Hepatitis C is a blood-borne virus that spreads rapidly when people share needles. Difficult to treat, hepatitis C can result in death. There is no vaccine available to prevent its spread.

People who inject drugs acquire hepatitis C infection rapidly through shared needles, with 50 to 80 percent of users testing positive within 6 to 12 months of beginning injection drug use.  Injection drug use accounts for at least 60 percent of chronic hepatitis C infections in the United States.⁽¹⁾

Some people with hepatitis C live a normal life span without the virus significantly damaging the liver; other people develop irreversible scarring and distortion of the organ, resulting in fatal liver failure or liver cancer.  After two decades, 10 to 20 percent those infected with hepatitis C are predicted to develop cirrhosis and 1 to 5 percent develop liver cancer.  Persons infected with both HIV and chronic hepatitis C experience a faster progression of HIV disease than those infected only with HIV.

The treatment of last resort is a liver transplant.  Each transplant costs an average of $300,000.  It is estimated that, short of transplant, standard care for a person with advanced cirrhosis of the liver or liver cancer costs $20,000 a year.

Prior to 1992, when an effective test for the presence of hepatitis C in donated blood was developed, people who had blood transfusions were at risk for hepatitis C.  That risk is now extremely low, in the range of 1 in 100,000 units transfused. 

The risk of sexual transmission of hepatitis C, though much lower than the risk associated with contaminated needles, is still present.  The highest rates of sexual transmission are associated with multiple sex partners, and the increased risk may be associated with traumatic sex that results in blood exposure.  Long-term monogamous sexual partners of persons infected with hepatitis C have very low rates of becoming infected (0 to 4 percent). 

Thus, as with AIDS, we have a deadly epidemic of a blood-borne disease where exposure through blood transfusion has been almost eliminated and where a major factor in the spread of the disease is sharing needles.⁽²⁾ 

The first step in the prevention of hepatitis C among people who inject drugs - needle exchange - is very inexpensive.  Without prevention, there can be pain, suffering, death - and expensive medical bills.

Footnotes

(1) This section is based on material from 3 sources: (1) National Institutes of Health Consensus Development Statement, Management of Hepatitis C, March 24-26, 1997, 41 pages; (2) Jerome Groopman, "The Shadow Epidemic," New Yorker,  May 11, 1998,  pages 48-60; and (3) National Institute on Drug Abuse, Community Drug Alert Bulletin, "Hepatitis C," May 2000; 4 pages.

(2) Although not as widespread as hepatitis C, hepatitis B is another virus infecting the liver that spreads through sharing infected syringes or unprotected vaginal, anal, or oral sex.  Most people recover from hepatitis B within six months and afterward develop immunity.  Some 5 to 10 percent of the people who get hepatitis B remain contagious for the rest of their lives and develop chronic liver disease, with all its attendant problems.  The presence of either hepatitis A or hepatitis B causes the disease of a person with hepatitis C to progress more rapidly.  "Hepatitis Facts for Injectors," distributed by the University of California, San Francisco, and the Department of Epidemiology and Biostatistics, San Francisco, General Hospital, March 1997.

For a list of other materials used on this website, see References.