Fewer than half of those treated are cured. There is no vaccine. The disease is particularly prevalent among intravenous drug users. For example, in Baltimore 90 percent of those seeking treatment for heroin addiction are infected. In total, more than 4 million Americans have been exposed to the disease, of whom up to 15 percent can expect to become seriously ill in the next 20 years, according to David Thomas of Johns Hopkins University Hospital.
Carriers often have no symptoms.
Most state prison systems do not require testing of inmates. In many systems, testing is voluntary and in a few it is non-existent. Prison activists charge that prison authorities do not want to know if inmates are infected because once they do know they are obliged to offer costly treatment. Diagnosis may involve giving patients liver biopsies to determine how far the disease has progressed. In some advanced cases, the only treatment may be liver transplants.