Bad Blood Print
Written by Justin Reedy   
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Bad Blood
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ImageAs many as three million Americans are carrying the hepatitis C virus—but most don’t even know it. The UW is trying to solve its secrets before more potential carriers find out.

The gruff circulation manager of the Spokane Spokesman Review was in trouble—Russ Ewan’s heart was failing him, and his doctor told him he had to go through heart surgery.

During his operation in 1983, Ewan had the usual blood transfusions but didn’t think much of it. When he left the hospital, he had a new lease on life. But he had no idea that the transfusions had given him an insidious disease that was lying in wait. He was in the early stages of what would become a chronic infection, one that would not reveal itself until the beginning of the next decade.

Ewan began having problems with his liver several years after his surgery. At that time, newspapers like the Spokesman Review were full of stories of people contracting AIDS through tainted blood transfusions. When he was tested, Ewan found out that the virus he had picked up from the transfusion wasn’t HIV. It was a newly discovered virus called hepatitis C.

Ewan is one of thousands of Americans who unknowingly contracted this mysterious virus from tainted blood in the 1970s and ‘80s, only to have it hang around for many years before showing its deadly potential. Country music star Naomi Judd is one hepatitis C carrier who was diagnosed in 1990, after being stuck with an infected hypodermic needle during her previous career as a nurse. Baywatch’s Pamela Anderson and Aerosmith’s Steven Tyler have announced that they, too, carry hepatitis C.

For many years, scientists and physicians have known about hepatitis A, which is spread through human feces, and hepatitis B, which is spread through bodily fluids via sexual intercourse, drug use and other contact. Both were prolific diseases, but they have since been reined in with protective vaccines and effective treatments.

Hepatitis C, however, is a mystery disease. It was identified in the late 1980s, and it wasn’t until 1992 that scientists developed an adequate screening test. Since then, all donated blood and organs are screened for the hepatitis C virus.

In the U.S., about 12,000 people die every year from hepatitis C-related liver failure, making it a significant cause of death among the general population and the leading killer of people with HIV/AIDS. An estimated three million Americans, perhaps more, are carrying hepatitis C. It is even more prevalent in other countries, especially in Africa, Southeast Asia, and the western Pacific—about 170 million people around the world are chronically infected with hepatitis C.

The UW is a leader not only in treating the disease through drug therapies and liver transplantation, but also in unraveling the mysteries of how the virus affects the body.

Hepatitis C is very difficult to spot during the initial infection. People may have flu-like symptoms, nausea, back pain or fatigue, but most people who are infected have no symptoms at all. In fact, less than half will even develop jaundice, the yellowish skin tint that can indicate liver problems.

“That’s why they often don’t know that they are carrying the virus,” says General Internal Medicine Professor Anne Larson, director of the Hepatology Clinic at UW Medical Center.

“It can take 20 to 25 years for patients to get cirrhosis,” says Laboratory Medicine Professor David Gretch, a medical scientist who studies hepatitis C. “It’s a silent disease, in some ways—at least 50 percent of people in the United States with the chronic infection don’t know they have it.”

In the 1960s and ’70s, up to 30 percent of people receiving blood transfusions mysteriously grew ill, suffering from liver inflammation—also known as hepatitis. Harvey J. Alter, a researcher at the National Institutes of Health, studied samples from the nation’s blood supply for years before finally determining an infection was responsible. Initially known as non-A/non-B hepatitis, the virus was eventually isolated and dubbed hepatitis C.

Before donated blood was screened for hepatitis C, it was probably quite common in the blood supply. Unfortunately, drug users donated blood at plasma centers in exchange for a quick buck. They were much more likely to carry the unknown virus, which – like HIV – can be passed through sharing of dirty hypodermic needles. Scientists estimate that during the 1970s and ’80s, as many as one in 10 units of blood was infected with the virus.

Some people who are exposed to hepatitis C virus don’t actually get infected, and of those who are infected, about twenty percent wind up beating the virus on their own during this so-called “acute” stage.