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Living with Hepatitis C

Prospects improve for those with disease, but risks still loom

FRIDAY, March 22, 2002 (HealthDayNews) -- Pamela Anderson's announcement this week that she has hepatitis C is the talk of Tinseltown, but her future may not be that grim.

Many people infected with the liver disease go for decades without symptoms, experts say, and those who do become ill can turn to antiviral drug treatments that can be effective.

"Not everyone who gets hepatitis (C) dies from it. In fact, most people don't," says Frank Myers, an epidemiologist with Scripps Mercy Hospital in San Diego. Fifteen percent of hepatitis C patients actually get better on their own as their bodies eliminate the virus from their blood.

However, hepatitis C can ravage the liver and cause other symptoms. As many as 10,000 Americans die from the disease each year, while the side effects of drug treatment can be devastating.

Anderson, 34, says she suspects she was infected when she shared a tattooing needle with her ex-husband, rock star Tommy Lee. Anderson, a former star of the TV show "Baywatch," is undergoing outpatient treatment.

For his part, Lee, 39, claims he doesn't have the disease.

There are three major types of hepatitis -- A, B and C. All affect the liver, which acts a kind of clearinghouse for cholesterol, nutrients, blood-clotting products and other substances, says Dr. Kenneth Gould, an infectious disease consultant with the Southern California Permanente Medical Group in Los Angeles.

An estimated 4.5 million Americans are infected with hepatitis C, and it kills 8,000 to 10,000 people a year, making it only slightly less deadly than HIV, which kills about 12,000 Americans annually.

Hepatitis C is a bloodborne virus, like HIV, which causes AIDS. However, unlike AIDS, hepatitis C seems to be much easier to transmit through shared needles and much harder to spread through sex.

The chances of HIV infection through a contaminated needle stick are estimated to be one in 333, while they're just one in 50 for hepatitis C, Myers says.

Viruses try to survive by developing different ways of infecting people, he explains.

"Each virus develops its own niche strengths and weaknesses," Myers says. "I don't think we know enough to know what hepatitis C gained by designing itself in a way that does not allow itself to easily be sexually transmitted."

Infection through tattooing is unusual because the sharing of needles is uncommon, Myers says. It could happen "only if the tattoo artist completely violated his or her training."

Even if both Lee and Anderson were found to have the same strain of hepatitis C, it would be difficult to determine exactly how it was transmitted, he says. Shared razors or even toenail scissors could spread the virus.

Once a person is infected with hepatitis C, the prognosis can vary. It's possible to live for 20 to 30 years without encountering symptoms, Gould says. In some cases, infected people aren't diagnosed until their blood is tested for some other reason.

"Many times, it's serendipitously found," he says.

Even if someone doesn't notice any signs of infection, hepatitis C is usually still at work. Often, Myers says, "the liver is slowly attacked by the virus, but (the patients) die of something else before the virus destroys their liver."

Hepatitis C scars and inflames the liver, potentially blocking circulation within the organ, Gould says. Liver cancer is also a possibility.

Only a few years ago, there was no treatment for hepatitis C. Now, doctors use antivirals such as interferon and ribavinin.

However, drug treatment can make patients feel like they have the flu and even cause anemia, so it's generally limited to those whose livers are already damaged, Gould says. The treatment typically takes six to 12 months.

"Most people don't opt for therapy because it's prolonged and somewhat difficult," he says.

There's also a risk that treatment may not vanquish the virus, Myers says. While blood levels of the virus disappear in nearly half of people on drug treatment, hepatitis C returns in about half of them.

Despite the limitations, Gould says, the future for hepatitis patients is much brighter than it was just a few years ago.

"We have improved knowledge, and there are options for therapy that weren't available previously," Gould says.

What To Do: There is no vaccine to protect against hepatitis C. For more information about hepatitis C, and how to prevent it, go to the CDC, HepNet or the National Hepatitis C Coalition.

SOURCES: Frank Myers, CIC, epidemiologist, Scripps Mercy Hospital, San Diego; Kenneth Gould, M.D., consultant, infectious disease, Southern California Permanente Medical Group, Los Angeles
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