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Doctors Fear Growth in Hepatitis C Infections

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The top three treatments for hepatitis C are very basic, Dr. Patrick Quinn told a seminar audience recently.

First, stop drinking alcohol, the Santa Fe gastroenterologist said. Then he repeated the advice two more times. "That is really crucial," he stressed.

Alcohol speeds liver destruction that can occur with hepatitis C, which leads to 10,000 to 20,000 deaths each year in this country, Quinn said. "We're expecting that to triple in 10 to 20 years," he added.

An expected growth of hepatitis complications is one reason The American Liver Foundation sponsored seminars to educate the public earlier this month in Albuquerque and Santa Fe. The foundation also hopes to establish a chapter in New Mexico, said Leanne Marco, chapter director in Arizona.

"It's not easy to do," she said. "I'm hoping to meet people passionate about liver disease who can create a board of directors."

"In New Mexico, we've got a lot of hepatitis C. We know we do," said Dr. Gary Simpson, medical director of infectious diseases with the state Department of Health. Studies put the national rate at about 1.8 percent of the population; in New Mexico, it's likely more than 2 percent, he said.

Infection rates are high among injection drug users, who get the virus by sharing needles. The other most common means of transmission was from blood transfusions before donor blood was screened for the virus in 1992. Some people also picked it up through kidney dialysis.

The virus also is transmitted when health care workers are accidentally stuck by needles or people get tattoos or body-piercing from unsanitary equipment. Women can pass the virus on to their babies during pregnancy.

And the virus can be passed on through sexual activity, but not easily. "We don't even recommend barrier protections (such as condoms) to people who are monogamous," Simpson said.

People are advised to get vaccinations against hepatitis A and hepatitis B, he added, since those infections could further damage a person's liver. There are no vaccines to protect a person from hepatitis C, the disease which now is the top reason people need liver transplants in this country.

About 20 percent of people who get the virus manage to get rid of it, but the rest develop a chronic infection, according to Jessica Doyle, a physician assistant. People may get the virus without ever showing any symptoms, while others may get flulike symptoms, such as fatigue, nausea, fever and weakness.

The latest treatments can get rid of the virus in 52 percent to 56 percent of patients with chronic infections, Quinn said. "A fair number discontinue therapy because of side effects," he said. "But a lot waltz right through it."

Antiviral drugs interferon and ribavirin are combined and taken for six months to a year. Quinn said he tests patients after three months to see if they are responding to the treatment. If their virus levels aren't dropping, he recommends stopping treatment.

Side effects to the drugs can include depression, anemia, flulike symptoms, fatigue and loss of appetite.

Since many people never develop liver damage even with a chronic infection, doctors try to target who needs treatment and who doesn't.

Quinn said he has his patients get a liver biopsy to show how much scarring may have developed. Older people who have had the virus for many years but don't show much scarring probably don't need treatment. A younger person who developed significant scarring over a shorter time probably should consider treatment, he said.

Copyright 2003 Albuquerque Journal

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