Longform

THE HEP-C GENERATION

part 1 of 2
The gravel crunches beneath the slow tread of Mike Lamb. Every so often, he pauses to gather his strength, then continues on up the trail that winds into the heart of the Garden of the Gods.

One of his old drinking buddies is getting married at the rock formation known as the Three Graces. The ceremony was supposed to be a small affair, family only, but Lamb had asked if he could attend. He might not have much time left for personal connections.

It's the end of the first day of winter. Sinking below the black outline of the mountains just south of Pikes Peak, the sun streaks the sky with pastel pink. On such an evening, Lamb, only 47 years old, finds it hard to believe that he will die soon unless someone else's tragedy gives him a second chance at life.

Disease has destroyed his liver, and Lamb's only hope is a transplant. He believes he's been carrying his viral assassin since his days in the jungles of Vietnam as a Navy corpsman. His hands awash in the blood of men he was trying to save, he was unmindful then of cuts and needle pricks.

A football player and wrestler at his Colorado Springs high school, Lamb used to be an avid outdoorsman. Now he spends weary days inside his mother's apartment, hardly able to get out of bed.

He waits for a telephone call from Tracy Steinberg, a transplant coordinator for University Hospital in Denver. She's the one who will tell him if he gets another chance to live. There's already been one false alarm that ended in disappointment. But he hangs on, hoping.

His enemy is one of the most dangerous viral epidemics of the Nineties--and beyond. But it is not AIDS. It is hepatitis C.

Like almost everyone else outside of the medical community, Lamb had never heard of hepatitis C until a doctor informed him a year and a half ago that the disease had destroyed his liver. He was dying.

Records of hepatitis outbreaks stretch back thousands of years. From the beginning, its victims were identified by jaundiced, yellow-looking skin and eyes; other symptoms included vomiting, diarrhea and flu-like aches and pains that lasted for weeks.

By the 1800s doctors realized hepatitis could be contracted by drinking polluted water or eating food contaminated with human feces. In 1885 scientists discovered that hepatitis also could be transmitted through contact with contaminated blood. But it wasn't until the 1940s that they were able to distinguish between hepatitis A and hepatitis B.

Hepatitis A, also known as infectious hepatitis, is rarely fatal--it kills only about one person in 10,000. It's the version transmitted through oral-fecal contact, usually by contaminated food or water. About half of all the people in the United States have been exposed to hepatitis A by the time they become adults, but most exhibit minimal or no symptoms. Those with severe cases still recover in six to ten weeks with rest and are immune to reinfection.

Hepatitis B, however, can lead to chronic liver disease that often proves fatal over the long term. About 300,000 new cases of hepatitis B are reported each year in the United States, according to the Centers for Disease Control (CDC); about 800 of those are in Denver. A blood-borne virus, hepatitis B preys on people who receive blood transfusions or other blood products such as anti-bleeding concentrates required by hemophiliacs. Others at risk are junkies and medical personnel, as well as people who have sexual contact with infected persons. Some 200 health-care workers die from occupationally acquired hepatitis B every year, according to James Marx, an infection-control and epidemiology consultant in San Diego.

A vaccine was developed in the late Seventies that protects against hepatitis B infection, and some medical professionals advocate a widespread inoculation program--like the mass polio vaccinations of the Fifties--to eradicate the virus. For those already infected, there are several forms of treatment. The most common is injections of interferon that will deactivate the virus in 30 to 60 percent of hepatitis B patients, half of whom go on to purge the virus from their bodies entirely.

But even as the medical community was making strides in combating the disease, researchers were becoming increasingly worried over the growing presence of what they thought was hepatitis B in the nation's blood supply. By the mid-Seventies, about 10 percent of the people who received blood transfusions were becoming infected.

Researchers began looking into ways to inactivate the virus in the blood, including heat treatments and a detergent process. But they were stonewalled by the blood industry, which did not want to alarm the public. After all, industry officials argued, a test for hepatitis B was close to approval by the Food and Drug Administration, and soon they would be able to screen for infected blood.

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Steve Jackson