HEPATITIS C

For about three months preceding the physical, I was feeling a bit more fatigued than usual, but I chalked it up to crossing my 60th birthday. On this latest trip, one drink was enough to get me moderately high. It was strange but I rationalized the phenomenon as a way of saving money.

So when the doctor told me that blood tests had showed that my liver enzyme levels were way off the scale, ten times higher than they were the previous year when I was adjudged healthy, I got a little concerned. I asked the doctor what could cause those symptoms. He mentioned a number of things including Hepatitis, but my life style certainly didn't indicate that I'd have contracted Hepatitis, nor had I experienced the symptoms associated with Hepatitis A or B.
He suggested that I check in with my Internist who, by the way, is an airborne qualified graduate of Ranger School. I also checked in with my nephew, an excellent Emergency Room doc. Everyone was upbeat.

Then I was directed to take numerous blood tests, the results of which led to more tests, ultrasound analysis of my liver, and spleen, a viral load analysis and finally, a liver biopsy. While awaiting the final test results, I read a long article in the San Francisco Chronicle about Hepatitis C, and the folks who were suffering and dying from it. I'd never even heard of Hep C or HCV as its also called. So I mumbled a little prayer that whatever I had wasn't Hep C. I guess God had other plans, because I rather quickly after that found out two things. One I had Hepatitis C. On a scale of one to ten, my liver infection was a seven. Two, at that point most doctors didn't know too much about the disease. So with the help of my nephew digging into the medical journals, and my wife and I searching the World Wide Web, I found out enough about the disease to know I was about to embark on one hell of a fight.

Hepatitis C is an insidious viral disease that can lie dormant in one's body for twenty years or more before commencing a viscous attack on the liver. It is only within the last 14 years that its presence could be identified. Without effective treatment, liver failure, cirrhosis and liver cancer develop. Only expensive and risky liver transplants can then maintain life. And as you probably know, demand for liver transplants greatly exceeds supply. Some 4.5 million Americans are infected with Hepatitis C, which is the most important cause of chronic liver disease in the United States. Increasing numbers of infected individuals are now being identified on a daily basis. Approximately 10% of Vietnam Era Vets tested for HCV at VA facilities have been identified as having it. The national rate is 2%. Placed in context, there are more than four times as many Americans infected with Hepatitis C than with HIV/AIDs.

Hepatitis C is most usually transmitted by direct exposure to infected blood: blood transfusions before the virus was identified in 1992; use of contaminated needles and syringes by drug users; immunization with needles before the days of throw away syringes; tattoos; unprotected sexual relations with multiple partners; body piercing; extensive surgical procedures; air powered immunization guns; commercial razors which were not sterilized etc. For those of you who served as Ranger Advisors in Vietnam, think back to the Vietnamese village barbers using straight razors to help cut our hair. In 20-40% of the cases, the cause of the disease is unknown. In these cases, infected persons probably lived in developing countries or had been vaccinated with an inadequately sterilized needle in the days before the introduction of disposable needles. In my case, and those of other friends and acquaintances, the hepatologists believe we contracted the disease while serving in Vietnam, or other similar areas. For example, I also spent time in Africa on behalf of the US Army and in Pakistan and the Middle East as a civilian employee. Most people are absolutely unaware when they contract the disease because the initial short lasting symptoms mirror those of the flu.

When I began treatment in1997, the only medication available was Interferon. My prescribed treatment by a doctor with an aggressive approach to fighting the disease, included self injection of Interferon in the stomach on a daily basis for thirty days, followed by Interferon self injection, three times per week for one year. The treatment didn't work, since success rates were at best 20%. The following year I went on a new regimen of Interferon with Ribaviron pills. Side effects included, but were not limited to: fatigue, shortness of breath, nausea, drowsiness, muscle aches and pains, general flu-like symptoms, mood swings and depression. Believe me, it was nasty stuff. You had to dig deep into your being to drive on. This time the projected success rate was 40%. The experience derived from surviving the pressure and stress of West Point Plebe Year, Ranger School, and combat, helped me to get through. And the support and prayers of family and friends continued to keep my spirits up. This time the medication worked and my HCV has been in remission since January 2000. Once the virus stays in remission for four years, there is a 96% chance of it remaining in remission. And the treatment offered today, is better than what I took four years ago. Though only about 50-60% of those who start the treatment make it through, if you require treatment for HCV, calling upon your Ranger and combat experience will get you into that group of determined patients.

But the purpose of this article is far more than describing my fight. This website is here to provide you with information I didn't have. I strongly urge any 75th Ranger Regiment Association member who served in Vietnam, or in an underdeveloped country, or ran any of the risks I described above, to take a Hepatitis C blood test. The local VA Center is obligated to give any Vietnam Vet an HCV screening test. You don't want to find out, as I did, well after the disease was ravaging my liver. Or in the case of other people I've met, when their livers are beyond saving. Most people who have the virus lying dormant in their system have no idea it is present. I certainly didn't know, nor did most of the infected people with whom I've subsequently spoken. Chances are that you don't have the virus in your system. But if you do, you'd best know about it.

If you have any questions you can contact me at billschwartz@west-point.org

RLTW

Bill Schwartz