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  • C attn:baby boomers hepatitis · According to the CDC, baby boomers are the largest group at risk, 1 in 30 have Hepatitis C. Baby Boomers are individuals who were born between1945
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24 Inside Medicine | late summer 2017 Hepatitis C is a blood borne disease that was identified in 1989. Prior to 1989 it was labeled non A non B viral Hepatitis. Hepatitis C is a contagious disease caused by the Hepatitis C vi- rus. The Center for Disease Control (CDC) estimates 2% of the US population or 3.5 million individuals currently have Hepatitis C in the USA. Most do not know they have the disease. The virus can be present/active for decades with little or no symptoms. According to the CDC, baby boomers are the largest group at risk, 1 in 30 have Hepatitis C. Baby Boomers are individuals who were born between1945 - 1965. Nine months after World War II ended more babies were born in 1946 than the prior year. In 1965, 3.4 million babies were born, that is 20% more babies born than in 1945. This was the beginning of the baby boom and in 1964 the birth rate began to taper off. In 1964 there were more than 76.4 million baby boom- ers in the USA, making up 40% of the population. The most ac- cepted explanation for the baby boomer generation is families were confident after the war to start a family. They believed in the future and prosperity of our country. Why are baby boomers the highest risk group diagnosed with Hepatitis C? According to the CDC most baby boomers were infected in the 1970’s & 1980’s. During these decades in- fection control standards were not the same standards as we have today. Hepatitis C virus is spread through direct contact with infected blood. This means blood to blood transmission, such as having a cut with blood exposed and touching another person’s cut with blood exposed that is infected with the Hepa- titis C virus. Most people with Hepatitis C contracted it through shared needles, snorting cocaine, sharing razors, toothbrushes, tattooing and body piercing if strict hygienic precautions were not taken. Prior to 1990, blood was not tested for the Hepatitis C virus, therefore receiving a blood transfusion prior to 1990 is a risk factor. History of HIV is also a risk factor. Keep in mind baby boomers are the highest risk group, however any one with high risk behaviors are at risk of contacting the Hepatitis C virus. Intravenous drug use is a significant risk factor, unfortunately IV drug use is on the rise. According to World Health Organiza- tion (WHO), 13 million people globally inject illicit drugs. The esti- mated global prevalence of Hepatitis C in people who inject illicit drugs is 67%. The CDC reports more people die from Hepatitis C than from HIV infection. Hepatitis C is NOT transmitted with shar- ing utensils or casual contact such as hugging, shaking hands or sneezing. The risk of spreading Hepatitis C during sex is low (3% over 20 years in monogamist couples with unprotected sex). Hepatitis C is a virus that affects the liver. It can cause acute or chronic liver disease, ranging from mild to serious liver dis- ease. It tends to be worse or accelerated in persons with moder- ate to heavy alcohol use. According to the WHO approximately 71 million people globally have Hepatitis C. Approximately 399,000 people worldwide die annually from Hepatitis C, mostly from cirrhosis or liver cancer. Cirrhosis is extensive scarring of the liver. Hepatitis C is the leading cause of liver cancer and liver transplantation. Hepatitis C is diagnosed with a blood test. Ask your health care professional if Hepatitis C screening is for you. A positive Hepatitis C test doesn’t mean the virus is active, it does mean you were infected at some point. Remember it takes only one exposure to be at risk. Most people do not know exactly when they were infected. Hepatitis C antibodies remain in the blood once a person is infected with the virus for life. Another spe- cial blood test, Hepatitis C RNA is then ordered to see if one is currently infected with the virus. According to American College of Gastroenterology (ACG) approximately 15-25% of people infected with Hepatitis C spontaneously clear the virus without treatment. According to ACG, symptoms can include fatigue, ab- dominal discomfort, nausea or itching. Once a patient devel- ops cirrhosis, symptoms are more prominent and can include jaundice (yellowish color of the skin), weight loss, abdominal swelling, vomiting of blood. The virus is slowly damaging the liver over years to decades. Untreated Hepatitis C can lead to liver cancer and even death. The goal of Hepatitis C treatment is to clear the Hepatitis C virus. Prior to starting treatment the health care specialist will spend time discussing Hepatitis C and develop a plan of care. Today’s Hepatitis C treatment has less side effects and is easier to take than treatment from years prior. The end goal is sus- tained virologic response (SVR). In other words Hepatitis C virus is cleared after treatment. Hepatitis C is treated by a specialist, such as a Gastroenter- ologist, Hepatologist or Infectious Disease Doctor. These health care professionals have been trained and have the knowledge to best treat and manage Hepatitis C. The first step prior to treat- ment is to order specific blood tests to confirm active Hepatitis C. An abdominal ultrasound is also ordered to assess the liver status. After careful review of blood test, ultrasound, current medications the specialist will come up with a treatment plan. Direct Acting Antivirals (DAA) are medications currently used to treat Hepatitis C. These medications are taken by mouth and have less side effects than prior treatments. Average treat- ment last 8-24 weeks, depending on the lab results, liver status and prior history of any treatments. Treatment holds 90-100% cure rates. Currently there is no vaccine for Hepatitis C. In summary it is important to discuss Hepatitis C with your health care provider. Get tested if you are at risk. If you do test positive for Hepatitis C, there is a cure with a high cure rate 90- 100%. The major barrier why most people avoid discussing Hepatitis C with their health care provider is the social stigma of having Hepatitis C. Also avoid high risk factors that increases risk of contracting the Hepatitis C Virus. Don’t let this prevent you from getting treatment, preventing liver cancer or liver failure. Know the facts, it can save your life or a love one’s life. If we can be of help with any questions or screening for Hepatitis C please contact our office. 256.430.4427 } HEALTH FEATURE by Dr. Michael Dohrenwend Board Certified, Gastroenterology Center for Digestive Health Karen Fox, CRNP C hepatitis Hepatitis C...Know the facts not the myths...not only can people with Hepatitis C be treated, they can be cured. attn:baby boomers

