Higher Rate of Hepatits in Native Americans

Pythoness · #1 03-25-2008, 07:20 PM

ndian clinics uncover high rate of hepatitis C
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An epidemiological study conducted at 2 Indian Health Service (IHS)
clinics in Montana uncovered a hepatitis C infection rate that is 6
times higher than is found in the general population. The finding
surprised tribal and state health officials, who responded by
creating an educational brochure that targets young American Indians.

The 2005-06 study, authored by IHS epidemiologist Christine Dubray,
revealed a 6 percent hepatitis C infection rate among women who went
to the clinics for prenatal care. Only about one percent of people in
the US population has hepatitis C, Dubray said. "We have an
unexpected number of young women with hepatitis C infection," she
said. "In the general American population, the prevalence of
hepatitis C is much lower in young women."

Hepatitis C is a virus that can lead to serious liver damage and
death. It is spread through contact with infected blood and cannot be
cured. "There is a treatment for hepatitis C," said Dubray, who is
based in Albuquerque, New Mexico. "It doesn't work for everyone, but
there is a treatment. It's not hopeless."

During the 13-month period of Dubray's study, 205 women were screened
for the virus, and 13 tested positive. It is thought that the women,
who were probably exposed to the virus as teenagers or very young
adults, contracted it through intravenous drug use. The study did not
examine what kind of drugs might have been used.

Although the study examined only American Indian women, it is likely
that other groups of young Montanans would also have higher than
expected hepatitis C infection rates because of drug use, said Laura
Baus, hepatitis C coordinator for the state Department of Public
Health and Human Services. "Whether American Indian or Caucasian,
there's no division there," Baus said of hepatitis C infection among
the state's youth. "We're seeing it in both populations."

Nationwide, the average age at a hepatitis C diagnosis ranges from 40
to 59, Baus said. "What we're seeing in Montana is we're averaging 15
to 24," she said. "We're seeing them younger."

About 9000 Montanans are known to have hepatitis C, which the state
tracks as a reportable disease. Officials think another 5000 people
are infected but don't know it, Baus said. Symptoms often do not
develop until years, and sometimes decades, after infection occurs.

Between 75 percent and 85 percent of people who are exposed to the
virus become what is called chronically infected, according to the
Centers for Disease Control and Infection (CDC). The rest "clear" the
virus. About 3.2 million Americans are chronically infected with
hepatitis C. Intravenous drug use is the most common infection source.

Tribal and state health officials used Dubray's study for the basis
of an educational brochure that will be distributed via Montana IHS
clinics and other outlets on the state's reservations. "After
Christine's work, it was obvious we needed to do a public-health
initiative," said Jennifer Giroux, an epidemiologist with the Rocky
Mountain Tribal Epidemiology Center in Billings. "If we don't get the
information out there to the public, what good is having looked?"
Giroux asked. The brochure, an educational medium favored by CDC, was
designed specifically for American Indian consumers, Baus said. "One
size doesn't fit all," she said. "You have to gear it toward your audience."

[Byline: Diane Cochran]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Hepatitis C virus (HCV) infection can cause liver inflammation
(hepatitis) that is often asymptomatic, but ensuing chronic hepatitis
can result later in cirrhosis (fibrotic scarring of the liver) and
liver cancer. Transmission of hepatitis C occurs when blood from an
infected person enters the body of a person who is not infected.
Hepatitis C virus is spread predominantly through sharing needles
when injecting drugs, through needlestick injuries, or through
accidental occupational injuries, or from an infected mother to her
baby during birth. There is no preventative vaccine, but current
guidelines recommend that hepatitis C patients be vaccinated for
hepatitis A and B if they have not yet been exposed to these viruses,
as this would radically worsen their liver disease.

Recent estimates indicate that hepatitis C virus infects affect 170
million people worldwide and 4 million in the United States. There
are about 35 000 to 185 000 new cases a year in the United States.
Co-infection with HIV is common and rates among HIV positive
populations are higher. 10 000-20 000 deaths a year in the United
States are from HCV; expectations are that this mortality rate will
increase, as those who were infected by transfusion before HCV
testing become apparent.

Interferon and ribavirin are 2 drugs licensed for the treatment of
persons with chronic hepatitis C virus infection. There are 6
genotypes of hepatitis C virus (and sub-strains) with distinct
prognoses and responses to treatment. Combination therapy, using
pegylated interferon and ribavirin, is currently the treatment of
choice. Combination therapy can get rid of the virus in about 5 out
of 10 persons for genotype 1 and in up to 8 out of 10 persons for
genotypes 2 and 3. It would be interesting to know whether the
hepatitis C virus serotypes prevalent in the American Indian
population on Montana differed in any way from that of the general population.

The state of Montana and Billings can be located in the
HealthMap/ProMED-mail interactive map of the USA via
<http://healthmap.org/promed?v=40,-97.6,4>. - Mod.CP]

Rusty · #2 03-25-2008, 07:27 PM

These Americans are the most forgotten group in our society.

Higher Rate of Hepatits in Native Americans

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