All women who had Caesarean sections, vaginal births or other gynecological procedures requiring blood transfusions before 1992 are at risk for hepatitis C, the California Hepatitis C Coalition announced this week.

Women who think they might be at risk are urged to ask their doctors for a test to detect the deadly virus, coalition organizers said. Some gynecologists, especially those who serve as primary care physicians, are also authorized to order the test under most insurance plans.

Stanislaus County women without insurance must find a plan -- either private insurance or government insurance like MediCal -- to get tested, said David Jones, spokesman for the county Health Services Agency. While the county offers sexually transmitted disease tests at nine offices throughout the county, there is no such program for hepatitis C tests, he said. The same is true in San Joaquin, Merced and Tuolumne counties.

Hepatitis C, spread by blood-to-blood contact, is an infection that causes inflammation and ultimately scarring of the liver. In 1989, the virus was identified, but it took three more years before researchers could effectively screen blood for hepatitis C.

Hepatitis C often has no symptoms, according to the Centers for Disease Control and Prevention. The most common sign of the virus is extreme tiredness. It's possible to be infected for 20 years or more before more recognizable signs of the virus, such as liver damage, appear.

It's important for those who test positive for hepatitis C to develop a relationship with a doctor because, unlike other viruses, hepatitis C requires ongoing treatment, Jones said.

Early diagnosis gives doctors the opportunity to discuss treatment methods and to slow the progression of the disease, according to the National Institutes of Allergy and Infectious Disease.

The American College of Obstetricians and Gynecologists, in conjunction with the California Hepatitis C Coalition, is asking doctors throughout the nation to examine records of patients who had transfusions during child birth before 1992.

"We are concerned about women who received transfusions during gynecological procedures," said Dr. Josephine L. Von Herzen of the American College of Obstetricians and gynecologists.

"In addition, women who gave birth may not be aware that they had a transfusion of blood during the confusion and excitement of their procedure and the resulting birth of their child," she said.

She urges physicians to double-check charts and discuss the risk factors for hepatitis C with all patients.

Physicians who need further information can call the American College of Obstetricians and Gynecologists at (415) 474-1818 or get the Center for Disease Control's clinical recommendations on hepatitis C online at http://www.cdc.gov/ncidod/diseases/hepatitis/resource/index.htm.

Information for the public is available directly from the Centers for Disease Control and Prevention (888 4-HEP-CDC) and online at http://www.drkoop.com.

Reprinted by permission of the Modesto Bee.