Orlando Velarde is one of 32,000 or more New Mexicans infected with a liver disease called hepatitis C. He learned he had it in 1999, while hospitalized for a blood clot in his arm.
He probably had been sick for two decades. But like many people with hepatitis C, he had no symptoms. Velarde believes he caught the virus through a blood transfusion in 1980 — long before plasma banks screened for the disease.
Hepatitis C is a leading health concern in New Mexico, where deaths from liver disease and cirrhosis outpace the nation. (Alcoholism contributes to the problem, too.)
Less than 6 percent of New Mexicans with hepatitis C are getting treated. Part of the problem is access.
Velarde understands. To get the regimen of shots and pills, which can last a year, he had to drive from his home in Espanola to Santa Fe. There were no other options at the time.
The side effects alone can be grueling — fatigue, nausea, pain. Adding a one-hour round-trip drive to that can make it agonizing.
Velarde dropped out of the program. But now he’s back on track, because Health Centers of Northern New Mexico in Espanola began offering the treatment last year.
“I am now at seven months and feel good about getting cured,” said Velarde, in his mid-40s.
Mainstream medicine offers one treatment for hepatitis C. It cures 50 to
80 percent of cases.
With a three-year grant from the federal government, The University of New Mexico School of Medicine has made treatment more available. Project ECHO, developed by Dr. Sanjeev Arora, educates primary-care physicians on the treatment of hepatitis C and provides weekly support, via telephone, with a broad-based group of specialists at UNM.
Under this telemedicine program, new outlets for care in Northern New Mexico include: Health Centers of Northern New Mexico, Pojoaque Primary Care, Santa Fe Indian Hospital and New Mexico State Penitentiary in Santa Fe. Other locations are: Bernalillo, Albuquerque, Las Cruces and five prisons.
At an open house Thursday, Health Centers of Northern New Mexico will spread the word that treatment is available. “Although not everyone is cured, it helps the liver even if you aren’t cured,” Bjeletich said.
The treatment isn’t free. For uninsured patients, the clinic can bring the cost down to $1,000, using donated services and medicines, she said. Otherwise, insurance usually covers the cost of treatment, minus copays.
Espanola’s first patient — Velarde — started in August 2004. Now the clinic has six. Patients must be clean from drugs and sober before beginning treatment, Bjeletich said.
The course of therapy lasts six months to a year, depending on what strain of the virus the patient has. Besides taking pills (ribavirin) daily, the patient must self-inject once a week with interferon. Like chemotherapy, the treatment kills infection- fighting blood cells, making patients vulnerable to germs.
New Mexico has lots of deaths related to hepatitis C, according to Arora, though firm numbers aren’t available. The disease can lead to cancer of the liver, cirrhosis of the liver and death. For people with significant liver disease, treatment is urgent, he said.
Without medical care, one-fourth of hepatitis C patients develop cirrhosis of the liver — a condition of irreversible scarring — within 20 to 30 years of infection, Arora said.
Plenty of others, however, never suffer enough liver damage to endanger their lives. For them, treatment is optional, Arora said. They must decide whether they’d rather live with the fatigue, sleep disturbances, depression and loss of sexual vitality that hepatitis C can cause or endure the side effects of treatment, he said.
Hepatitis C is commonly transmitted through contaminated needles or straws during heroin or cocaine use. But nearly 10 percent of New Mexicans with the virus contracted it through blood transfusion — a risk that has virtually disappeared, Arora said. Tattoos, especially those made in prison, can be worrisome; the virus can live up to a week in ink.
“There’s a stigma attached to hepatitis C that does not need to be there,” Bjeletich said. “There’s lots of ways to get it.”
And to date, there’s no vaccine against it.
(Sidebar)
Hepatitis C: The silent epidemic
Most people infected with hepatitis C have no symptoms. But this disease of the liver can kill you.
In New Mexico, hepatitis C is
20 times more prevalent than AIDS, according to University of New Mexico School of Medicine
Dr. Sanjeev Arora.
The virus is transmitted by blood-to-blood contact. To find out who is at risk and should take a blood test, Health Centers of Northern New Mexico in Espanola developed a screening tool:
1. Have you ever been diagnosed with hepatitis C? (If yes, stop here.)
2. Have you ever injected yourself with illegal drugs, even one time many years ago?
3. Do you have HIV or AIDS?
4. Did you have a blood transfusion or organ transplant before July 1992?
5. Did you have dialysis or other blood products before July 1992?
6. Are you a chronic hepatitis B carrier?
7. Have you ever snorted cocaine, even once?
8. Do you have tattoos or body piercings?
9. Have you been in jail or prison?
10. Have you had sex with someone who is hepatitis C positive?
11. Have you shared razors, toothbrushes or had blood contact with someone who is hepatitis C positive?
12. Do you drink more than four drinks a day, or have you ever been diagnosed as alcoholic?
The treatment program — six months to one year of shots and pills — is not right for everyone. Health Centers of Northern New Mexico offers information to help patients decide if they want treatment.
The New Mexican
If you go …
What: Hepatitis C Awareness Day, including free lunch, risk screenings and information.
When: 11:30 a.m. to 1:30 p.m. Thursday.
Where: Health Centers of Northern New Mexico, 620 Coronado St., Espanola.
Who: Community leaders, relatives of high-risk people, people with hepatitis C.
Follow-up: By appointment only. The Espanola clinic will offer blood testing May 4 to anyone considered at high risk for the disease.
Information: Barbara Bjeletich, 753-7395
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