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Indian clinics uncover high rate of hepatitis C
 
 
  By DIANE COCHRAN
 
March 22, 2008
Of The Gazette Staff
http://www.billingsgazette.net
 
An epidemiological study conducted at two Indian Health Service clinics in Montana uncovered a hepatitis C infection rate that is six times higher than is found in the general population.
 
The finding surprised tribal and state health officials, who responded by creating an educational brochure that targets young American Indians.
 
The 2005-06 study, authored by IHS epidemiologist Christine Dubray, revealed a 6 percent hepatitis C infection rate among women who went to the clinics for prenatal care.
 
Only about 1 percent of people in the U.S. population has hepatitis C, Dubray said. "We have an unexpected number of young women with hepatitis C infection," she said. "In the general American population, the prevalence of hepatitis C is much lower in young women."
 
Hepatitis C is a virus that can lead to serious liver damage and death. It is spread through contact with infected blood and cannot be cured.
 
"There is a treatment for Hepatitis C," said Dubray, who is based in Albuquerque, N.M. "It doesn't work for everyone, but there is a treatment. It's not hopeless."
 
During the 13-month period of Dubray's study, 205 women were screened for the virus, and 13 tested positive.
 
It is thought that the women, who were probably exposed to the virus as teenagers or very young adults, contracted it through intravenous drug use.
 
The study did not examine what kind of drugs might have been used.
 
Although the study examined only American Indian women, it is likely that other groups of young Montanans would also have higher than expected hepatitis C infection rates because of drug use, said Laura Baus, hepatitis C coordinator for the state Department of Public Health and Human Services.
 
"Whether American Indian or Caucasian, there's no division there," Baus said of hepatitis C infection among the state's youth. "We're seeing it in both populations."
 
Nationwide, the average age at a hepatitis C diagnosis ranges from 40 to 59, Baus said.
 
"What we're seeing in Montana is we're averaging 15 to 24," she said. "We're seeing them younger."
 
About 9,000 Montanans are known to have hepatitis C, which the state tracks as a reportable disease. Officials think another 5,000 people are infected but don't know it, Baus said.
 
Symptoms often do not develop until years, and sometimes decades, after infection occurs.
 
Between 75 percent and 85 percent of people who are exposed to the virus become what is called chronically infected, according to the Centers for Disease Control and Infection. The rest "clear" the virus.
 
About 3.2 million Americans are chronically infected with Hepatitis C. Intravenous drug use is the most common infection source.
 
Tribal and state health officials used Dubray's study for the basis of an educational brochure that will be distributed via Montana IHS clinics and other outlets on the state's reservations.
 
"After Christine's work, it was obvious we needed to do a public-health initiative," said Jennifer Giroux, an epidemiologist with the Rocky Mountain Tribal Epidemiology Center in Billings.
 
"If we don't get the information out there to the public, what good is having looked?" Giroux asked.
 
The brochure, an educational medium favored by CDC, was designed specifically for American Indian consumers, Baus said.
 
"One size doesn't fit all," she said. "You have to gear it toward your audience."
 
Contact Diane Cochran at dcochran@billingsgazette.com or 657-1287.
 
 
 
 
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