UK: Killer Virus Hits Past Drug Users Pubdate: Sun, 04 Jul 2004 Source: Observer, The (UK) Author: Jo Revill, health editor The Observer

KILLER VIRUS HITS PAST DRUG USERS

Thousands of middle-aged professionals who experimented with drugs during their student days will be warned in a major government health campaign this autumn that they may be infected with hepatitis C.

It is thought that up to 400,000 British people may be carrying the potentially fatal virus without knowing it, because there is such a long delay between infection and symptoms appearing.

Ministers have decided to go ahead with a national public awareness campaign in September, warning that anyone who has ever injected drugs, particularly sharing a needle, used straws to sniff cocaine or had a blood transfusion before 1991, is at risk and should consider having a blood test. However, they are worried about causing mass panic and want to adopt a 'softly-softly' approach by focusing on the treatment available for the disease, rather than its potential consequences.

The co-ordinators are hoping to find a celebrity who has been infected with the virus to spearhead the campaign, but so far those approached have declined publicity, such is the embarrassment associated with the condition. The general public view about hepatitis C is that only hardened drug addicts are at risk, but increasingly doctors are seeing patients who have been infected after just one or two injections.

The virus is passed on through blood-to-blood contact, and those at risk also include people who had a blood transfusion before blood screening was brought in 13 years ago. Sexual transmission, tattooing and piercing are the other possible methods of transmission.

At present only 2,000 people a year are treated for hepatitis C on the NHS, but estimates of the numbers infected in the UK vary from around 0.4 per cent of the population, some 240,000, to 1 per cent, some 600,000.

It is potentially fatal, but effective new antiviral drugs can cure between 50 to 80 per cent of sufferers who have a chronic form of the disease. Of those who carry hepatitis C, about 80 per cent go on to develop a chronic infection in the liver, and about one-fifth of these will develop serious liver disease.

However, many people do not know they are carriers until they have serious symptoms such as severe liver pain. Many of those at risk will be people who experimented with drugs in their youth. Charles Gore, chief executive of the Hepatitis C Trust, said: 'How do you reach the man on the street, who might have had a blood transfusion 20 years ago, or who might have injected drugs in his youth. and warn him that he could be wandering around with this virus?'

People can have the disease for 20 years or more before they develop symptoms, which means those who experimented at college might not realise the risks.

'Typically, it might be someone who didn't know how to inject drugs into the vein and who borrowed a syringe from someone who was more experienced. The virus can then be passed directly into the bloodstream.'

Gore added: 'Between 1975 and 1985, in particular, there was a huge experimentation with drugs. It was before the Aids crisis, no one was aware of the dangers of blood-borne viruses, and many more were injecting than was commonly supposed.'

Gore, who backs the government's efforts, says that Britain is far behind other European countries in identifying patients. 'It is hard to get people to admit that they might be at risk. It involves them owning up to their past.'

The chair of the Department of Health's advisory group on hepatitis, Professor Howard Thomas, re-iterated the warning that patients don't have to be drug addicts to be at risk. 'Many of those infected will be people in influential positions who dabbled with drugs years ago while at college,' he told the Health Service Journal last week. While admitting there is more to be done in making GPs aware of the disease, he said that they have now taken the first steps in setting up a national system of clinical centres for hepatology, or liver disease.

The first signs of the disease are not easy to spot. They commonly include fatigue and aching joints, which are fairly usual for people in their middle age. Patients also experience differing degrees of pain. Some have a mild form of the virus and are in acute pain, others have serious liver damage before they realise anything is wrong.

Ministers, highly aware of how the HIV campaign in the Eighties scared a generation of people, want to take a more 'softly-softly' approach. They started last week by sending out an action plan to all GPs and health professionals.

A spokeswoman for the Department of Health would say little about the campaign, other than to state that an outside consultancy firm had been brought in to work on strategy. 'We will have a public awareness campaign, but in order not to get people panicked, you have to do it in stages, so the first stage is to make the professionals aware of the potential problems.'

. For more information, call the Hepatitis C Trust's helpline on 0870 200 1200.

MAP posted-by: Terry Liittschwager