After 12 Years, Gregory Everson, MD, Still Writing the Book on Hep C
Twenty years ago, a medical breakthrough signaled a change in Gregory Everson's professional career and personal life. He continues to write the book on those changes - literally.
The breakthrough for Everson, director of Hepatology at University of Colorado Denver School of Medicine, was the 1989 discovery of the hepatitis C virus (HCV), the cause of an infection that inflames, injures and scars the liver. The Centers for Disease Control (CDC) says hepatitis C affects more than 4 million Americans.
"The biggest misconception is that [Hep C]
can't be treated," says Everson. "In fact,
we have lots of treatment options."
The discovery of HCV and the test that was developed for it resulted in a barrage of questions for Everson from newly diagnosed patients. What started as a series of lectures to spread the initially limited amount of information Everson could offer evolved into pamphlets and ultimately a book, first published in 1997, Living with Hepatitis C: A Survivor's Guide.
Twelve years later, Everson is still learning and writing about the disease: the book enters its fifth edition this month.
As has been true from the beginning, Everson's collaborator is writer Hedy Weinberg, a hepatitis C patient who originally suggested that Everson pull together information from his lectures into the book's first edition.
"The book was driven from the beginning by Hedy's questions," Everson says. Reflecting a concern for those afflicted with hepatitis C, the book is dotted with her and other patients' observations about their experience with the disease.
What's new in this edition is a chapter detailing the many new advances in treatment for hepatitis C. What's remained constant is a focus on the concerns of patients: understanding what the disease is, how it is diagnosed, how it affects the body, how to treat it and more.
Everson and Weinberg also help prepare patients to deal with the financial and emotional challenges the disease can present.
Lots of questions, better answers
While contracting hepatitis remains an often-frightening proposition for patients, Everson says he is able to answer many more questions today than he was when he wrote the first edition.
"At that time," he remarks, "there were few treatment options; ribavirin [a now routinely used drug that inhibits the virus from replicating] was just finishing trials. We tried to provide general information about how to cope with a poorly understood disease."
That understanding has vastly improved among many in the medical community and a large number of well-informed patients, but hepatitis C remains a malady still surprisingly often misunderstood, Everson says.
"The biggest misconception is that it can't be treated," he states. "In fact, we have lots of treatment options, and there are more coming in the future… We're studying quite a few of them here [at UCH]." He estimates some 20 new drugs are now being tested, the most promising being those that target enzymes responsible for viral replication.
"The fact is, our ability
to clear the disease is
Closely related to the idea it can't be treated is the widely held conviction that hepatitis C can't be cured. In fact, as Everson writes in the book, the "current standard of care" – pegylated interferon plus ribavirin – results in "sustained viral clearance of approximately 55 percent…more than 50 percent of patients treated today may be 'cured' of hepatitis C."
The misconception is partially fueled, Everson believes, by the CDC's avoidance of the word "cure." Still, he says, the cure rate for some types of hepatitis C - there are six - is as high as 90 percent. "The fact is, our ability to clear the disease is dramatically better."
While providers and informed patients battle both hepatitis C and misunderstandings of it, the disease continues to represent a challenge to the health care system. "It has a huge impact," Everson says. "Chronic liver disease is emerging as an increasing burden to health care costs."
Living with Hepatitis C: A Survivor's Guide, 5th Edition, is available at most bookstores, including Borders, Barnes & Noble and the Tattered Cover. It can also be ordered online via Amazon.com.
This page is adapted from a story that appeared in the UCH Insider, the hospital's candid e-newsletter. The Insider, which is published biweekly, is available to people outside the hospital via a free e-mail subscription. Tyler Smith (firstname.lastname@example.org) is managing editor of the Insider.