AD 2017 Q4

RESEARCH, EDUCATION & MEDICINE
EXPERT OPINIONS
Diving and Hepatitis C
By Jim Chimiak, MD
STEPHEN FRINK
The hepatitis C virus (HCV) infection
can range from a mild illness to
chronic liver disease, cancer or even
death. The leading cause of infectious
disease deaths in the U.S., HCV has
currently infected an estimated 3.5
million Americans. Early symptoms include nausea,
malaise, abdominal pain and jaundice, but as many as
70 percent to 80 percent of infected people show no
symptoms until the onset of serious liver disease. HCVrelated
liver disease is now the most common reason for
liver transplants in the United States.
HCV is very contagious; a microscopic amount of
blood is all that’s required for transmission. While
effective vaccines are available for hepatitis A and B,
there is not one for HCV. New medications, however,
offer promising results: Several drugs, when used over
two- to three-month-long treatments, have success rates
higher than 90 percent, and in some cases no follow-up
is required if there is no additional liver disease.
Divers encounter situations that involve sharing
masks, snorkels, helmets and alternate air sources. It is
reasonable to be concerned about sharing equipment
with a diver who has HCV. A diver’s saliva might be
tinged with blood following a barotrauma or abrasion
to the lips or gums by a mouthpiece. This divingspecific
concern is not directly addressed in the medical
literature, but the Centers for Disease Control and
Prevention (CDC) states there is a risk of transmission
by sharing razors or toothbrushes. Most organizations
assume there is no further risk of transmission from
people who have undergone treatment, but the Red
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