Joint U.S.-Russian Epidemiology Project To Seek Risk Factors for Hepatitis C

June 05, 1997

Albuquerque, N.M.--Sandia National Laboratories has organized a novel project to monitor a newly recognized, emerging disease known as Hepatitis C in cooperation with the Russian Nuclear Center at Chelyabinsk-70, the New Mexico Department of Health, the University of New Mexico School of Medicine, and Los Alamos National Laboratory.

Hepatitis is an inflammation of the liver characterized by jaundice, fatigue, abdominal pain, intermittent nausea and vomiting. The Centers for Disease Control in Atlanta estimates 3.9 million Americans are chronically infected with the Hepatitis C virus, which was first identified in 1989. New Mexico state health officials estimate up to 2 percent of New Mexico's population is infected with the virus.

Those most at risk of contracting the disease include injecting drug users, blood transfusion recipients and health-care workers. "The virus causes liver failure and cirrhosis over a period of 10 to 20 years, and most patients are unaware they are carrying the virus until symptoms of liver failure appear," said Dr. Alan Zelicoff, who is coordinating the project for Sandia National Laboratories.

The project is an outgrowth of previous cooperative work between Sandia and Chelyabinsk-70. Similarities in the prevalence of Hepatitis C in New Mexico and the Chelyabinsk region in the southern Ural Mountains also provide a sound basis for the study.

The project will begin this summer and last four to six months. It will consist of the taking of about 2,000 random blood samples in emergency rooms in New Mexico, and another 2,000 samples from the Sanitary-Epidemiology Facility at Chelyabinsk-70. A questionnaire will be given to all subjects in an attempt to define previously unknown risk factors for the spread of the disease.

Sandia will provide all diagnostic equipment, and data will be shared and analyzed over an existing telecommunications network between Chelyabinsk-70 and Sandia's Cooperative Monitoring Center. The New Mexico Department of Health, under the direction of State Epidemiologist Dr. Mack Sewell, will take the blood samples and administer the questionnaires in Silver City, Alamogordo and Los Alamos, three New Mexico communities whose demographics resemble those of Chelyabinsk-70 in terms of ages, education and numbers of military retirees. Dr. David Mills of New Mexico's Public Health Reference Laboratory in Albuquerque will oversee testing of the samples.

The estimated cost of the study is $350,000, which will be provided by Sandia National Laboratories. A recent study of the prevalence of Hepatitis C in Albuquerque, conducted by Dr. Judith Brillman of the UNM School of Medicine, will provide critical base information for the current study. Gerald Myers of Los Alamos National Laboratory will study the samples to analyze how genetic differences affect the spread and progression of the disease.

"This is a disease for which we have very little knowledge, and yet it is extraordinarily prevalent," said Dr. Gary Simpson, medical director of the Infectious Disease Bureau for the New Mexico Department of Health. "When a person becomes infected, instead of the immune system kicking in to fight off the disease, Hepatitis C has a remarkable ability to avoid the immune system." Although high-risk factors include blood transfusions and the reusing of needles for injections, a third or more of Hepatitis C cases have no discernible mode of transmission.

"It's very disconcerting when 30 to 40 percent of the cases have acquired the disease by means you really haven't sorted out yet," Simpson said. For instance, Zelicoff said fairly large numbers of Hispanics in northern New Mexico have Hepatitis C and yet they do not fall into any of the high-risk groups.

The cooperative study will look at traditional risk factors as well as factors that previously have not been examined in an effort to better pinpoint the causes of Hepatitis C. Data gathered in the study will be shared openly via a telecommunications network. Results of the study will be reported in an internationally recognized epidemiology journal.

Zelicoff said health organizations throughout the world, including the World Health Organization in Geneva, are interested in obtaining more information on Hepatitis C in an effort to combat its spread.

Sandia is a multiprogram Department of Energy laboratory, operated by a subsidiary of Lockheed Martin Corporation. With facilities located in Albuquerque, N.M., and Livermore, Calif., Sandia has major R&D responsibilities in national security, energy, environmental technologies, and economic competitiveness.

DOE/Sandia National Laboratories

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