Noodle Padoodle

The Silent Epidemic

Because so many people were infected before the disease was discovered, and it can take decades to discover the infection, this disease is a silent epidemic.  The majority of the people already infected don’t know they have it. It is suspected that there are, at present, more than 5 million people in the United States that are infected with Hepatitis C, and perhaps as many as 200 million around the world. This makes it one of the greatest public health threats faced in this century, and possibly one of the greatest threats to be faced in the next century. Without rapid intervention to contain the spread of the disease, the death rate from hepatitis C will surpass that from AIDS by the turn of the century and will only get worse.

In my case, I was infected in 1989, when a drunken PASSENGER grabbed the wheel of my car and wrestled it from me. We went over an embankment, and I went through the driver’s side window. (I wear seatbelts now, and chose my friends more wisely). After being rushed by ambulance to the nearest hospital, I received a transfusion that was contaminated with the Hepatitis C virus. Twenty-two years later, I was in another accident, and through an uncommon series of events, we discovered the virus. 

What Is Hepatitis?

Hepatitis B (Hep B) and Hepatitis C (Hep C) are similar, but are caused by structurally different viruses. The word hepatits, like so much medical language, comes from Greek, and means simply "liver inflammation". Hepatitis B is a DNA virus, and Hepatitis C is an RNA virus.  This RNA virus is particulary small, and mutates rapidly, which is what mades it so very difficult to kill. It can cause painful swelling, cirrhosis, and liver damage, sometimes bad enough to cause the liver to stop working.

Hep B and Hep C can be latent (very low level), active (initial infection), or chronic (life-long high level). Your doctor will tell how well your liver is working by measuring your liver enzymes. If your enzymes are high, this indicates that liver damage is occurring. Your liver is working overtime to deal with your infection. But if you've had hepatitis a long time, and have sever liver damage, your enzymes might be low because the liver can't produce them. This can trick you and your doctors into thinking that everything is really all right.

Liver damage mild to moderate liver damage can NOT be seen on a CT (‘cat’) scan, x-ray, MRI, or ultrasound. Severe liver damage (cirrhosis) will be visible, but not until this has occurred is it detectible in non-invasive ways. The only way to know is with a liver biopsy.

Something new are viral load measurements (PCR) of Hep B DNA and Hep C RNA, which gives you an actual count of viral activity. The count will be high or low depending on how active your Hepatitis virus is.
There are in fact two kinds of RNA viruses - those that have a "sense" strand of RNA (coded information about how to build proteins) as their genetic material, and those that have an "antisense" strand (the paired opposite of the coded information). Hepatitis C is of the "sense" type.

Sense RNA viruses have an extremely powerful approach. Because their information is stored in a sense strand, the viral RNA itself can be directly read by the cell's ribosomes, functioning like the normal mRNA present in the cell. The virus thus needs to carry nothing with it. It uses the cell's own ribosomes to synthesize the RNA transcriptase it will need for reproduction, and once this is done, it creates an antisense version of itself as a template for the creation of new viral RNA. The new viral RNA can itself be used to synthesize more RNA's and the necessary viral proteins. The fact that their genes can be directly read by their host cells means that these types of RNA viruses are incredibly simple, requiring only small amounts of genetic material to encode the information necessary for their survival, and requiring no additional enzymes to be packaged into their cores. Some of our most deadly viral enemies are of this type. Hepatitis C is such a virus.

It is important to recognize that the HCV virus is extremely long lived. In a single drop of dried blood, the virus will live for three months. Understand, this dried drop of blood can be infectious. Get it into an open cut, and you have the risk of being infected. The good news is that at least it is difficult to transmit. After 12 years of marriage, and 10 years of unprotected sex, my husband (and our three children) have tested negative for the disease. In order to reduce risk, never have sex during your period, don’t share toothbrushes, earrings, tweezers, and don’t share razors.

Be sure to keep rubber gloves in your house in case of serious injury. About three months before I knew I was infected, I made the mistake of trying to coax my cat out from under a car after some fireworks, and was viciously mauled. Holding tightly to the terrified cat, I ran, bleeding all over myself, the cat, and the neighbors’ driveway, all the way into the kid’s bathroom, where I dropped the cat and shut the door. The cat shook itself, and sprayed my blood all over the walls. After I found out I had hepatitis C, I went back and wiped the walls, first with chorox, then with hydrogen peroxide.