NEW HAVEN REGISTER By Ed Stannard
Published 4:02 pm, Sunday, March 18, 2018
Published 4:02 pm, Sunday, March 18, 2018
NEW HAVEN — The epidemic of opioids, with increased sharing of syringes, has been accompanied by a spike in cases of hepatitis C, which can lead to liver failure and death.
Meanwhile, the lack of an effective test for the viral disease before 1992 and the high rate of injected-drug abuse in the 1970s has led the federal Centers for Disease Control and Prevention to call for all adults born between 1945 and 1965 to be tested for the contagious blood-borne disease.
“We are seeing more cases of recently acquired hepatitis C infection, primarily through young individuals,” said Dr. Joseph Lim, director of the Yale Viral Hepatitis Program.
“This is of great importance … because we have believed that hepatitis C is a curable disease that has been on the decline for the past 20 years,” Lim said. “But very recently, between 2010 and 2015, new hepatitis C infections have tripled in the United States and there is concern in young people between 20 and 29, according to the CDC.”
The CDC reports more than 3.5 million people living with hepatitis C nationally.
The problem is serious enough that in 2014, Gov. Dannel P. Malloy signed into law “a mandate for hepatitis C screening for all baby boomers,” Lim said. “Three-fourths of all patients with hepatitis C are born in those years 1945-1965,” he said.
“The baby boomer peak in 1955 coincides with the peak of drug injection in the late ’60s and early to mid-’70s,” said Robert Heimer, professor of epidemiology and director of the Yale School of Public Health’s Emerging Infections Program.
Hep C “is a very indolent, slow-progressing viral infection,” Heimer said. “It actually doesn’t kill the infected cells.” Instead, the body’s immune system attacks the infected cells, he said. And, while the liver does regenerate, “pockets of cell death called necrosis” develop.
The problem with the disease is that in many cases symptoms don’t occur until years after infection. According to hepchope.com, one in 30 baby boomers is infected and most aren’t aware of it, which is why the CDC is recommending that they be tested. Also, “there remains a stigma between hepatitis C and drug use,” Lim said.
“Many of our patients are individuals who used drugs once or twice but never abused drugs … but now unknowingly have the disease,” he said. “Up to half of all individuals with hepatitis C in the United States remain unaware of infection.”
According to Dr. Richard Martinello, medical director for hospital epidemiology and infection control at Yale New Haven Hospital, 25 percent of those infected with hepatitis C will recover without treatment. The rest, however, “develop a chronic infection,” he said. “They have the virus in their liver; they have the virus in the blood.
“People who have chronic hepatitis C infections often have no symptoms at all. Others may feel tired, fatigued, but often they’re not aware of any problems,” Martinello said.
He said the rate of hepatitis C is “rising directly due to the opioid crisis and one of the most common ways hepatitis is transmitted is through the use of shared needles,” shooting up heroin or methamphetamine.
“It’s a major problem,” Martinello said. “A proportion of persons who have hepatitis C will go on to develop liver failure and that’s a fatal complication … especially if they have other diseases or they’re a drinker.” Cirrhosis is another danger, as is liver cancer.
Besides contaminated syringes, hepatitis C can be spread, at a much lower rate, through blood transfusions and sexual contact. “Sexual transmission of hepatitis C is thought to be very inefficient,” Martinello said. “The rate of the noninfected person becoming infected is pretty low.
TO CONTINUE READING STORY:https://www.nhregister.com/news/article/Opioid-crisis-bringing-spike-in-hepatitis-C-baby-12762567.php
Meanwhile, the lack of an effective test for the viral disease before 1992 and the high rate of injected-drug abuse in the 1970s has led the federal Centers for Disease Control and Prevention to call for all adults born between 1945 and 1965 to be tested for the contagious blood-borne disease.
“We are seeing more cases of recently acquired hepatitis C infection, primarily through young individuals,” said Dr. Joseph Lim, director of the Yale Viral Hepatitis Program.
“This is of great importance … because we have believed that hepatitis C is a curable disease that has been on the decline for the past 20 years,” Lim said. “But very recently, between 2010 and 2015, new hepatitis C infections have tripled in the United States and there is concern in young people between 20 and 29, according to the CDC.”
The CDC reports more than 3.5 million people living with hepatitis C nationally.
The problem is serious enough that in 2014, Gov. Dannel P. Malloy signed into law “a mandate for hepatitis C screening for all baby boomers,” Lim said. “Three-fourths of all patients with hepatitis C are born in those years 1945-1965,” he said.
“The baby boomer peak in 1955 coincides with the peak of drug injection in the late ’60s and early to mid-’70s,” said Robert Heimer, professor of epidemiology and director of the Yale School of Public Health’s Emerging Infections Program.
Hep C “is a very indolent, slow-progressing viral infection,” Heimer said. “It actually doesn’t kill the infected cells.” Instead, the body’s immune system attacks the infected cells, he said. And, while the liver does regenerate, “pockets of cell death called necrosis” develop.
The problem with the disease is that in many cases symptoms don’t occur until years after infection. According to hepchope.com, one in 30 baby boomers is infected and most aren’t aware of it, which is why the CDC is recommending that they be tested. Also, “there remains a stigma between hepatitis C and drug use,” Lim said.
“Many of our patients are individuals who used drugs once or twice but never abused drugs … but now unknowingly have the disease,” he said. “Up to half of all individuals with hepatitis C in the United States remain unaware of infection.”
According to Dr. Richard Martinello, medical director for hospital epidemiology and infection control at Yale New Haven Hospital, 25 percent of those infected with hepatitis C will recover without treatment. The rest, however, “develop a chronic infection,” he said. “They have the virus in their liver; they have the virus in the blood.
“People who have chronic hepatitis C infections often have no symptoms at all. Others may feel tired, fatigued, but often they’re not aware of any problems,” Martinello said.
He said the rate of hepatitis C is “rising directly due to the opioid crisis and one of the most common ways hepatitis is transmitted is through the use of shared needles,” shooting up heroin or methamphetamine.
“It’s a major problem,” Martinello said. “A proportion of persons who have hepatitis C will go on to develop liver failure and that’s a fatal complication … especially if they have other diseases or they’re a drinker.” Cirrhosis is another danger, as is liver cancer.
Besides contaminated syringes, hepatitis C can be spread, at a much lower rate, through blood transfusions and sexual contact. “Sexual transmission of hepatitis C is thought to be very inefficient,” Martinello said. “The rate of the noninfected person becoming infected is pretty low.
TO CONTINUE READING STORY:https://www.nhregister.com/news/article/Opioid-crisis-bringing-spike-in-hepatitis-C-baby-12762567.php
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