Study finds troubling trends in hepatitis C screening, diagnosis an...( epatitis C either in the initial acute...),Health

epatitis C, either in the initial acute phase or the long-term chronic phase, have no signs or symptoms. Only blood tests for antibodies against the virus, or for the virus' genetic material, can show for sure that they're infected. Infections can go undetected for years or even decades before symptoms begin, even while the liver is slowly destroyed. In the current study, the percentage of patients whose biopsy showed significant liver scarring was high - at least 10 percent of all those who tested positive for the virus.

As many as 3.9 million people in the United States may have the hepatitis C virus, and an estimated 2.7 million of them have chronic infections, putting them at risk for liver failure. Both professional societies and federal agencies have developed guidelines to help doctors find and treat infections. But public health authorities know that many infections aren't spotted. There is no vaccine against the virus, and even advanced treatments are only moderately successful in slowing the pace of the chronic disease's progression toward either liver transplant or death.

The stigma attached to some risk factors may play a part. Intravenous drug use, risky sexual practices, cocaine use and tattoos from dirty needles are all common means of transmission. Lok notes that patients need to volunteer information about these behaviors to their doctors - even if it has been decades since the last time. And doctors need to act on that information.

Meanwhile, other behaviors that don't carry a stigma may still put people at risk of infection: occupational exposures in health care workers, long-term dialysis, or having received a blood transfusion or organ transplant before 1992, when surveillance of the blood supply improved.

Once a person tests positive for hepatitis C, further tests and biopsies to determine the subtype of the virus, whether the infection is active or dormant, and the extent of accumulated impact on the liver, are often needed t
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
20-May-2001

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