Emerging Epidemic
Donnie Beitchman is walking today. Slowly. But he and Karen, his wife, are grateful for each and every measured step down the hospital corridor on this chilly, early-December afternoon. The trucking-company owner has endured two major surgeries within weeks. He nearly died after part of his cancer-ravaged liver was removed a couple of months ago. The organ didn't revive, a staph infection and kidney failure followed, and four weeks later, Beitchman, 48, had a liver transplant. Now, in his darkened room at Duke University Medical Center in Durham, N.C., his face is still a jaundiced yellow and his fluid-filled abdomen undulates like a waterbed when disturbed.
But Beitchman is alive. That makes him more fortunate than thousands of the estimated 3.2 million Americans thought to be infected with the hepatitis C virus. Each year roughly 10,000 people die from cancer, liver failure, and other complications of the disease. It is the nation's most common chronic blood-borne infection; about three times as many people are carrying hepatitis C virus as are infected with HIV.
Yet hepatitis C may be the most lethal disease you've barely or never heard about. Partly that's because it bides its time, often causing no symptoms for decades--so 3 out of every 4 of those carrying the virus, say researchers, are unaware they are infected. Shame, or at least embarrassment, is another reason. Many of those with hepatitis C were infected by needles while experimenting with drugs long ago and aren't eager to revisit or advertise their adventures. The source of Beitchman's virus was likely a dirty tattoo needle more than 20 years ago. "We didn't think about it back then," he says regretfully.
Deadly forecast. For many of these individuals, however, their past is becoming their present as the virus emerges from hibernation. At the peak, in 1989, nearly 300,000 people contracted hepatitis C, nearly 10 times the current rate, and the millions who got it during this decade and before are fueling a sustained burst of illness. "We're on the edge of a liver-disease epidemic," says Ian Williams, chief of epidemiology in the federal Centers for Disease Control and Prevention's division of viral hepatitis. Physician office visits for hepatitis C were an early indicator, jumping from 450,000 in 1996 to 1.5 million in 2002, according to a study last year in the journal Hepatology. Over the next 10 years annual deaths are expected at least to double, perhaps triple. And cases of liver failure and cancer, the two most serious complications of hepatitis C, are rising and will probably climb faster.
The bright spot is that better therapies should arrive as well. Dozens of companies are pouring money into research, and "there's almost a race on" to be the first with an effective treatment, says Eugene Schiff, chief of hepatology at the University of Miami School of Medicine. The current treatment, a combination of interferon to help the immune system better attack the virus and ribavirin to make the interferon more effective, cures fewer than half of those infected with the most common viral strain found in Americans--and it's not easy to endure. Side effects from the weekly injections of interferon for six to 12 months include fatigue, pain, gastrointestinal problems, and depression. Ribavirin, taken as a pill, can cause severe anemia.
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