ABCs of hepatitis, The

Electrical Apparatus, Mar 1998 by Elsberry, Richard B

Feeling tired and experiencing flu-like symptoms? It may not be the flu at all

AT ACHY, RUN-DOWN condition and lack of appetite may be hepatitis, an insidious viral infection that will over time result in cirrhosis or liver cancer. Or worse.

You could unknowingly be infected with the most virulent and dangerous form of hepatitis, yet remain symptom free for years or suffer only from minor fatigue. With hepatitis, the more severe the onset of symptoms, the more likely you are to recover.

Hepatitis comes in three varieties, A, B and C. The only one that does not develop into a chronic disease is hepatitis A. It is transmitted through dirty hands or contaminated water or food, particularly shellfish. Hundreds of school children were recently exposed to hepatitis A after eating contaminated strawberries from Mexico. It invariably manifests itself as a non-fatal, short term stomach ailment that clears up completely.

Far more serious is hepatitis B, which is transmitted through infected blood and bodily fluids and is 100 times more contagious than the AIDS virus. It can result in acute (short term) or chronic illness, causing abdominal pain and swollen joints while simultaneously ravaging the liver.

An estimated 250,000 Americans contract hepatitis B in any given year. Once contracted the cure rate is less than five percent. Both hepatitis A and B can be prevented by long-lasting vaccinations. But no vaccine has yet been developed for hepatitis C and none is on the horizon.

Few know they have it

An estimated 3.5-4 million Americans are believed to be infected with this incurable virus, which kills 10,000 people annually. But because it produces few overt symptoms, only one in ten of those who have it know it. Many have been silent carriers for years. Some 180,000 new cases of hepatitis C are diagnosed in the U.S. each year, the majority as a result of a routine liver-function test or when donating blood.

Prior to 1989, hepatitis C didn't even have a name, and there was no test to isolate it. It was formerly known as non-A non-B. Hepatitis C is transmitted mainly through blood. Intravenous drug use with unclean needles is currently the most common mode of transmission, but transfusions, sexual intercourse, accidental needle pricks, and sharing an infected person's toothbrush or razor also provide avenues for infection.

Epidemiologists also believe infection can result from certain lifestyle decisions-such as having your nose or ear pierced to accommodate a ring, or being tattooed-if strict hygienic measures are not followed. Still, in some 40% of cases the source of the infection is unknown.

Hepatitis C was one of the complicating factors leading to the late Baseball Hall of Famer Mickey Mantle needing a liver transplant. Another afflicted celebrity is Naomi Judd, half of the mother-daughter country music duo, who has had to give up her singing career.

Liver failure

Nationally, 85% of those who contract hepatitis C develop liver failure. Severe cases invariably result in jaundice, a yellowing of the skin and eyes caused by malfunctioning of the liver. While there is no drug that can wipe out the virus, its ravages can be reduced and delayed by injections of interferons, synthesized versions of the body's own immune system infection fighters. To be effective they generally are administered weekly over a 6-to-12 month period.

Because heavy use of alcohol also promotes liver damage, anyone diagnosed with hepatitis B or C must abstain from drinking alcoholic beverages. Testing for the hepatitis virus should be a regular part of your annual physical checkup. The consequences are too serious for it not to be.

For more information:

* Counseling and information are available from The Hepatitis C Foundation, (800) 324-7305, http://www.hepcfoundation. org, and The Hepatitis Foundation International, (800) 891-0707, http:// www.hepfi.org.

* "Preventing Hepatitis B" and "Hepatitis C" are booklets available in packs of 50 from Krames Communication, 1100 Grundy Lane, San Bruno, Calif. 94066, (800) 333-3032.

* "Hepatitus B: The Enemy Within" and "Hepatitis C: The Silent Scourge" are 23minute color videos available for $99 each from Films for the Humanities & Sciences, PO. Box 2053, Princeton, N.J. 08543, (800) 257-5126.