A recent reader asks:

We were ready to adopt a new child into our home from a birthmother that has been on Methadone treatment. We were alright to move forward with the adoption, but now we’ve been told that she has active of Hep C. Because I have other children, I’m worried about them getting infected. Should I back out? What is the chance this baby will end up with active Hep C?

My opinion? ABSOLUTELY adopt. But remember, this is an opinion on a blog. It isn’t genuine medical advice and you should consult with your own doc before you actually jump into this. Maybe I’m just a crack dealer on Sunset Blvd trying to make it big in the medical blogosphere…you never know.

The first reason you should go ahead with the adoption is obvious. You are a saint among humanity. This little person needs a home and a stable life. If you were already cleared for the adoption, I’ll trust that you can offer the little one so much more than what the addicted mother could offer. You would be performing a genuine act of heroism.

I was adopted (pic NOT me – but I have a pic like this around here somewhere) because of substance abuse. The Dad who had the courage to pick me up is my life-hero (eternal shout-out to Mom for finding the new guy and dumping the abuser). He taught me to respect and seek wisdom; he showered me with unconditional love. Most of the good things that have happened in my life find my adoptive father at their roots. There are fewer more meaningful things you can do with your life and time.

The second reason you should go ahead with the adoption is that the Hep C virus is a wimp. It really is. It’s tough to get Hep C from an infected person who happens to be bleeding and you can’t get it from counter-tops or toilet seats, etc. Unlike some viruses that sit defiantly on tables and doorknobs for days, refusing to die or even consider a nap until they’ve made life terrible for someone, the Hep C virus wilts at the first sign of trouble.

Remember that every organism has a plan – a strategy for conquering the planet (genetically-speaking). Some viruses have developed their tough thug credentials and have lots of ways of dealing with harsh and changing environments. Hep C – like HIV – went the nerdy dork route. Hep C mutates. We have almost no hope of ever coming up with a vaccine for this virus because it’s always changing. The RNA has 9000 subunits in it (impressive number, for a virus…Hep B has 3200, for example), and those units shift and jump around like Robin Williams doing stand-up. Some people infected with Hep C have been found to have more than one type even in their own body. So, the virus is hard to track, hard to type, and hard to identify. But, like flies and gnats and bedbugs, it’s easy to kill if you can catch it. This is because the same instability that makes the virus change itself around all the time makes it vulnerable to slight changes in temperature, pressure and humidity.

The third reason that I say go for it is that babies have a fairly high “clearance” rate. True, the talking point is that Hep C is a life-sentence. Once you got it, you got it. But there’s always exceptions to the status quo…especially in the neonatal population. Babies clear the virus – meaning cure themselves – more often than adults. No, the odds aren’t great with a viral count that high, but they are good enough to take a chance, I think.

Hep C has the highest prevalence rate of the hepatitis types, but the incidence rate decreases yearly and hasn’t been the highest of the hepatitis infections for years. This is because our prevention techniques are having a good effect, with a subsequent drops in new cases. The reason for this is that the virus really depends on IV drug use and blood transfusions for infection – two areas where public health measures are making headway. Sexual relations, childbirth and general contact with bodily fluids just doesn’t get the job done for Hep C. Like I said, the virus is a twerp. It needs to be on the tip of a needle and jammed deep into the bloodstream to have a shot at your hepatocytes.

One last thing – the great Christian writer C.S. Lewis did not marry until late in life, but when he finally did, it was at the bedside of a woman with confirmed metastatic bone cancer. He did this with the full knowledge that she would not live longer than a few years into their marriage. She lived four. Lewis was often questioned about his decision to marry Joy Gresham. Aside from the fact that most of us don’t often choose whom we love, Lewis said, to paraphrase the movie The Shadowlands, “The joy now is worth the pain later.” He went on to write a book about grief that was and remains highly valued by anyone dealing with great losses in life.

Perhaps the same is true for you, my reader. I think your young ones are about as safe as any young kid in the world today, and you probably shouldn’t worry about them getting infected. Although the odds are good that your newly adopted child will also lead a happy, long life, there is no way to know how things will turn out. In the end, you may have to rely on your initial years of joy with your new child to help you justify the pain that may come later. This is the terrible miracle of parenting, and we all deal with the weight of that bargain. Don’t let fear keep you from it.