Hepatitis C: It’s Huge Epidemic In U.S. Largely Unknown, The Disease Is Usually Lifelong And Incurable

In 1972, Vernon Sears was fresh out of the Marine Corps, with time on his hands and a feeling of omnipotence. One day he took up a friend’s offer and injected methamphetamine, the drug known as speed.

“If I counted on one hand the number of times I tried it, I’d have fingers left over,” he said recently.

It didn’t matter, though, that this period of risky experimentation was brief. In a shot with a borrowed needle, Sears became infected with the hepatitis C virus. He’s had it ever since.

Now a 50-year-old artist living in Prince George’s County, Md., Sears is part of a huge, but largely unknown, epidemic in the United States.

Over the past 30 years, about 4 million Americans have contracted hepatitis C, an infection of the liver that usually is lifelong and incurable. It is four times more common than the AIDS virus.

What will happen to those people - 1.8 percent of the country’s population - is one of contemporary medicine’s biggest questions.

“I think it’s going to be the next big public health problem in infectious disease, though we’re not going to see it until the next century,” said David L. Thomas, a hepatitis researcher at the Johns Hopkins University School of Medicine.

Although the existence of the disease had been suspected for decades, the virus that causes the infection was not isolated until 1989. A laboratory test for hepatitis C, and a flood of research, quickly followed.

Since then, researchers have begun to develop a better understanding of the magnitude of the hepatitis C problem. But much about the disease is uncertain.

The National Institutes of Health is holding a three-day “consensus conference” in Bethesda, Md., this week to discuss the latest research into the illness and how best to treat it.

While much remains unknown, a few things are becoming clear about this “emerging” infection.

Hepatitis C rarely causes immediate illness. Often, it is diagnosed by chance, years, or even decades, after a person contracts it. In about 85 percent of cases, the infection is permanent and people with it become “chronic carriers.”

In a minority of cases, hepatitis C causes severe liver scarring - known as cirrhosis - or, more rarely, liver cancer. Although neither complication emerges until decades after the infection occurs, about 20 percent of patients are expected to develop them sometime in their lives, according to current projections. Already, complications from hepatitis C are the leading reason for liver transplants in the United States.

“We may have an epidemic of chronic liver disease in 20 years,” said Miriam J. Alter, the chief epidemiologist of the hepatitis branch of the Centers for Disease Control and Prevention. “The medical system may be overcome with individuals … coming to get it treated.”

Carriers can transmit the virus indefinitely, although not by casual contact. Sexual transmission occurs, but appears to be relatively uncommon. In blood, however, the virus passes with astonishing ease.

“If I had to draw a moral from my drug use, it’s that it can hurt you trying it just once,” said Sears, whose infection was not discovered until 1994, when he was hospitalized for a different ailment.

While the hepatitis C virus was isolated only eight years ago, physicians had long suspected a microbe was behind a mild form of liver disease that began to be noticed in the late 1960s in some people who had received blood transfusions.

When those patients were tested, they did not have either hepatitis A or hepatitis B, the two most common viruses known to cause inflammation of the liver, a large organ in the abdomen with myriad vital functions.

Doctors called the new liver disease “non-A, non-B” (NANB) hepatitis because they could not identify the virus until decades later. Once they did, doctors determined that most of the cases were actually hepatitis C.

Experts now believe that hepatitis C started to spread to a much larger segment of the population when, by chance, a few of the people infected with it became intravenous drug users decades ago.