The CDC estimates that there are 36,000 new infections in the United States (1996 estimates). While 25-30% of infections are symptomatic, chronic infection occurs in 85% or more of infected persons. Deaths from chronic liver disease, a result of HCV, are estimated to be 8,000-10,000 a year. HCV is the leading indicator for liver transplants in the US. Approximately, 3.9 million (1.8%) Americans have been infected with HCV of whom 2.7 million are chronically infected.

Based on the US Census population estimates for July 1, 2000, estimates for HCV infection in NH are 22,032 and 11,106 in VT. Of these, 85% or more, would be estimated to be chronic, 18,727 NH and 9,440 in VT.

TESTING:

The earlier you are diagnosed and begin to treat hepatitis, the more likely you are to prevent complications from the disease, minimize potential damage to your body, and avoid spreading the disease to others. If you think you may have been recently exposed to hepatitis, have symptoms (yellow eyes, dark urine, stomach ache, fatigue, loss of appetite, nausea, vomiting, fever) or suspect that you might have had hepatitis at some point in your past, it's a good idea to get tested.

A blood tests screens for specific antibodies. Your doctor can determine exactly what type of hepatitis you have as well. For persons who think they may have had an acute infection with hepatitis, the doctor will be able to tell if you now have a chronic form of the virus. Eighty five percent of those infected with hepatitis C will become chronically infected.

Who should be tested?

Testing of pregnant women should include hepatitis B screening. Women who are found to be infected with hepatitis need to be followed during their pregnancy by physicians which understand their risks and needs. Appropriate prenatal care can significantly reduce the risk of transmitting disease.

The following are considered risks for HCV. Persons who have engaged in these behaviors should consider testing:

• Sharing drug paraphernalia (needles, straws, cookers, etc)
• Tattooing, body piercing, sharing tooth-brushes, manicure equipment, or razors
• Receiving blood products prior to 1993
• Unprotected sex
• Occupational exposure (health care worker receiving a needle stick)
• From mother to baby

Where to go for testing?

Hepatitis tests are available at most doctor's offices, Planned Parenthood, medical clinics and at some public-health clinics. As part of special awareness campaigns, testing may be offered at other places (i.e. AIDS service organizations). (create link to ASO page.9) Home Access does offer a home test kit for HCV.

More Information on Testing:

• National Guidelines for the Management of the Viral Hepatitises A,B, and C.
• Testing and counseling guidelines for VA Health Care Practitioners
  
  

PREVENTION

There is no vaccine to prevent hepatitis C. The same strategies used for HIV prevention work in preventing the transmission of viral hepatitis. These strategies include: safer sex practices; safer drug use; and prenatal testing.

Safer Sex Guidelines:

• Use of condoms and barriers for all penetrative acts including anal and vaginal intercourse as well as oral sex;
• S & M or rough sex which does not involve blood. When shaving, separate razors should be used. For piercing, use separate needles if possible. If not, soaking in bleach will reduce transmission of HIV, but is less clear for HCV.
• Sex toys should not be shared unless a new condom is used each time.

Drug use guidelines include:

• Not sharing straws;
• Not sharing needles and using needle exchange programs where possible, if no exchange program is available, find a doctor who will write a prescription for needles and syringes;
• Instead of shooting drugs up with a needle, try snorting (sniffing); smoking (chasing the dragon) or keestering (inserting them in the rectum);
• Use an area for shooting up that is clean. An inside unused section of the newspaper is a clean work surface). Do not share works, ties, cooker, cotton and water.

Other Prevention and Immunization Links

• MMWR Recommendations for Prevention and Control of HCV Infection and Related Chronic Disease.
• National Guidelines for the Management of the Viral Hepatitises A,B, and C

• The Hepatitis Report: A critical Review of the Research and Treatment of Hepatitis C and Hepatitis C and HIV Co-infection.
• National Guidelines for the Management of the Viral Hepatitises A,B, and C
• Liver Biopsy Questions and Answers: The following Q & A sheet has been developed by Twin States Network for persons who are considering a liver biopsy.
• Hepatitis C: Treatment Alternatives from the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM).
• A comprehensive guide for Veterans infected with Hepatitis B and C.
• Liver transplant information and resources