Facing the ‘Hep C’ Crisis

Mounting evidence suggests that hepatitis C, a little known but often fatal disease, has reached epidemic proportions in the state, infecting half a million Californians and 41% of the state’s prison population.

Despite its prevalence, which public health experts call “mind-boggling,” state officials are only now considering programs to diagnose and treat the disease, which typically spreads among drug addicts sharing infected needles or having unprotected sex.

The state’s reluctance to confront “hep C” is particularly unfortunate because early detection is key to treating this “silent killer,” so named because of its ability to wreak havoc on the liver years before any symptoms surface. When identified early, hep C can be treated with medication, dietary change and even gene therapy. Left untreated, liver failure is common. It is the leading factor for liver transplants in the United States.

The logical place to begin reining in the epidemic is the California state prison system, which houses the largest concentration of hep C victims in the nation. In a letter to Youth and Adult Correctional Agency Director Robert Presley last December, California Department of Corrections Director Cal Terhune said he will “continue to monitor” the disease. He suggested a study of whether inmates in a drug counseling program at San Quentin state prison have contracted fewer cases of hep C. But that’s a far too cautious response to a disease that is, as Jeff Thompson of the California Correctional Peace Officers Assn. puts it, “running rampant in our prisons.”

State legislators and Gov. Gray Davis can and should move with more urgency and approve $5.2 million that the state Senate recently set aside to start hep C testing, prevention and treatment programs in all state prisons. State leaders should also approve another $5 million the Senate set aside to fund a bill by state Sen. Richard Polanco (D-Los Angeles) that would develop a statewide plan for slowing the spread of hep C. The study would help fund efforts like some undertaken last year in Riverside County, which tested 2,009 adults in its jails and found that a “staggering” 24% were infected with hep C. Hep C is far more deadly and expensive to treat than its biological cousins--hepatitis A, a common and highly treatable liver infection typically spread when food handlers fail to wash their hands after using the bathroom, and hepatitis B, a more serious but still curable blood-borne viral disease.

From another quarter, Congress should prod Veterans Administration officials into better care of the other key group in which the disease is concentrated, military veterans. Federal surveys indicate that the rate of infection among veterans is four to five times higher than in the general population and that the rate among the 8.1 million Vietnam-era vets is even higher. But VA doctors will currently treat only veterans who can prove that their hep C infections are service-related.

Congress can correct that blunder by passing identical bills by Rep. Vic Snyder (D-Ark.) in the House and Sen. Olympia J. Snowe (R-Maine) in the Senate that would compel the VA to treat any veteran with hep C. Taken together, these modest steps will help rein in an underrecognized disease that public health officials say will be killing more Americans annually than AIDS by 2010.