Hepatitis C: Still the Silent Epidemic

Hepatitis C is the most common, chronic blood-borne viral infection in the United States. The number of Americans currently infected is conservatively estimated to be 3-times the number infected with HIV. Yet to date, some 18 years after the hepatitis C virus was first isolated and 16 years since the breadth of the epidemic was first recognized in the U.S., the national public health response to hepatitis C is virtually non-existent.

In 1998, the House Government Reform and Oversight Committee held a hearing ironically and prophetically entitled, “Hepatitis C: Silent Epidemic, Mute Public Health Response.” Former Surgeon General Koop – the man who spearheaded the federal HIV campaign - testified with a stark warning about hepatitis C. “We are at the edge of a very significant public health challenge - not unlike the AIDS epidemic…. that is an undisputed threat to the public health.” The Committee recommendations supported Dr. Koop's call to action, but it is a call that remains largely unheeded.

The gross mismatch between the disease burden of hepatitis C in the U.S. and the astonishingly limited national public health response defy logic, and the very ethical and scientific principles that are the foundation of all public health systems. The historic precedence for the current status of the hepatitis C epidemic including the political, social, and economic factors, and the ethical issues raised by the continued status of the crisis as “the silent epidemic” will be addressed in the presentation.