Hepatitis C a liver disease caused by the hepatitis C virus (HCV) is spread through blood-to-blood contact with an infected person. As with HIV, the immune system is usually unable to fight off HCV, and like HIV, HCV appears to be able to mutate to avoid the immune response.
The Centers for Disease Control estimates that injection drug use accounts for 60 percent of all new cases of hepatitis C and sexual transmission accounts for another 15 percent. Other ways HCV can be spread include blood transfusions (before 1992), or exposure to blood from tattooing with unclean needles, or sharing personal items such as razors and toothbrushes that might have blood on them. The virus can also be passed from a mother to her unborn child.
About one million people are living with HIV in the United States, but an estimated 3.9 million people two percent of the population carry the hepatitis C virus. Alarmingly, few of these carriers even know they're infected. However the number of new infections each year has declined from an average of 240,000 in the 1980s to about 25,000 in 2001.
Fifteen percent of infected people have a strong enough immune response to clear the virus spontaneously within a few months of infection, but eighty percent of those exposed to HCV develop chronic hepatitis C. One in five people who are chronically infected develop liver cirrhosis (scarring of the liver) which can lead to liver failure and liver cancer.
Public awareness about hepatitis C has been poor largely because there are often no symptoms when a person is first infected with HCV. With chronic infection, HCV incubates slowly and may not manifest itself for up to 20 years, or until serious liver damage occurs. It is not known why the disease progresses more quickly in some patients than in others, however if a person is aware that they are infected liver disease progression can be monitored by performing a biopsy every 3-5 years.
HIV/Hepatitis C Coinfection
Though HIV has become a chronic manageable disease for many people, liver disease is an increasing danger for individuals coinfected with both viruses. HIV appears to accelerate the progression of hepatitis C, and HCV-related liver failure can develop even if the patient's HIV is under control.
Sources: "Hepatitis C," Newsweek, April 22, 2002; "An Examination of HCV and Co-Existing Medial Conditions," WebMD.com; "Hepatitis C and Hepatitis C-HIV Co-Infection Handbook, Version III," AIDS Treatment Advocacy Project, prepared by Jules Levin, March 2002.
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