HEPATITIS EMBARKS ON SILENT EPIDEMIC

Most victims are unaware of virus

A silent and deadly epidemic is sweeping through Massachusetts and
the nation and most of its victims don't even know they're infected.

More than 100,000 people in the Bay State - and 4 million nationwide -
are believed to carry the fatal hepatitis C virus. That's four times
the number thought to be infected with HIV.

"The seriousness of the situation wasn't apparent until recently,"
said Dr. Jerome Groopman, an infectious disease specialist at Beth
Israel Deaconess Medical Center who is studying the virus.

Hepatitis C, a blood-borne virus which is contracted much like HIV,
usually shows no symptoms for at least 10 years. In that time,
however, the virus is doing its dirty work, eating away at the
person's liver.

By the time most who have it find out they are infected, it's too
late. A liver transplant is usually the only hope.

The disease, which was only discovered 10 years ago, is incurable
unlike hepatitis A and B. Two new drugs are showing some effectiveness
in slowing the deterioration of patients' livers.

In September, the U.S. Public Health Service issued a call for some
300,000 people who received blood transfusions prior to 1992 to be
tested for hepatitis C.

While no official government call has been issued for those besides
transfusion recipients to get tested, Groopman and others say it
wouldn't be a bad idea for anyone else who may be at risk to get a
test. That exam isn't part of a usual physical and at-risk people
should ask specifically for the blood test.

Included in the at-risk category are those who have injected drugs or
who work in a job that puts them in contact with human blood.

But many others who probably don't think they are at risk may also
face the deadly disease.

In this group are those who have engaged in sex with multiple partners
or snorted cocaine via a shared straw or dollar bill. Even those with
tattoos or body piercings may be at risk.

For these people, the risk is small but real, Groopman
said.

Cocaine snorters face risk because cocaine powerfully constricts the
blood vessels in the nose, and the result is often ulceration of the
nasal lining and pinpoint bleeding.

When someone infected with hepatitis C inhales cocaine through a
straw, microscopic droplets of blood-tinged mucus collect at the upper
end of the straw and form a scrim of virus-laden material, according
to Groopman.

Sharing the straw moves the virus around a circle of users, with each
subsequent user inhaling the virus, along with the drug, into the
vulnerable nasal lining.

Groopman compares the risk to that of getting infected with HIV
through oral sex. Rare, but possible.

An internationally known AIDS doctor and researcher, Groopman said
hepatitis C is even harder to figure out than HIV.

"It can't be grown outside the body," he said. "No one has figured out
a way."

And it mutates repeatedly, meaning it will be tough to come up with a
vaccine to prevent it.

Groopman said funds for research on hepatitis C are sparse - with the
National Institutes of Health providing only about $25 million per
year. That compares to about $1.5 billion for AIDS.

"The government needs to invest seriously now to get a breakthrough,"
he said.

But that may not happen until tens of thousands of baby boomers start
needing liver transplants.

Wayne Strong, 54, got hepatitis C through his work as a Boston EMT. He
found out in 1992, when he landed in the hospital with what he thought
was a heart attack.

Today, the Melrose resident and father of five is on a transplant list
and has been unable to work for a year.

"Hepatitis C, you can't stop it," he said. "It works its way in and

begins to kill."

By the time he found out he had it, his liver was already too damaged
for any of the treatments available at the time.

"I was beyond the drugs," he said.

Now, just marking time until he gets his transplant, Strong said he
isn't surprised that medicine hasn't paid much attention to hepatitis
C until now.

"I've been around medicine for many years," he said. "There are a lot
of realities we don't talk about. There's a lot of politics. It's not
a popular thing right now. The other diseases are at the head of the
list. When the politicians get on the bandwagon, it will happen. It's
like anything else."

Checked-by: Rich O'Grady