Infectious

The Chronicle has an extensive retrospective on the AIDS virus, which first entered the public consciousness 25 years ago with a brief article in a medical journal describing a cluster of cases of Pneumocystis jiroveci pneumonia, an incredibly rare disease which usually occurred in immuno-compromised cancer patients, in a group of gay men in Los Angeles. It’s worth reading through some of the articles on the Chronicle’s feature site, especially the reprints of articles from the 1980s, when AIDS was still a deeply misunderstood and feared disease.

We are making progress in the treatment of AIDS. In the first world, the disease is no longer a death sentence, although most residents of the third world can’t afford the expensive drug cocktail one must undergo in order to survive the disease. It still affects 40 million people worldwide, mostly in the third world, but there is hope.

Henry Waxman, a Democratic congressman from Los Angeles, had this to say:


“There is no doubt in my mind that if the same disease had appeared among Americans of Norwegian descent, or among tennis players, rather than among gay males, the response of both the government and the medical community would have been different.”

Reading the pieces on the AIDS crisis, and how it exploded from Gay Related Immune Disorder to an international epidemic, got me thinking about another blood borne disease, also deadly, which currently affects 150-200 million people worldwide. This disease also comes with a heavy stigma–most people are highly uneducated about it, and it is assumed that only junkies and the sexually promiscuous get it. Unlike AIDS, it hasn’t exploded into the public consciousness yet–in fact, one might argue that the disease is underfunded and not being appropriately addressed by world governments and the medical community, despite its prevalence. It’s one of a family of viruses, and was only isolated in 1989. Like AIDS, it has several genotypes and is a stealthy and determined killer.

Unlike AIDS, many people escape with only mild symptoms. In fact, many people have it and don’t know it because the symptoms are not serious enough for them to seek attention. It’s unclear, in fact, how many people may actually be infected. Those who are forced to pursue treatment face a variety of drugs, most of which don’t work, and ultimately liver transplant if they are to survive.

Have you guessed what it is yet? Here are a few more hints.

Unlike AIDS, it can only be transmitted through direct blood to blood contact, such as IV drug use with shared needles, blood products (anyone who was given a blood transfusion before 1992 is at risk), improperly sterilized medical equipment, occupational exposure to blood (such as needle sticks–many health care professionals test positive for this disease), blood-play and other sexual activities which may involve direct blood to blood contact, and potentially through sharing of personal items such as razors or toothbrushes which may come into contact with infected blood.

With the exception of one subtype, the disease cannot be transmitted through bodily fluids like mucus, saliva, semen, ectoplasm, and so forth.

The virus can be vertically transmitted (from a mother to a child) but this is rare–vertical transmission through breastfeeding has not been documented.

This disease is a growing threat globally, thanks to miseducation and low funding.

The treatment process is brutal. For maximum effect, the patient needs to take combination therapy–ribavirin and polyinterferon. Depending on the genotype, success ranges from 50-80%. If the illness can be caught during the acute phase (within 3-12 weeks of infection), the treatment is substantially more effective. Treatment on these drugs may continue for up to one year, in the hope of reducing the viral load to negligible amounts–you are never completely cured. However, ribavirin is extremely hard on the heart, meaning combination therapy is contraindicated for those with heart conditions. Treatment with interferon alone works in less than 20% of cases. Furthermore, interferon is hard on the body–side affects essentially create temporary disability in the patient, characterized by extreme pain, irritability, psychosis, hair loss, convulsions, cardiac events, suicidal thoughts, flu-like symptoms and other physiological stress.

Currently, there are five viruses in this disease family–there are vaccinations for the first two.

Still haven’t guessed?

This disease is Hepatitis C.

Right now, Hepatitis C is where AIDS was at 20 years ago–imperfectly medically understood and socially maligned. The full scope of the virus is only beginning to be realized, but it will be years before funding, education, and social comprehension will allow us to make positive steps against this virus.

I cannot encourage my dear readers enough to educate themselves about all matters, but please take the time to learn about Hepatitis C if you haven’t already. Please get vaccinated for Hepatitis A and B. Please help to disabuse people of their misconceptions about the ways in which C is transmitted. It’s long past time for this virus to enter the social consciousness so that we can make efforts to treat it, vaccinate it, and stamp it out.

You’d be surprised by who in your life might have Hepatitis C–I assure you, it’s not all druggies and sex depraved maniacs.

[Hepatitis C]