Silent epidemic targets Latino community

Nationwide studies show that about twice as many Latinos are infected with the Hepatitis C virus compared to non-Latino whites. But studies for San Francisco are lacking and the amount of Latinos affected by the virus is still a mystery.

At the beginning of the year the San Francisco Hepatitis C Task Force released a report recommending that the Mayor and the Department of Public Health begin a rapid assessment of the Hepatitis C virus in the Latino community.

“In San Francisco there is no pin-point data,” said Jorge Vieto, Hepatitis C Task Force member and staff member at the Stop Aids Project. “We know anecdotally about Hep C in the Latino community and we can definitely say, ‘Yes, there is an issue.’”

An estimated 40 million Latinos live in the United States and 2.1 percent are infected with Hepatitis C, which is almost twice the amount compared with non-Latino caucasians, according to the Hepatitis C Support Project.

“Latinos are disproportionately affected by Hep C,” said Robin Roth, City College health teacher and steering committee representative for the Hepatitis C Task Force. “They haven’t done as well at treatment as caucasians,” Roth said.

Hepatitis C has been labeled the silent epidemic and the Department of Public Health acknowledges the virus as a significant burden to the people of San Francisco. The disease is a blood-born virus that attacks and destroys the liver. Infection occurs only during blood-to-blood contact. It is a curable disease, but because of the mild and vague symptoms the patient often does not seek treatment and the disease goes undiagnosed until it can be too late and the liver fails.

Hepatitis C also has a stigma associated with intravenous drug users where it happens to be the most prevalent. However, tattooing, body piercing and sharing razors are more common ways to contract the disease.

“The biggest thing right now,” said Vieto, concerning Hepatitis C, “is that Hep C is not mentioned by anyone. The awareness just isn’t there.”

Veito is unsure why this is, but speculated it may be a number of contributing factors, including cultural elements in the Latino community, undocumented immigrants and the drug using and homosexual stigma sometimes attached to the Hepatitis C virus.

“It is hard for someone to be empowered enough and go out and get tested,” Veito said.

San Francisco General Hospital has a small Hepatitis C clinic and it recently did a survey that corroborates problematic issues of Hepatitis C in the Latino community. The study also showed proper knowledge and awareness of the disease are effective tools in reducing the disparities among vulnerable populations.

And for the Latinos that are infected with the virus, treatment results haven’t been as promising as they have been for Asians and caucasians, said Miranda Surjadi, nurse practitioner for the Department of Gastroenterology/ Hepatology at S.F. General’s Hepatitis C clinic. The reason is genetics. Asians and non-Latino caucasians have the gene IL28B, which is considered the “good gene” because it is responsible for the positive responses to the treatment, Surjadi said.

“The good gene is a big predictor for who is going to respond favorably to treatment,” she said, adding that Latinos and African Americans don’t have this gene and therefore don’t have as positive a response as other groups to the treatment.
But there is good news. Scheduled for release at the end of May, according to Surjadi, is a new drug, that, when used with existing treatment, increases the success rate for patients, including Latinos and African Americans, by 40 percent to 70 percent.

“It’s a huge, huge jump,” Surjadi added. “I am really excited.”

However, the treatment can very difficult. The treatmet causes a lot of side effects and is expensive.
“There’s a big barrier if a patient doesn’t have insurance,” Surjadi said. “I don’t know how they can do it. These medications cost thousands of dollars.”

Healthy San Francisco insurance will cover the cost of Hepatitis C treatment.
“Patients who are eligible and referred to our clinic get everything for free,” Surjadi said.

For more information, contact your primary care provider. Also look online at http://www.hcvadvocate.org for additional Hepatitis C information in Spanish and English.