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
)
