Hepatitis C Kills More Than HIV

Alex Monto, MD

Hepatitis C virus — not AIDS-causing HIV — is the leading chronic virus infection leading to death in the United States, and its victims most often are baby boomers. More than half who are infected do not know it. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) found in a study published in the February 21 issue of the “Annals of Internal Medicine” that hepatitis C had overtaken HIV as a cause of death in the United States by 2007. Deaths in the United States due to HIV infection have been steadily decreasing, and dropped below 13,000 in 2007, while deaths from hepatitis C infection have been steadily increasing, first surpassing 15,000 per year in 2007. The good news, according to UCSF liver specialist Alex Monto, MD, is that there has been progress in fighting both diseases, and the kinds of drug combination strategies that have done so much to transform HIV infection from a death sentence to a manageable disease are poised to further boost cure rates for those infected with hepatitis C. “We know that not enough people with risk factors get tested,” Monto said. “There are a lot of people walking around with hepatitis C who don’t know it.” Monto directs the liver clinic at the UCSF-affiliated San Francisco Veteran’s Affairs Medical Center, one of four hepatitis C centers nationally within the VA system. Like boomers, veterans are disproportionately affected by hepatitis C. The VA cares for 165,000 patients who are chronically infected with the virus. Chronic Hepatitis C has been diagnosed in about three million people in the United States. It often causes no symptoms, and many who have been infected for years or even decades may remain unaware of it until symptoms finally appear. The ultimate cause of death attributable to chronic infection is cirrhosis or liver cancer, although the disease progresses to cirrhosis in fewer than half of cases. There is no vaccine. “The main risk factor in the United States is past injection-drug use,” Monto said “The others most at risk are those who received blood transfusions before 1992,” he said, referring to the year when high-quality screening of the blood supply was implemented.
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