that may help, and if none is available, will determine what you are able to pay and absorb the rest of the cost. To learn more, call (800) 521-7157, ext. 147.

The National Institutes of Health is investigating whether a common weed, the milk thistle, may be a source of treatment for chronic hepatitis C. The NIH's National Center for Complementary and Alternative Medicine is supporting a Phase II research study to better understand its use. In collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases, the NCCAM is planning further studies of milk thistle for chronic hepatitis C and nonalcoholic steatohepatitis (liver disease that occurs in people who drink little or no alcohol).

If you suffer from hepatitis C and cannot obtain health insurance coverage, you may be eligible to receive disability benefits from the Social Security Administration. Disability, under Social Security, is based on your inability to work. You will be considered disabled if you are unable to do any kind of work for which you are suited and your disability is expected to last for at least a year or to result in death. For more information, call (800) 772-1213 or visit www.socialsecurity.gov.