INDIANA — Helen Rominger, infectious diseases nurse practitioner with the Damien Cares Clinic in Indianapolis, calls hepatitis C a silent disease; many people can have it for decades without knowing.

“You generally don't know you have it until someone tests you for it or you've had it so long that it's compromised your liver.”

Treatment is available, but it's costly — between $65,000 and $80,000 for the 12-week pill regimen — and not everyone is a candidate.

“It depends on the damage that has already occurred to the liver,” Rominger said.

While HIV does not live long outside the body — no more than a few minutes — the vacuum of a syringe gives it a few more hours of activity.

The incubation period for HIV could be as little as a few weeks.

“Many symptoms patients will experience is an acute flu-like syndrome,” Rominger said. “High fever, body aches, malaise, fatigue that will last [longer] than 10 days.”

This may often be accompanied by heavy night sweats, swollen glands and torso rash.

Treatment for HIV is in the form of antiretroviral drugs — from one to several daily pills to keep viral levels low enough that they are undetectable. This also means they are unable to transmit the disease to others at this level.

“The cost, if you don't have insurance, is prohibitive,” she said.

Monthly middle-ground cost for the lifetime medication is $5,000 to 6,000. But HIV treatment assistance programs can help with costs, said Jeremy Turner, director of development and communication at the Damien Center in Indianapolis.

“As long as a client can get access to a care coordination site, they are going to get treatment,” he said.

But he said clinical care, alone, is not enough. The Damien Center provides mental health and substance abuse counseling, medical and non-medical case manager, a housing program, employment help and support groups.

Other health complications include abscesses, which are bacterial infections caused by unhygienic needles, and endocarditis, a heart valve infection.

“Anybody that is injecting is going to be prone to endocarditis or abscesses,” Rominger said.

Treating the individuals, she said, will lead to a healthier community as a whole.

“If we get everybody that's infected on medicine and keep them on medicine, then we reduce the incidents of new infections in the community," Rominger said.

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