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Saturday, September 9, 2017

Hepatitis C symptoms can mimic other diseases, thwarting diagnosis; Ky. infection rate is nation's highest; screening needed

With a range of symptoms that lasted for years that culminated so badly that her doctors thought she had cancer, Gail T. Wells finally found out what was wrong with her. She had hepatitis C, a lingering disease in which Kentucky leads the nation.

Gail Wells (Photo provided
to The Washiington Post)
“I felt like I was dying,” Wells, a nurse practitioner, told Sandra G. Boodman of The Washington Post, describing how she felt when she first met with her neurologist, Dr. Thy Nguyen, in February 2016, who diagnosed her.

Wells, who was then 62, said she had gone so far as to reviewing her funeral arrangements before she learned that she had hepatitis C, a potentially fatal disease that can cause liver cancer.

Boodman reports that over the years Wells had an ongoing list of ailments like numbness in her toes, heartburn, a chronic cough, weight loss and extreme fatigue that she was always able to attribute to something else going on in her life.

But it wasn't until she started having episodes of extreme abdominal cramps and left-sided numbness in her leg and tongue that she sought medical care, which prompted a battery of tests that finally led to her hepatitis C diagnosis.

She was also diagnosed with a rare disorder called Type 2 mixed cryoglobulinemia, which hits about half of chronic hepatitis C patients, though only 30 percent have symptoms. The disorder causes abnormal proteins in the blood that thicken and clump together, which restricts the blood flow to surrounding organs and causes damage to blood vessels.

Symptoms include fatigue, abdominal pain, weakness, neuropathy and Raynaud’s disease, a reaction to cold temperatures or stress that can result in a narrowing of blood vessels. It is three times as common in women as in men, and most cases have been found in those between 40 and 60.

Nguyen told Boodman that Wells' condition was likely overlooked because her symptoms -- abdominal pain, numbness, fatigue -- were common to many other diseases. And, she said, no one had thought to screen her for hepatitis C.

New cases of hepatitis C are largely driven by intravenous drug use, though many Baby Boomers have the disease and don't know it. Both groups should be routinely screened for it.

Wells said she thinks she was infected at the same time she got hepatitis B while working in an emergency room. Wells said her body cleared itself of hepatitis B, as is the case in 95 percent of adults. She has since been treated with Harvoni, a costly medicine that can effectively cure hepatitis C, and the abnormal proteins in her blood have been "undetectable" since April.

To her relief, Wells said the rest of her family has tested negative for hepatitis C, which can be transmitted during childbirth; when the blood from an infected person enters the bloodstream of someone who is not infected; and, though rare, through sexual intercourse.

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