Hepatitis Heroes
Project ECHO brings the fight against Hepatitis C to communities and rural patients in southwest New Mexico.
By Heidi Hillesland
"The viruses are winning," said the doctor. I imagined virus particles, like thousands of little spaceships, docking onto and invading human cells. Microorganisms have strategies to evade our immune defenses and can develop resistance to our drugs. I can picture biochemists in the lab working fast, bent over test tubes with sweat glistening on their foreheads, trying to outsmart microbes with new and improved treatments.
The most publicly feared virus is HIV. Another, lesser-known virus that experts believe will be a major public health concern of the new century is Hepatitis C.
The World Health Organization calculates that three percent of the world's population is infected with Hepatitis C. In the United States, more than 3.9 million individuals are believed to have the virus—making Hepatitis C the most common bloodborne infection. In New Mexico, the total number of infected persons is conservatively estimated at more than 32,000. The impact of this virus could be devastating. Fortunately, experts in New Mexico have already joined forces with community physicians in order to combat this difficult disease.
Hepatitis means inflammation of the liver; Hepatitis C, once called "non-A non-B," is a viral cause of hepatitis. Due to the multiple critical functions of the liver, Hepatitis C can have far-reaching consequences.
How Is Hepatitis C contracted? Hepatitis C is spread by direct contact with human blood:
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Potential long-term consequences of hepatitis include liver cirrhosis (scarring) and hepatocellular carcinoma (liver cancer). Of every 100 persons infected with the virus, approximately 55-85 will develop chronic illness, 5-20 will develop cirrhosis after a period of 20 to 30 years, and 1-5 people will die from cirrhosis or liver cancer. Hepatitis C is the primary reason for liver transplantation, and experts predict that Hepatitis C will be the leading cause of chronic liver disease in this decade.
Who is leading the fight against Hepatitis C here in southwestern New Mexico? Experts are teaming up with community physicians via Project ECHO (Extension for Community Healthcare Outcomes). Project ECHO was founded in 2003 by Dr. Sanjeev Arora, executive vice chair of the University of New Mexico Department of Internal Medicine, to provide support for physicians of small communities in treating difficult illnesses. Hepatitis C is one such illness where treatment is complicated and most specialists are located in urban areas. Project ECHO utilizes videoconferencing technology so that specialists and community physicians can discuss current patients weekly and together plan the optimum treatment. The result is the best possible level of care to rural patients with chronic disease. Dr. Michael Sergeant of Hidalgo Medical Services in Silver City is the specialist for this region.
Monetary help is also available for patients. Hepatitis C treatment is very expensive; cost of treatment varies based on the subtype of the virus and other factors, but typically ranges from $1,600 to $3,000 a month. Two pharmaceutical companies, Roche and Schering, provide medication assistance programs for treatment to individuals with limited and no funding. Tricore lab donates genotypes and viral loads (the most expensive labs during treatment) to indigent patients who are under the care of providers participating in ECHO. Also, fortunate for Dr. Sergeant's patients, Hidalgo Medical Services offers a sliding-scale fee that can significantly reduce the cost of treatment. Also at Hidalgo Medical Services, Audra Saenz leads a free support group for both patients and loved ones.
You can also help in the fight against Hepatitis C. Spread awareness. Do not use IV drugs. If you cannot stop IV drug use, do not share needles (syringe exchange is provided at most local public health offices). Make sure that tattoo equipment is adequately sanitized. If you already know you have the virus, do not share toothbrushes, razors or other household items that may have blood on them. Get tested if you have reason to believe you may have been exposed. Free hepatitis testing for individuals at risk is available at many public health offices; call first for details at the Hepatitis Hotline at (800) 545-2437.
Heidi Hillesland is a former Silver City resident
who is currently in her
second year of medical
school at the University of New Mexico.