Newsday - February 7, 2001
Laurie Garrett
Chicago-Hepatitis C is emerging as a leading cause of death in Europeans and Americans who are infected with HIV, some of whom may carry a genetic mutation that makes them more vulnerable to hepatitis infection, according to studies presented at the annual AIDS retrovirus conference.
An estimated 200 million people worldwide are infected with the hepatitis C virus, Dr. Kenneth Sherman of the University of Cincinnati told the 8th Conference on Retroviruses and Opportunistic Infections, a meeting of 3,000 AIDS scientists and clinicians. More than 4 million Americans are among them, and hepatitis C infection is now the No. 1 reason for liver transplants in the United States.
Only recently, however, has hepatitis C been noticed on a wide scale in HIV patients. In Africa, no hepatitis C-infected individuals have been found among HIV patients in the sub-Sahara region, Sherman said.
In contrast, in the United States 80 percent to 100 percent of HIV- positive hemophiliacs are infected with hepatitis C as a result of contaminated blood transfusions. About 70 percent of HIV-positive intravenous drug users are also infected with hepatitis C. A massive survey conducted by Sherman of 55,000 HIV patients in the United States in clinical trials found that 16.1 percent of them are coinfected with the hepatitis C virus.
A survey of San Diego area hospitals shows that between 1993 (before effective anti-HIV drug cocktails existed), and 1999, hospitalization rates increased dramatically for HIV patients. It turns out HIV patients now are not being hospitalized for classic AIDS problems, but for new illnesses, particularly hepatitis C liver disease.
Dr. Luis Martin-Carbonero of the Institudo de Salud in Madrid reported that in the year before HIV drug treatment became widely available in Spain, only 5 percent of hospitalizations were due to hepatitis. Last year, he said, 8.4 percent of all HIV hospitalizations were for acute hepatitis, with the hepatitis C virus the primary cause. Fifteen percent of all Spanish HIV patients last year had systematic hepatitis, and nearly half of all deaths in HIV patients in that country were due to acute liver disease.
In Chicago, physicians from Cook County Hospital said that 35 percent of all deaths last year in HIV-positive patients in this city were due to liver failure, indicating a worrisome hepatitis C trend in the United States that may be mirroring that seen in Europe.
There may be genetic factors that complicate this picture. German scientist Ranier Woitas of the University of Bonn discovered that a genetic trait that protects some people against the most common forms of HIV actually increases their likelihood of hepatitis C.
Woitas says the hepatitis C virus has found a way to exploit the very cellular receptor that HIV rejects.
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