Colorado responds to a silent epidemic
More than 83,000 Coloradoans have been infected with the hepatitis C virus (HCV). In recognition of Hepatitis Awareness Month (May), Colorado’s Chief Medical Officer, Dr. Ned Calonge, urges individuals to learn more about this silent epidemic and its risk factors.
Hepatitis C is the most common chronic blood borne infection in the United States and the Centers for Disease Control and Prevention estimate that 4.1 million Americans have been infected with HCV. Approximately 8,000-10,000 HCV-related deaths occur nationally each year. HCV infection is the leading indication for liver transplants both in Colorado and nationally.
Calonge explained that hepatitis C is often called a silent epidemic because symptoms may not develop until 20 to 30 years after a person is infected. However, even in the absence of symptoms, liver damage may silently occur.
“ A person may lose up to three-quarters of their liver before symptoms of liver disease develop and the consequences of chronic HCV infection may only become apparent 20 to 30 years after infection,” said Calonge. “Approximately 20 percent of individuals with chronic hepatitis C infections will develop cirrhosis, or scarring of the liver, and 1 to 5 percent will develop liver cancer. Chronic liver disease is now among the top 10 causes of death among American adults with chronic hepatitis C accounting for 40 to 60 percent of all chronic liver disease.”
Experts with the Colorado Department of Public Health and Environment say injection drug use has consistently accounted for a substantial proportion of hepatitis C cases in Colorado. Anyone who has ever injected drugs, at any time, should be tested for Hepatitis C.
State officials explained that the virus is spread when the infected blood of one person enters the body of another. Injection drug use provides an efficient mode of transmission because shared drugs, cookers, cottons, and syringes may contain small amounts of blood capable of transmitting the infection.
Because symptoms of this infection may not be evident for years, some people who experimented with injection drugs in the 1970s are only now finding out that risks they engaged in decades ago are threatening their future health and wellness. Individuals who have ever been on hemodialysis, received a blood transfusion prior to 1992, or received clotting factor concentrates prior to 1987 are also at high risk and should seek testing.
Colorado Responds
Together with ‘Team Hep C’ a consortium of hepatitis C service providers, the Colorado Department of Public Health and Environment (CDPHE) has been working to address this public health threat.
In 1999 the Colorado State Legislature passed the Hepatitis C Prevention Act (HB 99-1118), which authorized implementation of a public health program to address hepatitis C. These activities include public information, education, support and referral. This collaboration also supported the creation of a resource directory for hepatitis C in Colorado ( http://www.hepc-connection.org/directory/ResourceDirectory.pdf) and a help line (1-800-522-HEPC).
There is currently no effective vaccine against HCV infection, nor is there an effective post-exposure prophylaxis to prevent hepatitis C infection following an exposure. Therefore, HCV prevention activities focus on two areas: 1) reducing the risk for contracting new HCV infections; and 2) reducing the risk of liver disease and other chronic diseases in HCV infected individuals.
“A key strategy in preventing hepatitis C infection has been to partner with community based organizations and local health departments throughout the state to provide free HCV testing for at-risk individuals,” said Calonge. “This allows us to address both areas of prevention.”
In 2004, more than 900 high-risk individuals received free HCV testing through these sites. During the testing process individuals are counseled on ways to prevent HCV infection and transmission. Positive individuals are also counseled on steps they can take to minimize liver damage such as avoiding alcohol, getting vaccinated for hepatitis B and hepatitis A, and obtaining medical follow up.
The Denver Metropolitan area is also home to the Hep C Connection, a non-profit support organization involved in hepatitis education, counseling and prevention activities.
“ A little bit of education goes a long way toward making sure others don’t have to suffer the ill effects of hepatitis C,” explained Kathy Jensen, director of education and community outreach at Hep C Connection. “Our goal is to support and empower the people affected by this disease and stop the spread of new infections.”
How Hepatitis C is treated
Hepatitis C is treated with a drug called Interferon in combination with the drug Ribavirin. Approximately half of the people who receive treatment actually clear the virus. Even those who do not clear the virus may experience positive changes in their liver tissue as a result of treatment.
Individuals living with HCV are encouraged to check with their health care provider to discuss treatment options.
For more information about hepatitis C, support group meetings, or locations for free or low cost HCV screening call the Hep C Connection at 1-800-522-HepC or contact the State Health Department’s Viral Hepatitis Program at 303-692-2700.
