Wrong, Pamela, there is a cure

[Guest guest]

Wrong, Pamela, there is a cure

(Filed: 28/04/2005)

Lack of public awareness - and funding - is holding back the treatment of

hepatitis C. Barbara Lantin reports on a medical 'timebomb'

Three years ago, when actress Pamela went public about being

infected with hepatitis C, health education campaigners were delighted that

a celebrity had brought the virus out of the shadows.

Pamela thought hepatitis C was incurable

But delight turned to dismay, however, when asserted -

erroneously - that there was no treatment or cure for her condition.

In an interview last week, the former Baywatch star told a newspaper: " The

doctor said 'you have a glitch with your blood.' He told me I had hepatitis

C. I asked how I could get rid of it, and he said, 'Well, you can't'. "

As those who work with hepatitis C patients know, that is no longer the

case.

" We have a major problem in this country with very few people being

treated, " says Gore, chief executive of the Hepatitis C Trust. " One

of the reasons is that people are not aware that a cure is available. If you

think you may have the disease, but believe there is no cure, you may feel

there is no point in getting a diagnosis. "

Of the estimated 200,000 to 500,000 people who are infected with the

hepatitis C virus (HCV) in Britain, only 50,000 have been diagnosed. The

rest are unaware that they are carrying the virus, which can lie apparently

dormant but actually replicating - usually in the liver - for 30 years or

more. By the time symptoms appear, chronic and sometimes fatal liver damage

may have occurred. Last month, an all-party committee of MPs described the

problem as a " time bomb " .

HCV is carried in the blood and those most at risk are people who had a

blood transfusion before 1991 - when screening was introduced - and

intravenous drug users. Needles used more than once in tattooing, piercing

and acupuncture can also spread the infection, as can shared razors, even

toothbrushes. Indeed, last week, more than 2,000 women in England and

Scotland were warned that they could have been infected with the virus after

being treated by a gynaecologist with HCV.

" Only a small number of individuals have symptoms at the time of infection, "

says Dr Hamlyn, a consultant physician and liver specialist at the

Dudley Group of Hospitals in the West Midlands. " Without treatment, a vast

majority will develop chronic infection and about a third will have

cirrhosis of the liver. " In a few cases, cancer of the liver can develop.

In up to 15 per cent of patients, the virus clears itself. The rest will

need treatment to eliminate HCV from the blood, ideally before it does

serious damage, which is why early testing is so vital.

Treatment involves a tough regime of weekly interferon injections and daily

anti-viral ribavarin tablets that bring unpleasant side effects. Some

strains of HCV respond to treatment better than others: the overall success

rate is around 60 per cent.

" Even when the virus cannot be eliminated, inflammatory activity in the

liver can sometimes be suppressed, " says Dr Hamlyn. " And new drugs are being

developed that stop the virus from replicating. Trials have shown them to be

very effective, but at the moment, they are too toxic for general release. "

But the real problem is lack of funds, says Dr Hamlyn. He told the all-party

Parliamentary Group on Hepatology, which reported last month, that he needs

£750,000 worth of drugs a year but receives less than a third of that. " This

under-funding is storing up trouble. Failure to identify and treat those

with hepatitis C will result in thousands requiring expensive treatment for

serious liver disease in the future. "

The government action plan and awareness campaign, launched late last year,

was branded as " slow, low-key and under-resourced " by the all-party group,

which pointed out that in Scotland, 40 per cent of HCV patients have been

identified - compared with 10 to 19 per cent in England. In France and

Germany, at least five times as many patients are treated for HCV as in

Britain, despite similar infection rates. According to the group's report:

" An overriding requirement is for the Government to demonstrate greater

urgency in dealing with this coming 'tidal wave' of disease. "

For further information, call the Hepatitis Trust helpline, tel: 0870 200

1200, or see www.hepcuk.info. The Department of Health's Face It campaign;

0800 451451, www.hepc.nhs.uk

'I have probably gained 20 years'

When photographer Michele oli began to get drunk after only two

glasses of wine, and suffer from repeated kidney infections, she knew

something was wrong. Swiss-born oli, 55, had taken drugs as a young

woman, but had led a healthy life for the past 30 years.

C was something that happened to other people, " she says.

A blood test confirmed hepatitis C, and further tests revealed severe liver

scarring.

" I knew that treatment was really harsh, but no one could tell me how long I

would live without it, " she says. " I would probably have gone progressively,

and quite quickly, downhill. With treatment, I had a 70 per cent chance of

being cured after a six-month course. "

After each weekly injection, flu-like symptoms would set in. " You get a

fever, your brain feels fogged, and you can't concentrate. Over the course

of the week, you feel better, until the next injection. I lost half my hair,

and the skin on my back was so sensitive it became raw from scratching.

" My energy levels dropped to 40 per cent and I could only walk about 50

metres. I dragged myself around and slowed my life down. "

At her last blood test, oli - whose vast pictures of HCV patients were

recently displayed in Leicester Square as part of the Government's Face It

awareness campaign, and will soon tour the country - was clear of the virus.

" Only now, one year after treatment, do I feel I have 100 per cent of my

energy back. But I have probably gained 20 years - no question, it was worth

it. "

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