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Monday, Oct. 7, 2019

Baby Boomers and Hepatitis C

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What is the link?

People born between 1945 and 1965 are considered “baby boomers,” a generation group that is also five times more likely to have hepatitis C virus (HCV) than other people. It’s estimated that between three and five million people have chronic hepatitis C in the U.S., and most of those people don’t know they’re infected. The majority of this group is from the baby boomer generation.

What is hepatitis C?

Hepatitis means inflammation of the liver. There are different viruses of hepatitis (like A, B, C, D and E) which are caused by viruses. Hepatitis C is the type that is most common and is the leading cause of liver disease in the United States. Hepatitis C virus spreads when blood from a person infected with the virus enters the body of someone who’s not infected. Hepatitis C infection can be acute (short-term) or chronic (long-term). Most people with acute hepatitis C eventually develop chronic hepatitis C without knowing the presence of hepatitis C in their body, since many people can live with hepatitis C for decades without symptoms or feeling sick. Left untreated, chronic infection can progress to cirrhosis, liver failure and even liver cancer. There is no vaccine to prevent hepatitis C, which makes early detection very important. While anyone can get hepatitis C, three in four people with hepatitis C were born from 1945–1965. The Centers for Disease Control and Prevention (CDC) calls it “an unrecognized health crisis in the United States.” That’s why the CDC and other health officials recommend one-time hepatitis C testing for all baby boomers.

Why do baby boomers have such high rates of hepatitis C?

The reason that people born from 1945– 1965 have high rates of hepatitis C is not entirely understood, but the biggest reason baby boomers are more likely to have hepatitis C is probably due to unsafe medical procedures at the time. In the past, there was no protocol or screening method to check if a blood supply was virus-free. Baby boomers could have gotten the infection from medical equipment or procedures before universal precautions and infection control procedures were adopted. Widespread screening virtually eliminated the virus from the blood supply by 1992, so others could have gotten infected from contaminated blood and blood products before 1992. Sharing needles or equipment used to prepare or inject drugs, even if only once in the past, could spread hepatitis C. Still, many people do not know how or when they were infected.

Why should people born from 1945-1965 get tested for hepatitis C?

We must identify everyone with chronic HCV because they are at increased risk for early death due to liver disease and its complication. There is also significant evidence that chronic hepatitis C is associated with increased risk for diseases outside the liver, including heart and kidney disease, as well as diabetes. In addition, recent advances in antiviral therapy allow us to cure the vast majority of HCV infections using short courses of well-tolerated oral medications.

The World Health Organization (WHO) has committed to a global effort to reduce new cases of HCV infection by 90% and to reduce HCV-related mortality by 65% by 2030. Some countries are on track to achieve this target and have done so by enacting

widespread population screening campaigns coupled with access to antiviral therapy. We can and must do better with screening in the United States.

How to diagnose hepatitis C?

A simple blood test will reveal whether blood has hepatitis C antibodies. If antibodies are present, it will be confirmed by hepatitis C viral load in blood or HCV RNA test. If the test is positive, remember that you don’t have to change any behaviors with family and loved ones, as HCV is not transmitted from casual encounters. Hep C antibodies always remain in the blood once a person has been infected, even if they’ve cleared the virus.

What are the treatments for hepatitis C?

While the disease can lead to cirrhosis, liver cancer and even death, dramatic improvement in newer treatments hold more than 95 to 99 percent cure rate. Treatments in the past were more complicated. Today, a drug combination pill for 12 weeks can treat hepatitis C. After finishing this treatment, a person is considered cured.

TAKEAWAYS

Hepatitis C can feel scary, but it does not have to be!

Educate yourself and the baby boomers in your life. Getting tested for HCV starts with having a conversation with a doctor.

Overcome the stigma and encourage screening. HCV is stigmatized mainly due to unfamiliarity of the disease. The CDC and the United States Preventive Services Task Force (USPSTF) recommends all baby boomers be screened for HCV at least once.

Testing, diagnosis and treatment is now easy. Hepatitis C is curable.

References: https://www.cdc.gov/hepatitis/hcv/index.htm

Dr. Hrishikesh Samant is an assistant professor of gastroenterology and hepatology at LSU Health Shreveport and the site director of hepatology at the John C. McDonald Regional Transplant Center.

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