ADVANCE/ WASHINGTON, Oct. 22 /PRNewswire/ -- The
executive director of a leading women's health group is urging the
federal government to take a stronger lead in educating and
alerting women to the potentially fatal consequences of hepatitis
C. Phyllis Greenberger, president of the Society for the
Advancement of Womens' Health Research, called hepatitis C "the
next major health crisis women are facing."
"Four million Americans are infected with the life-threatening
virus, and only five percent know they have it," she said. "Women
have special risk factors for this disease," and because the
symptoms are mostly silent, the federal government has a particular
responsibility to alert women at risk."
Ms. Greenberger is joined in the call to action by former U.S.
Surgeon General C. Everett Koop. He said: "We stand at the
precipice of a grave threat to our public health...it affects
people from all walks of life, in every state, in every country.
And unless we do something about hepatitis C soon, it will kill
more people than AIDS."
Before 1992, when a reliable screening process for the disease
was available, an estimated 7-10 percent of all people who received
blood transfusions became infected with the virus. This includes a
large number of women who received blood transfusions -- often
while under sedation and without their knowledge -- during cesarean
A 1993 study published in the Journal of Reproductive Medicine
indicates that only 25 percent of women who received blood during a
C-section realized they had been transfused. It is estimated that
250,000 women may have contacted the virus in this way. "If these
women don't know about the virus or do not realize they received
transfusions, they may not be tested until severe liver damage
becomes evident," says Greenberger.
Both Greenberger and Dr. Koop said that a national program to
notify those who received blood transfusions between 1988 and 1992
is a step in the right direction. But she urged the Administration
to create a greater public awareness effort to reach those who were
transfused before 1988 or those who received blood from infected
donors who were never traced.
Hepatitis C is a blood-born disease that attacks the liver and
quietly damages other vital health functions. Often it can take 20
years for the symptoms to appear. People with hepatitis C can also
develop cirrhosis, liver cancer, and other diseases causing severe
symptoms. Those infected can spread the disease through blood to
blood contact and during birth.
Greenberger urges those who may have received a C-section before
1992 to have their blood tested for the disease. "The good news is
that there is treatment available, including Rebetron, a new drug
recently approved by the FDA, to help fight the disease."
"The federal government should not wait to start alerting the
public to this womens' health crisis," she says.
WOMEN AND HEPATITIS C
What is Hepatitis C?
Hepatitis C is a potentially fatal virus carried in the blood
that currently infects between four and five million Americans. It
was unrecognized until 1989 and effective screening tests became
available only in 1992. It is a "hidden disease" because after
infection it may take 10-30 years before it becomes chronic and
active in the human body. It is estimated that only five percent of
those who are infected know they have the disease; fewer than two
percent have been treated.
How is Hepatitis C Transmitted?
Generally, hepatitis C is transmitted through blood-to-blood
contact. In the 1970s and 1980s, doctors in America performed large
numbers of Cesarean section birth operations. Often the mothers
received transfusions without their knowledge. Before the screening
test was developed in 1992, hepatitis C was prevalent in the supply
of blood products. As a result, 250,000 women today may have
hepatitis C as a result of their C-section deliveries. Only a
fraction know they are infected.
The disease also is spread by drug abusers sharing needles and
by tattoo artists using improperly cleaned needles as well as
through sexual contact. Unfortunately, approximately 40 percent of
people diagnosed with hepatitis C have no clear idea how they were
What Are the Symptoms of Hepatitis C?
Because there is a 10-30 year period between infection and the
onset of the disease, often people don't know they are seriously
ill. The symptoms can resemble a flu and be easily misdiagnosed as
a variety of other illnesses. The symptoms include fatigue,
occasional nausea, liver pain, or depression.
How Serious Is Hepatitis C?
The disease can be deadly. A person exposed to the virus has an
85 percent chance of developing the chronic disease. More than 25
percent of those developing chronic hepatitis C die of cirrhosis or
liver cancer. An estimated 8,000 to 10,000 people die each year of
hepatitis C and this number is expected to triple over the next two
Is There Treatment Available?
Two treatments have proven effective. Both include use of alpha
interferon. Interferon is a naturally occurring protein that fights
the infection and is produced commercially through recombinant DNA
biotechnology. Interferon treatment eliminates the virus in 10 to
20 percent of cases and improves liver functioning in another 10 to
20 percent. When interferon is combined with Ribavirin, the
resulting combination eliminates the virus in 40- 50 percent of
Why Is Hepatitis C Appearing in Middle-Age Women and Why Is
This an Issue For the Society for Advancement of Women's Health
While hepatitis C does not uniquely affect women, we believe
that many women -- particularly those who unknowingly received
blood transfusions during C- section deliveries -- are at special
risk. Health professionals must understand the significance of this
disease and learn to diagnose and treat hepatitis C.
What Is the Federal Government Doing About Hepatitis
The Food And Drug Administration has delayed completion of the
first phase of its "look-back" program until March 1999. The
program will identify those who received transfusions of
contaminated blood donated between 1988 and 1992. Some notification
has already begun.
But the FDA effort leaves out a large number of people who may
have contracted the virus. Persons infected through transfusions
before that date -- including most of the women infected during
C-section births and critically ill newborns -- wouldn't receive
What Should People Do Who Think They May Have Hepatitis
Any concerned individuals should contact their doctor and
request an antibody test for hepatitis C. A positive test result
should be followed by a second test to confirm the virus is
present. The best person to conduct the test is a specialist in
liver diseases -- a gastroenterologist or heptologist.
HEPATITIS C FACTS
Hepatitis C is a chronic blood virus that currently infects
between four and five million Americans. It was unrecognized before
1989 and an effective test to screen blood products for hepatitis C
infection was not developed until 1992. It is spread through blood
to blood contact.
The disease attacks the liver and can be deadly. Eighty five
percent of those exposed to hepatitis C will be infected for life.
Approximately 25-30 percent of those who contract the disease
develop cirrhosis of the liver. Out of that group, 25 percent die
of cirrhosis or liver cancer.
Hepatitis C is spread mainly by direct contact with contaminated
blood. In October 1998, a report called "Hepatitis C: Silent
Epidemic, Mute Public Health Response" was adopted by the House
Committee on Government Reform and Oversight. It estimated that
approximately one million people may have contracted the
potentially fatal liver infection during blood transfusions before
effective screening tests were developed.
It is estimated that 250,000 women may have contracted hepatitis
C through cesarean sections, the most common surgery in the United
States. Transfusions were often given during or after C-sections,
especially in the 1970's and 1980's when the risk of hepatitis C
infection was highest. Women were often unaware they received a
blood transfusion because most of the time they were sedated when
they got blood.
Hepatitis C is often called the "silent epidemic" because the
symptoms are vague or easily misdiagnosed as a host of other
illnesses. Because the virus usually does not produce signs or
symptoms for the first decade, by the time they do appear the
disease has often caused serious liver damage.
A new treatment was approved by the Food and Drug Administration
in June called Rebetron. It is a combination of ribavirin and
interferon. Studies have shown that up to 50 percent of treated
patients were free of detectable virus a year later.
SOURCE Society for the Advancement of Womens' Health Research
; CO: Society for the Advancement of Womens' Health Research; ST:
District of Columbia; IN: HEA MTC; SU: LEG; 10/21/98 14:39 EDT
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