Women At Special Risk of Hepatitis C: Health Group Urges Government to Act Now


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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 section childbirth.

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.


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 infected.

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 decades.

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 cases.

Why Is Hepatitis C Appearing in Middle-Age Women and Why Is This an Issue For the Society for Advancement of Women's Health Research?

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 C?

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 notification.

What Should People Do Who Think They May Have Hepatitis C?

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 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 http://www.prnewswire.com

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