Newsday - May 21, 1992
Laurie Garrett
Three potentially fatal viruses are now rampant among inner-city poor, particularly black men, posing a threat to their sexual partners, health care workers and those with whom they may share intravenous drug injection equipment, according to a report in today's New England Journal of Medicine.
Either the human immunodeficiency virus, which causes AIDS, the hepatitis B virus or the hepatitis C virus was found in a quarter of all patients treated in 1988 in the emergency room of Johns Hopkins Hospital in Baltimore, according to the report. About 6 percent of the patients were infected with HIV, and 5 percent with hepatitis B.
Most surprising was the presence of the hepatitis C virus, said the study director, Dr. Gabor Kelen. Nearly 18 percent of the young white heterosexual women with no history of intravenous drug use tested positive for infection with the virus, presumably acquired from their sexual partners, Kelen said. And more than half the black men age 20 to 40 were infected with the hepatitis C virus.
The study was done using blood samples collected in 1988 and tested for hepatitis B and C, inflammations of the liver, in 1990. Hepatitis C was discovered only in 1989, and a screening test was developed in 1990. Given that the epidemics of HIV, hepatitis B and hepatitis C have expanded since 1988, Kelen said, these estimated infection rates must be considered conservative.
In the Baltimore study, intravenous drug users were at greatest risk for all three viruses, with 10 percent infected with hepatitis B, 27 percent with HIV and 83 percent infected with hepatitis C. For all three viruses, young black males were at greater risk then their female or white counterparts.
"We had previously thought HIV would devastate the black male population in American cities, but now we're wondering if it will be hepatitis C," Kelen said.
New York experts said all three viruses are presumed to be more prevalent in the New York area, but added that no similar studies have been done in any New York hospital.
When hepatitis C was discovered in 1989, it was thought to be acquired solely through blood transfusions, and its dangers were unclear. In the three years since, the federal Centers for Disease Control and several research laboratories have shown that hepatitis C can be transmitted in the same ways as hepatitis B and HIV: through sexual intercourse, blood transfusions and the use of contaminated needles by drug injectors. It is also now known that at least half of all people infected with hepatitis C develop chronic hepatitis, which kills 10 percent of its victims. The virus is also known to cause liver cancer. There is no vaccine for hepatitis C.
Hepatitis B can also be dangerous, and it is thought that 10,000 New Yorkers become infected with the virus each year, city Health Department representatives said. About half of all hepatitis B cases result in active hepatitis, and 10 percent become lifelong carriers of the chronic disease. Many of them - more than 25 percent - die of either liver cancer or acute cirrhosis.
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