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Considered one of the newer public health diseases, medical professionals may not be aware of current information concerning diagnosis and medical management of hepatitis C.

1. Less than 50% of local health departments provide hepatitis C counseling and only 23% provide HCV testing.
2. HCV prevalence among prison inmates is 3-5 times greater than in the general population.
3. HCV-associated chronic liver disease is the most frequent indication for liver transplantation among adults.
4. HCV is most efficiently transmitted by exposures that involve direct passage of blood through the skin i.e. a percutaneous exposure.
5. Deaths from hepatitis C among patients co-infected with HIV are expected to increase as antiretroviral therapy extends their life spans.

Therapy options for hepatitis patients have greatly improved, with the recent FDA approval of combination peg interferon. However, treatment does not provide a benefit for all patients and has side effects which should be discussed with the treating physician.

Hepatitis C infection is the most common chronic blood-borne viral infection in the U.S. Formerly known as non-A non-B hepatitis, HCV is estimated to have infected as many as 242,000 Americans annually during the 1980s.

A survey of the non-institutionalized U.S. civilian population found that 3.8 million [1.8%] have been infected with HCV. It is estimated that 2.7 million are chronically infected. These are probably conservative estimates since the survey excluded the incarcerated and the homeless.
Here in Orange County in the year 2000, 2,715 chronic and 4 acute cases were reported to the Health Care Agency. Sixty-four percent of cases were male and 36% female. The mean age was 45.

Dr. Hildy Meyers, Communicable Disease and Epidemiology Medical Director for Orange County Public Health has expressed her concern about this large reservoir of chronic cases.

For reporting purposes, a case of chronic HCV is defined as a person with anti-HCV antibody or HCV RNA or a liver biopsy consistent with chronic HCV infection.

Hepatitis C has been called the silent killer since many individuals are unaware of their infection and the symptoms may not become apparent for 10 to 20 years (or more) after infection.

Testing can identify those individuals infected with HCV but drug therapy is expensive and many of the infected have no health care coverage.

Who should be tested?

• Persons who ever injected illegal drugs, including those who injected once or a few times many years ago.
• Persons who received a blood transfusion or organ transplant before 1992.
• Persons who received clotting factor concentrates before 1987.
• Persons who were ever on long term dialysis.
• Children born to HCV-positive women.
• Healthcare, emergency medical and public safety workers after needlesticks, sharps, or mucosal exposures to HCV-positive blood.
• Persons with evidence of chronic liver disease.

The Orange County Advisory Council on Hepatitis C is currently working on a strategic plan. This plan will include collaboration with public and private providers and education of general public as well as professionals. If you are interested in more information on HCV or the Advisory Council in Orange County, please call Back to Life at (949) 654-4250.

For more information on Hepatitis C, call the California Hepatitis C Resource Center at: 1 (888) 85LIVER
or the Hepatitis Foundation International at: 1(800) 891-0707

Ref. Strategic Plan for Hepatitis C { in process}
Hildy Meyers, M.D.

CDC website: http://www.cdc.gov/ncidod/diseases/hepatitis/c/index.htm

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