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August 5, 2002

Grady opens hep-C clinic

By Alicia Sands Lurry

Three School of Medicine physicians at Grady Hospital have established a hepatitis C Clinic to treat and combat a virus that leads to chronic liver disease in the estimated 3.9 million Americans who have been infected.

The clinic was developed by Grady doctors Natalie Levy, Nomi Traub and Christopher Iverson, and it is designed to educate and treat those diagnosed with the disease about its signs, symptoms and long-term effects. In a five-month period last year, 650 patients at Grady tested positive for hepatitis C, prompting the need for a clinic that specifically treats the virus.

“We’re very excited about the clinic,” Levy said. “Many of our patients at Grady have hepatitis C, and treatment and management of this disease is sufficiently complex that we all sensed a growing need for a specialized program to support them.”

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), found in the blood of infected persons. The virus—considered the most common bloodborne infection in the United States—is primarily spread by contact with infected blood.

While 40 percent of patients do not know how they acquired HCV, the most common known modes of transmission are through intravenous drug use and blood transfusions before 1992. People with high-risk sexual behavior, multiple partners and sexually transmitted diseases also are at a slightly increased risk for hepatitis C.

Although the chronic form of the virus tends to be asymptomatic, some of the signs and symptoms of acute infection may include jaundice, fatigue, dark urine, abdominal pain, loss of appetite and nausea. The disease is typically diagnosed through a blood test. If left untreated for several years, chronic hepatitis C can lead to cirrhosis (scarring), liver cancer, liver failure and death.

At Grady, patients who test positive for hepatitis C are encouraged to enroll and participate in an hour-long group education session, where they see a video and are able to ask questions about the virus. Patients are then invited back to an individual session at the clinic. So far, the clinic has treated about 100 patients.

Currently, there is no vaccine to prevent hepatitis C. The best preventions are to avoid intravenous drug use and not to share personal care items that might have blood on them (such as razors or toothbrushes).

Health care or public safety workers should always follow routine barrier precautions and safely handle needles and other sharp objects. People with multiple sexual partners should use latex condoms to reduce transmission, and all those at risk should get vaccinated against hepatitis A and hepatitis B to protect against other kinds of preventable liver diseases.

Interferon and ribavirin are the two drugs licensed for treating people with chronic hepatitis C. While interferon can be taken alone or in combination with ribaviran, combination therapy currently is the treatment of choice. Combination therapy is known to eliminate the virus in up to five out of 10 persons.

According to the Centers for Disease Control and Prevention, the number of new hepatitis C infections per year has declined from an average of 240,000 in the 1980s to about 40,000 in 1998. By the year 2000, the number of annual infections had declined to 30,000.