Paying Attention to Hepatitis

Today is World Hepatitis Day!

I have recently learned a lot about viral hepatitis and I’m just starting to understand how dynamic and complex a disease (multiple diseases, really) it is. In the United States, Hepatitis B (HBV) and Hepatitis C (HCV) are two distinct diseases, far more prevalent than can even be accurately counted, with intersecting social histories. Abroad, HBV, HCV and Hepatitis A (HAV) have reached epidemic proportions in several regions. (To be clear HAV is present in the U.S., but has a relatively low incidence rate.)

While each hepatitis has its own specific disease profile, the populations affected by hepatitis are having distinctive experiences with the virus too. Still in the U.S…. For HBV we have a vaccine and (theoretically) the opportunity to eradicate this strand – HBV is primarily being spread through sexual contact (so for example there are higher rates in the “men who sleep with men” (MSM) population). HCV on the other hand is both acute and chronic, and currently there is no treatment which can “cure” chronic hepatitis C (no vaccine). The population most affected by chronic HCV are baby boomers, many of whom are completely unaware of their status until they develop cirrhosis of the liver and liver cancer (it is thought that many of these individuals contracted hepatitis C during the 60s and 70s). New HCV infections are highly prevalent among injection drug users (IDUs) – a fringe population very hard to understand, reach out to, and treat.

There can often be HIV/hepatitis co-infection, of both HBV and HCV, which can complicate treatment. Like with HIV in the 80s and 90s, hepatitis comes with stigmas, a lack of understanding from both health care professionals and patients, and a series of cultural factors which makes it an unknown.

Asian Americans, African Americans, those incarcerated, the undocumented, immigrants from countries such as Egypt and China, pregnant women, baby boomers, and IDUs all have specific needs and circumstances (goldmine for medical anthropologists?!). With infection rates far greater than those of HIV(in the U.S.) and research funding about a 10th of what HIV research gets, its seems about time we start paying some attention to hepatitis.

Information Overload

The snow seemed like it would never stop falling here in DC…while getting a work-out in, shoveling, I pondered the information overload the capital area is currently experiencing. News channels have been running non-stop coverage of the storm since noon Friday with no sign that they are going to stop any time soon – how much, really, can be said about a lot of snow?!

With this on my mind, I was perusing the Sunday Washington Post a little early (online of course, there is no-way it’s getting delivered!) and there I found a book review of Medicine in Translation by Dr. Danielle Ofri. The book seems to chronicle the experiences of patients through the eyes of their physician (Dr. Ofri) and the physician’s experience working with a broken health care system and patients from an array of cultural backgrounds. Part of her job, as a physician, is to translate for her patients – to expand their “health literacy” with her knowledge of biomedicine and the system.

As a country, what resources do we have to be health literate? Are we experiencing information overload in an attempt to in fact be more informed? This past week, Oprah did a show on America’s Silent Killer: Diabetes. Diabetes, especially Type II, is a major and growing concern for Americans, there are nearly 80 million people with or on the verge of having it. Questions of cause and treatment aside, is Oprah spreading the word better than nothing?

A Harvard Poll, reported in a NY Times article, finds that the majority of Americans think the H1N1 (swine flu) pandemic is over. They feel there is now no need to get vaccinated and that the whole thing was blown out of proportion. Do they think this because their doctors have told them it’s over or because it is no longer being reported on the news? On international health as well we are inundated with a variety of information – for example, the 2011 Federal budget has several budget cuts for global health programs – but it is often the filtered, bare minimum. Having public discussions about diabetes, health care, and global health is great, but finding the right mixture of information, translation, and literacy is hard. Hopefully, our health information overload isn’t making us illiterate.

*Image is author’s own.

In the News: Sex, Drugs, and Pepsi?!

*The Bill and Melinda Gates Foundation announced last week that they would be pledging $10 billion towards vaccinating children for the next decade. Vaccines to prevent diseases such as pneumonia and diarrhea could have a significant positive impact on child and population health in developing countries. Hopefully, funding and projects for other means of combating such diseases will be supported too – environmental/sanitation improvements, health delivery, etc.

*There have been a number of recent reports and op-eds dealing with the ongoing debate about the best sex-education curricula for U.S. students. A WaPo article today discusses a new study which claims abstinence-only programs do have positive results and a NYTimes opinion piece from Sunday brings-up the thought that perhaps sex-ed programs should be tailored locally and not debated in Washington.

*A Dartmouth Medical School study supports vaccinating HIV-positive Africans against TB, significantly lowering their chances of dying from the disease. TB/HIV co-infection is the leading cause of death among HIV-positive individuals on the continent, and tackling TB is just as important as slowing the spread of HIV/AIDS.

*Pepsi announced Monday they are launching the Pepsi Refresh Project. The project’s aim is “doing well by doing good” – being well by supporting local health initiatives sounds good to me!