SILENT EPIDEMIC HEPATITIS C HAS U.S. TAKING NOTICE

OraSure Technologies Is Developing A Diagnostic Test To Detect The
Disease Earlier

The reckless excess of the 1970s came back to haunt Jim Weaver in
1999, when he donated blood at his church.

Routine screening found the Lehighton resident had hepatitis C, a
potentially deadly liver disease. A family man with a factory job, he
traced his infection to an earlier life, when he experimented with
intravenous drugs.

"It's like somebody in your family dies when you get diagnosed," he said.

Hepatitis C kills as many as 10,000 Americans a year, a figure that
is expected to double or triple in the next decade or so, surpassing
annual AIDS deaths, according to the Centers for Disease Control and
Prevention.

Nonetheless, it is known as a silent epidemic because infections
often go undetected for years, even decades. The CDC estimates that
4.1 million people in this country, or nearly 2 percent of the
population, have the disease, although fewer than half are aware of it.

However, a new diagnostic test under development by OraSure
Technologies of Bethlehem could soon reduce the ranks of people who
- -- like Weaver, before his accidental discovery -- don't know they
are hepatitis C-positive.

OraSure is the company that created the first U.S.-approved rapid HIV
test, OraQuick, which can detect the AIDS virus in blood or saliva in
less than 20 minutes. Its hepatitis C test is supposed to work the same way.

Such ease of use and speed could have a major impact on the fight
against hepatitis C, much as it has with HIV/AIDS, according to
health officials and activists. Primarily, they say, it would prompt
more people to seek treatment and make lifestyle changes that can
head off more drastic measures, such as liver transplants.

"It's an important piece of health information," Ian Williams, head
of hepatitis epidemiology at the CDC, said of diagnosis. "Earlier is better."

Shortly after donating blood at his church, Weaver began to show some
of the symptoms of acute infection -- weight loss, fatigue,
confusion. His name was put on a liver transplant list.

But he had recently quit drinking alcohol. And with the addition of a
new diet heavy on fruits and vegetables, his liver function made a
dramatic turnaround. Transplant plans were scrapped.

"I still eat pepperoni pizza -- but only once in a while," said
Weaver, now 51 and leader of the Hepatitis C Support Group of the
Lehigh Valley. "It's a different way of living, but it beats the alternative."

Getting the facts

Hepatitis C, discovered in 1989, eight years after the first case of
AIDS was diagnosed, is caused by a virus that lives in blood. It has
spread primarily through intravenous drug use and blood transfusions,
and to a lesser extent through other routes, such as sex and
health-care worker needle sticks.

More than half of people infected with hepatitis C eventually become
chronically ill; two-thirds of those develop liver cirrhosis, making
it the leading reason for liver transplants. While the disease can
sometimes be cured through potent chemotherapy, such treatment has
only a one-in-three chance of success.

The rate at which hepatitis C is spreading in this country has slowed
dramatically. The number of new cases has dropped from an estimated
peak of 240,000 a year in the 1980s to 26,000 in 2004, according to the CDC.

But the bulk of hepatitis C carriers are baby boomers. And since the
disease tends to go undetected until people are into middle age --
all boomers are now at that stage -- epidemiologists are bracing for
a surge of acute cases.

"When you look at death certificate data, it does look like that
takeoff is starting to happen," the CDC's Williams said.

Pennsylvania began tracking hepatitis C cases in 2002. The number of
new cases increased steadily over the next three years, from 6,800 in
2002 to 10,400 in 2005, a 53 percent increase.

The number of new cases in Allentown jumped fivefold during the same
period, to 493 in 2005. Preliminary data for 2006 shows a decrease in
new cases, suggesting high-risk populations have been thoroughly canvassed.

Giving a face to the problem

Robert Csandl, executive director of Keenan House, a drug treatment
facility in Allentown, estimated that more than half of his clients
are hepatitis C-positive.

One such person is Joseph Bailey, 47, who was recently paroled to
Keenan House after a 31/2-year prison sentence. He believes he
contracted the disease from a prison tattoo, although there's really
no way to know for sure; he also acknowledged trying intravenous
drugs in the mid-1980s.

When he confides to others that he has hepatitis C, he said he
usually gets the same nonchalant response:

"'Yeah, me too."'

Beyond the prisons and drug treatment facilities where hepatitis C is
so common, the reaction can be quite different. At a recent gathering
of Weaver's Hepatitis C Support Group, which meets monthly at Sacred
Heart Hospital in Allentown, several participants described the
stigma associated with their illness.

"People assume you got it through drug use-Everyone thinks, 'It
serves him right for sticking that needle in his arm,"' said Marjorie
Wharton, 50, of Bethlehem.

In Wharton's case, transmission occurred during a blood transfusion
when she was treated for cancer as a teenager. A transfusion, after a
car accident in 1971, was also the likely culprit for James Bradley,
70, of East Allentown, who had a liver transplant nearly a decade ago.

Barbara Christman, 56, of Macungie, believes she contracted hepatitis
C cleaning surgical instruments for her father, a doctor. She was
diagnosed several years ago. "I lost a lot of friends as soon as they
knew," she said.

And that wasn't all. Her marriage of 20 years soon ended, as well.

"The most underreported aspect of hepatitis C is the damage it does
to relationships," Weaver said. "It breaks up families."

The OraQuick HIV test upon which the hepatitis C test is being
modeled is about as easy and quick as a home pregnancy test: One uses
a swab to capture saliva from the mouth; the swab is then inserted
into a plastic receptacle that indicates after 20 minutes whether the
test is positive or negative.

By comparison, the current method of testing for hepatitis C requires
a blood sample to be analyzed by a laboratory, which means people
typically have to wait at least a week for the results.

OraSure expects to begin formal hepatitis C test trials this summer
and to seek Food and Drug Administration approval by the end of the
year, said company Chief Executive Officer Douglas Michels. It hopes
to begin selling the test by the second half of next year.

Timothy Friel, an infectious disease specialist at Lehigh Valley
Hospital, said the public's understanding of hepatitis C is at least
a decade behind that of HIV/AIDS. OraSure's new test could help to
close that gap, he said.

"It allows you to take that testing technology out onto the street,"
he said. "It's definitely going to get people talking."

[Sidebar]

Hepatitis C Questions And Answers

What is it? A liver disease caused by the hepatitis C virus, which is
found in blood.

How do you get it? Leading causes include intravenous drug use,
health-care worker needle stick accidents, and blood transfusions and
organ transplants before 1992.

How many people are infected? An estimated 4.1 million Americans, or
1.6 percent of the population. Only one-fourth of them have been diagnosed.

What are symptoms: More than half of people infected become
chronically ill. Two-thirds of those develop liver disease. Hepatitis
C is the leading cause of liver transplants.

Is it deadly? Yes, but not necessarily. About one-fifth of people
with the disease die of it.

Is it treatable? Yes. Therapy can cure about one-third of infected
Americans. For those who can't be cured, lifestyle changes can help
to manage the disease.

How does it compare to other forms of hepatitis? There are vaccines
for hepatitis A and B, but not for hepatitis C. While hepatitis B is
spread through many of the same routes as hepatitis C, hepatitis A is
associated with food poisoning.

Source: Centers for Disease Control and Prevention