Hepatitis C 'time bomb' shock

AN EXPERT in infectious diseases has warned there are an estimated 2,700 undetected carriers of Hepatitis C in Suffolk that could have a potentially fatal "ticking time bomb" in their liver.

Dr Torbjorn Sundkvist, consultant in communicable disease control at the Suffolk Health Protection Unit, has now urged doctors to identify as many carriers of the blood-borne viral infection as possible.

In his latest quarterly newsletter, Germ Warfare, Dr Sundkvist said there are approximately 3,000 carriers in Suffolk and 90% are undetected.

Of those, 300 are not drug-related, 1,500 are among current drug users and 1,200 are former drug users.

This equates to every GP having possibly three undetected carriers on their list from a large group of patients who may have experimented with drugs in their youth, Dr Sundkvist said.

About 30% of those who are Hepatitis C-positive can develop chronic hepatitis, liver cirrhosis and, in some cases, liver cancer. Injected drug users are the highest risk, with the number of cases expected to escalate, as the infection progresses from drug use in the 1970s and 80s.

Dr Sundkvist said: "Our main focus is to find the undetected, previous drug users, who are now unlikely to associate themselves in any way with drug use.

"Some could have experimented with injecting drugs for just a short time, decades ago, but could have a time bomb ticking in their liver which could lead to death."

Statistically, every GP may have one patient who has Hepatitis C from a blood transfusion or haemophilia, which would already be under hospital care and most likely detected, he said.

Dr Sundkvist said the Department of Health should make extra money available for the treatment of Hepatitis C, which is a chronic, or ongoing, illness. The treatment of a patient with the infection can cost about £10,000 a year, but one liver transplant costs £250,000.

He said: "As usual there is no extra money available for this treatment, which has to compete in cash-strapped PCTs [Primary Care Trusts] with cancer treatments and other priorities.

"By not earmarking money for Hepatitis C treatment the UK is in the undignified position of treating 10 times fewer Hepatitis C patients than Germany or France."

However, he said there are public health interventions that can be made that are not costly and could benefit patients, if doctors can identify carriers of the infection.

Although Dr Sundkvist did not advocate the mass screening of patients he said those who had ever injected drugs should be tested.

However, Dr Gareth Richards, president of the Suffolk division of the British Medical Association, which represents GPs, said finding three carriers from their lists would be like searching for a needle in a haystack.

He added: "The only treatment we have for Hepatitis C is expensive and not terribly effective. When the NHS as a whole in Suffolk is overspent you have to ask 'do you want to find people who are going to cost £10-15,000 to treat year after year?'

"There are a lot of priorities. If the Government earmarked money for Hepatitis C we would have to look at it. I think probably there are more important things. Of course, it is very important if you have got Hepatitis C but if you're looking at the amount of money, would you be better off spending it on health education, needle exchanges for drug addicts so they are less likely to pass it around and safe sex messages?

"We still get a lot of people dying from heart disease, which is preventable, and poorly managed diabetes. They cost money to treat but have greater returns in terms of lives saved then Hepatitis C."

A spokeswoman for the Department of Health said: "It is down to the Strategic Health Authority to decide the extent of their budget they spend on specific campaigns or diseases.

"There's an overall NHS budget given to the Strategic Health Authority and then they spend it according to their priorities.

"No money is ring-fenced for anything anymore. Centrally, the Department of Health feels that Hepatitis C is potentially a very big problem.

"The chief medical officer has put together an action plan for Hepatitis C and there is the Face It campaign, which targets people who may have been exposed to Hepatitis C. There is also a helpline and website."