hepatitis c

Discussion in 'Diving Medicine' started by gehadoski, Apr 7, 2005.

  1. gehadoski

    gehadoski Liveaboard

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    I have a friend of mine how has inactive hepatitis c and he wants to dive. I don't know if he can dive or not? I went to a doctor specialized in the diving medicine, the doctor told me that he can't dive?
    As a matter of fact I don't trust just one opinion. So if you have any information about this please let me know
     
  2. Kim

    Kim Here for my friends..... ScubaBoard Supporter

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    I'm not sure that there is such a thing as 'inactive' hepatitis c. This is actually a very serious disease that normally has no apparent symptoms - until it destroys your liver. It is often fatal over time. The standard treatment involves Interferon or PolyInterferon used with Ribavirin for the best effect. How effective the treatment is depends on the type that you have - there are several. Someone undergoing treatment on these drugs would not be able to dive as they are very strong with considerable side effects.
     
  3. TwoBitTxn

    TwoBitTxn Scuba Instructor

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    Any reason why you don't trust the dive doc?

    Can you call DAN?

    TwoBit
     
  4. BillP

    BillP Senior Member

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  5. GoBlue!

    GoBlue! Manta Ray

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    He should go to a doctor who specializes in dive medicine. Individual cases vary, and I can assure you that you do not know enough details of his particular medical condition to provide enough info to the doc to make an informed judgement.

    Jim
     
  6. GoBlue!

    GoBlue! Manta Ray

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    Kim,

    Your response is approximately half true.

    I agree that Hepatitis C is a serious disease that is underdiagnosed, likely due to its lack of symptoms.

    Let's not nitpick over the semantics of "inactive hepatitis C;" suffice it to say that there are plenty of patients with detectable prior exposure to hepatitis C (hep C antibodies present) but no active replication of virus (e.g., HCV RNA undetectable). These are a lucky bunch, and the potential diver in question may, in fact, be among them.

    "It is often fatal over time" is a strong statement. The majority of patients with HepC do not die of cirrhosis/end stage liver disease.

    Jim
     
  7. Kim

    Kim Here for my friends..... ScubaBoard Supporter

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    Jim.
    Untreated HCV is often a time bomb waiting to go off. The testing for the virus is not a completely reliable test. It can exist at non detectable levels but that does not mean that it is not present and that it will not at some stage begin to replicate much faster and cause damage. Many people who have treatment seem to successfully respond and the virus falls below the detection threshold - unfortunately in the majority of these cases it comes back again after the treatment is finished. This is particularly true of Type 1. It is estimated that 85% of the people who contract HCV will not get rid of it.
    Maybe "It is often fatal over time" was worded a little too strongly - although I'd agree that the majority do not die from the disease, maybe you would accept that a significant number do.

    As related to diving my point was that you cannot/shouldn't dive while on a treatment regime of Interferon/Ribavirin. As related to 'inactive' - I believe this to be very misleading and inaccurate. Non-detectable is not the same as not present - and denial with this disease is not a good idea.
     
  8. GoBlue!

    GoBlue! Manta Ray

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    Kim,

    I don't want to imply that Hep C is not a cause for great concern, and that it's often underdiagnosed & undertreated. Yes, from the global perspective, it should be considered a "time bomb." Estimates range from approximately 55-85% that those who contract become chronically infected, but 30% of those people will never develop liver disease. Of course, that leaves the majority of the chronically infected that will develop some chronic liver disease, which is obviously a very serious matter, but despite this only 1-5% of all who contract Hep C actually die from chronic liver disease according to the National Center for Infectious Diseases/CDC. So, your comment that "it is often fatal over time" just stood out as being far too strong & sensational.

    With regard to the diving issue, yes, I agree that those treated with IFN/ribavirin would not be the best diving candidates.

    But, the diver in question is not being treated with IFN/ribavirin, so that wasn't the issue. He very well could be in the 15-45% (admitted, likely closer to 15-20%) of HepC patients that do NOT develop chronic infection, or he could have chronic infection but does not need IFN/ribavirin at this time. You refer to this as "standard therapy," which it has become, but you need to qualify that generally therapy is only considered in patients with persistently elevated liver enzymes, detectable HCV RNA, or liver biopsy evidence of progressive disease (according to the NIH Consensus panel).

