Column: The unspoken epidemic

By India Perez-Urbano

Today 180 million people around the globe are infected with Hepatitis C. In the United States, 3.2 million are infected with the virus—1.6 percent of the American population. Compare this to the prevalence of HIV/AIDS today, and you will see that the difference is colossal: 34 million people are infected with HIV/AIDS globally and 1.2 million people domestically. More people are dying today of Hepatitis C than of HIV/AIDS, a fact that is widely unknown.

While the numbers for HIV/AIDS are still high, they have dropped dramatically since the 1980s and ’90s. Due to an uprising of powerful activists groups and community advocacy, HIV/AIDS was brought to the forefront of political and social issues. Meanwhile, Hepatitis C is on the opposite side of the spectrum. It has lacked a community of concerned individuals and has consequently had very little attention since 1989, when it was first discovered. Advocacy for Hepatitis C is practically dismal, especially compared to HIV/AIDS and Hepatitis B. Funding for Hepatitis C research and resources is virtually negligible. This is due to the fact that Hepatitis C is not only an unspoken topic, but it is also an incredibly complex topic.

Hepatitis C is a slow-progressing, sometimes deadly blood-borne virus that attacks the liver. Of all people with the Hepatitis C virus, up to 85 percent will develop chronic hepatitis. Of this 85 percent, 70 percent will develop chronic liver disease, nearly 20 percent will develop cirrhosis, an incurable disease that results in scarring of the liver, and up to five percent will die of cirrhosis or liver cancer.

What many people are not aware of is that there is now a cure for Hepatitis C. A person with Hepatitis C can be free of the virus within 24 weeks if he or she follows a prescribed treatment plan. However, the virus is asymptomatic, which means that people who are infected are not aware of their status unless they are tested—and Hepatitis C testing is not a commonplace or encouraged procedure among medical institutions. The virus is also most commonly transmitted through injection drugs, contributing to the fact that Hepatitis C is most prevalent among poor, urban, and marginalized populations (especially drug users), many of whom are incapable of or not receptive to seeking out treatment.

This is for reasons such as a lack of motivation, a lack of peer, social, and community support, failure to recognize the long-lasting impact of not seeking treatment, lack of education about the illness, the attached stigmatization of infection, and an under-recognition of the condition (especially due to the fact that one could live 20 years without experiencing any symptoms). In addition, retention rates for those who actually seek treatment are incredibly low because the side effects are highly physically, financially, and emotionally debilitating.

Research has found that Hepatitis C is also most prevalent among the baby-boomer generation, the generation that lived through the “Summer of Love,” when experimentation with Schedule I drugs was especially high. Today, individuals who lived during that era have an HCV prevalence rate of more than double the national average. Targeting this generation is our best bet at drastically dampening the epidemic.

However, the “hippie” generation should not be our only focus. New statistics have shown that Hepatitis C is on the rise among American youth. In Massachusetts alone, HCV prevalence has risen from 65 cases per 100,000 between the ages of 15 and 24 in 2002 to 113 cases per 100,000 in 2009. This has been caused by to an increase in injection drug usage among America’s youth.

What the fight against Hepatitis C needs is both attention and money, and a lot of it. Specifically, it needs funding for programs such as the Division for Viral Hepatitis of the Centers for Disease Control, needle exchange sites, surveillance programs that value both casework and harm-reduction approaches, Hepatitis C education in communities and secondary schools, research funding for the development of a Hepatitis C vaccination, and more. But these needs cannot be met, let alone be requested, until our communities are educated and aware of the gravity and urgency of this issue. The time to act is now.

Read more here: http://www.thecrimson.com/article/2013/1/29/harvard-hepatitis/
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