Jan, a fifty-something mom, registered some surprise when I listed hepatitis C as one of the things I would test in her bloodwork. “But I’ve never had jaundice or anything that would say I have liver disease. Maybe I’m tired a lot, but who isn’t?”
I explained that the recommendation is that all “baby boomers” born between 1945 and 1965 get one blood test for hepatitis C even if they have no symptoms. In fact, the majority of folks with hepatitis C virus (HCV) are without symptoms. If they do get them they tend to be vague with many other possible causes – things like fatigue, muscle and joint aches, tingling in the extremities and itching. Due to its minimal symptoms, HCV is known as the “silent epidemic” and many infections go unrecognized and untreated for many years. But the baby boomer generation comprises about three fourths of the chronic HCV infections so screening them could help diagnose and treat a majority of the as-yet-undetected HCV infections.
HCV is caused by a virus that was finally identified in 1989. The virus particularly attacks the liver, and 75% of those who get it go on to a chronic infection that continues to damage the liver indefinitely unless treated. In some 20% this chronic HCV leads to cirrhosis, liver failure and/or liver cancer. The identification of the HCV led to the development of a blood test for it in 1990 and thus the ability to test the blood supply. This nearly knocked out the previously common problem of contracting HCV from transfusions.
HCV is so common that about 3% of the world’s population has been infected and there are more than 170 million chronic carriers. Here in the U.S. less than 2% of the population has HCV, but it nevertheless has surpassed HIV as a cause of death. Likewise, HCV just edges out alcohol as the #1 cause of chronic liver disease in the U.S. One of the reasons our bodies has such a hard time killing HCV when we are infected is that HCV can produce a staggering 10 trillion new viral particles each day.
So, how does one catch HCV? As noted, prior to 1990, blood transfusions were a common way for people to contract HCV. Nowadays the majority of new hepatitis C infections are from the use of illegal drugs with nonsterile needles or in those who snort cocaine with shared straws. HCV can also be transmitted by tattooing with improperly re-used needles, sharing razors, and acupuncture. The use of disposable needles for acupuncture eliminates this transmission route. Although sexual transmission is less likely it still ranks as the second most common mode of transmission. Infected pregnant women can also occasionally pass HCV on to their unborn child
If you do have any suspicion that you may be infected, if you were born between 1945 and 1965, or if you have engaged in any of the above-mentioned more high risk behaviors, a simple blood test can rule HCV in or out. Hopefully, if you get a HCV test it will be negative. But if the test shows that you have been infected with HCV and that it is still active in your system, there are now some highly effective treatments. A number of treatments, typically taking about 12 weeks, now result in cure rates greater than 90%. They are admittedly expensive, but there are a number of programs through which many patients receive help in getting their medications at least partially paid for. Of course avoiding alcohol and other liver toxins becomes even more crucial for those with HCV.
So the best bet for exposing and eradicating the silent epidemic of HCV infection is a rather simple and inexpensive blood test. If you’ve never had it tested and have any of the risk factors mentioned, ask your doctor to test you. It’s far better to break the silence than to let this little virus continue to advance its stealth attack on you and your liver.
Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. He is contracted with some commercial insurance carriers and sees Direct Primary Care patients who do not have insurance, who belong to a cost sharing ministry, or who are on Medicare. He is accepting new patients. You may contact him at 982-0835