    My point is, if the guy has Hep C but is not currently undergoing treatment (which may be a perfectly appropriate course), I would not jump to declaring a contraindication to diving.

    Jim
     
  9. gehadoski

    gehadoski Liveaboard

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    I do trust the doctor, but hearing more than one opinion gives you more information and help you to take the right descion
     
  10. wedivebc

    wedivebc CCR Instructor ScubaBoard Supporter

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    Getting medical opinions from laymen about a serious medical condition can be a costly mistake. I would ignore any advice from someone who doesn't have a MD after their name (including mine ;) )
     
  11. gehadoski

    gehadoski Liveaboard

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    you are totlaly right wedivebc.
     
  12. diveprn

    diveprn Nassau Grouper

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    Geez, and I thought Jim's "GO BLUE" oppinion counted. Last time I checked, Internest/Nephrologist was a MD
    Valerie
     
  13. gehadoski

    gehadoski Liveaboard

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    Location: Cairo, Egypt, Egypt
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    If you know anyone has a specific treatment he can take to be cured from that stupid disease. Please reply
     
  14. GoBlue!

    GoBlue! Manta Ray

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    <sigh> I don't know how else to say it. Have your friend go see a hepatologist (liver specialist). Yes, there are treatments. But the treatment (or decision not to treat) is highly individual. Send your friend to a physician familiar with hep C.

    Jim
     
  15. gehadoski

    gehadoski Liveaboard

    # of Dives: 500 - 999
    Location: Cairo, Egypt, Egypt
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    You know that this is a very serious case, I have to admit the Egypt is not advanced in technology like other countries. So I am afraid that he got a wrong treatment, or some doctors use my friend like rate in a lab. You know what I mean.
    I am not a doctor and know nothing about medicine. I am a diver and I trust divers other divers, because this is the ethics of diving. People and divers trust each other. I believe that this website is based on this idea. Honestly I don't trust doctors in this situation. But I anyone recommend any doctor, send me his contacts and I will be greatful.
     
  16. GoBlue!

    GoBlue! Manta Ray

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    I'm not familiar with Egypt, but I can tell you that in the last couple of years, hepatitis C-related research has been published from:

    Mansoura University, Egypt
    Minufiya University, Sadat City
    Ain Shams University, Cairo
    Alexandria University, Alexandria

    If one of those is near your friend, he should check into their Hepatitis C programs.

    Jim
     
  17. gehadoski

    gehadoski Liveaboard

    # of Dives: 500 - 999
    Location: Cairo, Egypt, Egypt
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    Really GoBlue this is a new information for me. I didn't know that. I will check universty of Alexandria and the see what I can do. Thanks a lot, I really appretiate it
     
  18. GoBlue!

    GoBlue! Manta Ray

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    I should also say, point your friend to www.medlineplus.gov for a wealth of reputable medical information. A search for Hepatitis C will bring up loads of great information for you.

    Jim
     
  19. Spratman

    Spratman Loggerhead Turtle

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    Might as well toss in my $.02...

    I have Hep C and it is inactive. I must go in once a year for liver function tests and cbc. I've already had one biopsy, and they better be darned sure I'm dying before I have another one!

    The nature of the virus is such that it can be triggered at anytime. It takes 10-20 years for symptoms to show. The doc pokes me everytime I go in to see if there is any additional inflammation. The last couple of years, my viral count has been minimal.

    See a medical profession (hepatologist, specifically or at least a gastro-intestinal doc). I cannot see why it would be any problem at all, unless you are taking treatments as mentioned before. Get a physical every year and you should be good to go.

    I like to inform the dive ops about my medical issues and when traveling, it usually requires an updated medical form from your appropriate agency. It's a hellava thing to find a diver buddy though....

    Jack
     
  20. GOAT

    GOAT Angel Fish

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    my stepdad has Hepatitis C.

    He went through the year long treatment about 4 or 5 years ago. and whatever the problem was nearly vanished. He's been diving for 2 years without any problems.

    if you're on the meds.. no way should you dive.. My stepdad is a big man, muscular, and the meds really messed him up.

    but if everything is under control... then it's up to you. Life is about quality :) so enjoy it.
     

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