many hepatitis C patients, Anthony Lo Russo, 64, lived with
the virus for years before he knew he had it. Even after a
routine blood test flagged it in 1995, he eschewed hep C drugs
because of their side effects. "I felt fine, so I
waited," Lo Russo said.
the 2013 introduction of kinder drugs, Lo Russo agreed to a
standard 16-week treatment. Two weeks into it, he heard the
word thatís music to hep C patientsí ears; his blood was
"clear" of hep C. He was cured.
happy to be alive," said Lo Russo, of Lake Worth, Fla. He
bowls in three leagues, swims and chats with fellow patients
2.7 million Americans have hep C (or "hep C virus"
or "HCV"), according to the U.S. Centers for Disease
Control and Prevention. So high is the rate among baby boomers
that doctors urge that everyone born between 1945 and 1965 be
test positive for hep C, you learn your genotype (genetic
strain), No. 1 being the most common in the U.S. Your genotype
affects your ability to clear hep C without drugs and the
effectiveness of the drugs.
one-third of hep C victims rid themselves of the virus within
six months without treatment. The remainder develop chronic
hep C. Untreated, it can lead to cirrhosis (scarring of the
liver) or liver cancer.
Hep C is
more likely to become chronic if you have HIV or hep B (see
sidebar), are male, drink alcohol or are Native American or
get hep C from infected blood, so injection-drug users who
share needles are at high risk. Lo Russo assumes he got the
virus while using heroin in the 1960s.
risky is getting a tattoo by an artist who doesnít use clean
needles or dips into ink he used for his last customer.
not likely to get hep C by having sex with someone who has it,
but you can get a trace of contaminated blood from a shared
toothbrush, manicure scissors or a razor.
the best ways to catch hep C is to frequent hospitals and
clinics, where the virus can linger on equipment for weeks.
"Thatís why people on dialysis have higher rates; they
have an increased exposure," explained Dr. Kris Kowdley,
hep C researcher and hepatologist at Swedish Medical Center in
also can transfer from mother to baby at birth, but itís
rare. Itís not transferred through breast milk.
received a blood transfusion before 1992, it may have infected
you with hep C because thatís when blood banks started
screening for it. "It was also when we went from paid
blood donors ó more likely to be young people in high-risk
lifestyles ó to volunteer donors," said Dr. Stuart Ray,
a professor at Johns Hopkins School of Medicine in Baltimore.
victims ó one in 10 hep C patients ó never learn where
they got the virus, however.
example, Ronni Marks director of the New York City-based
Hepatitis C Mentor & Support Group Inc. (www.hepatitiscmsg.org
tending to mask origin is that fact that early hep C symptoms,
such as fatigue or nausea, mimic other illnesses and may be
dismissed as flu because theyíre mild and intermittent. If
your hep C advances, however, you may have dark urine,
jaundice or fluid retention.
includes two blood tests: one for hep C antibodies and one for
the virus. If you test positive for the antibodies (the bodyís
disease-fighting warriors), you have had the disease. Your
body fought it and won ó for now. You do not become immune
tests ó ultrasound, magnetic resonance imaging (MRI) and
liver biopsy ó measure hep Cís damage to the liver.
be a candidate for hep C drugs, which took a giant step
forward in 2013. Before that, the side effects were so
debilitating that many patients, including Lo Russo, said no
thanks. For Marks, they were "painful and horrific,"
caused nerve damage and did not kill the virus.
concoctions, which include sofosbuvir and simeprevir, yield
better results and are easier to endure. "They just made
me tired and irritable," Lo Russo reported.
hep C meds are a godsend for most patients but fail to help
some patients with genotype 3 and people who also have chronic
kidney disease, Kowdley said. "But, in both cases, weíre
working on it," he added.
the new drugs come with hefty price tags, up to $100,000 per
person. It is not always covered by insurance or Medicaid.
day, we hear from patients who are denied coverage because of
insurersí restrictions," said Ivonne Perlaza Fuller,
CEO of Hepatitis Foundation International (www.hepfi.org
qualified for free drugs from a manufacturer, but not everyone
can take advantage of these "manufacturer-assistance
goal is to put ourselves out of business," said Ryan
Clary from the National Viral Hepatitis Roundtable (www.nvhr.org
back at the lab, scientists are studying why some peopleís
immune systems fend off hep C. "This will help us develop
a hep C vaccine," Ray said. And, they are developing
drugs that require shorter time frames.
fundraising for hep C research is the virusís reputation as
a "drug userís disease."
first time she staffed the HEPFI hotline, Fuller fielded a
call from a young woman hiding in her bedroom closet.
"She didnít want anyone in her family or in her small
town to know she had hep C," she said. "We need to
get past this stigma."
crystal ball says weíll still have hep C in 10 years,"
Kowdley said. "But, drug prices are falling. Testing is
more widespread. We do have a cure ó for most patients. Weíre
ABCDES OF HEPATITIS
gets more ink than its alphabetical cousins for good reason;
itís the most serious. Here are the others:
(infectious hepatitis) is spread by eating contaminated food
or having sex with an infected person. Many people have been
exposed to it and have become immune to it but donít know
it. There is a hep A vaccine; the CDC recommends children take
it at age 1.
(serum hepatitis) spreads through body fluids such as saliva,
semen and blood. You can get it from unprotected sex, injected
drug use or sharing a razor or toothbrush with an infected
person. Children should get the hep B vaccine at birth and
between 6 and 18 months, the CDC says.
piggybacks hep B. If you get B, you may get D too. But the B
vaccine protects you from D.
Hep E is
transmitted by feces of infected people, so it is more
prevalent in countries with contaminated water.