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Page 1: C attn:baby boomers hepatitis · According to the CDC, baby boomers are the largest group at risk, 1 in 30 have Hepatitis C. Baby Boomers are individuals who were born between1945

24 Ins ide Medic ine | l a t e s u m m e r 2017

HepatitisCisabloodbornediseasethatwasidentifiedin1989.Priorto1989itwaslabelednonAnonBviralHepatitis.HepatitisCisacontagiousdiseasecausedbytheHepatitisCvi-rus.TheCenterforDiseaseControl(CDC)estimates2%oftheUSpopulationor3.5millionindividualscurrentlyhaveHepatitisCintheUSA.Mostdonotknowtheyhavethedisease.Theviruscanbepresent/activefordecadeswith littleornosymptoms.AccordingtotheCDC,babyboomersarethelargestgroupatrisk,1in30haveHepatitisC. BabyBoomersareindividualswhowerebornbetween1945-1965.NinemonthsafterWorldWarIIendedmorebabieswerebornin1946thantheprioryear.In1965,3.4millionbabieswereborn,thatis20%morebabiesbornthanin1945.Thiswasthebeginningofthebabyboomandin1964thebirthratebegantotaperoff.In1964thereweremorethan76.4millionbabyboom-ersintheUSA,makingup40%ofthepopulation.Themostac-ceptedexplanationforthebabyboomergenerationisfamilieswereconfidentafterthewartostartafamily.Theybelievedinthefutureandprosperityofourcountry. Whyarebabyboomersthehighestriskgroupdiagnosedwith Hepatitis C? According to the CDCmost baby boomerswereinfectedinthe1970’s&1980’s.Duringthesedecadesin-fectioncontrolstandardswerenotthesamestandardsaswehavetoday.HepatitisCvirus isspreadthroughdirectcontactwith infectedblood.Thismeansbloodtobloodtransmission,suchashavingacutwithbloodexposedandtouchinganotherperson’scutwithbloodexposedthatisinfectedwiththeHepa-titisCvirus.MostpeoplewithHepatitisCcontracteditthroughsharedneedles,snortingcocaine,sharingrazors,toothbrushes,tattooingandbodypiercingifstricthygienicprecautionswerenottaken.Priorto1990,bloodwasnottestedfortheHepatitisCvirus,thereforereceivingabloodtransfusionpriorto1990isariskfactor.HistoryofHIV isalsoariskfactor.Keep inmindbabyboomersarethehighestriskgroup,howeveranyonewithhighriskbehaviorsareatriskofcontactingtheHepatitisCvirus.Intravenousdruguse isasignificantriskfactor,unfortunatelyIVdruguseisontherise.AccordingtoWorldHealthOrganiza-tion(WHO),13millionpeoplegloballyinjectillicitdrugs.Theesti-matedglobalprevalenceofHepatitisCinpeoplewhoinjectillicitdrugsis67%.TheCDCreportsmorepeoplediefromHepatitisCthanfromHIVinfection.HepatitisCisNOTtransmittedwithshar-ingutensilsorcasualcontactsuchashugging,shakinghandsorsneezing.TheriskofspreadingHepatitisCduringsexislow(3%over20yearsinmonogamistcoupleswithunprotectedsex). HepatitisCisavirusthataffectstheliver.Itcancauseacuteorchronicliverdisease,rangingfrommildtoseriousliverdis-ease.Ittendstobeworseoracceleratedinpersonswithmoder-atetoheavyalcoholuse.AccordingtotheWHOapproximately71 million people globally have Hepatitis C. Approximately

399,000peopleworldwidedieannuallyfromHepatitisC,mostlyfromcirrhosisorlivercancer.Cirrhosisisextensivescarringoftheliver.HepatitisCistheleadingcauseoflivercancerandlivertransplantation. HepatitisCisdiagnosedwithabloodtest.AskyourhealthcareprofessionalifHepatitisCscreeningisforyou.ApositiveHepatitisCtestdoesn’tmeanthevirusisactive,itdoesmeanyouwereinfectedatsomepoint.Rememberittakesonlyoneexposuretobeatrisk.Mostpeopledonotknowexactlywhentheywereinfected.HepatitisCantibodiesremaininthebloodonceapersonisinfectedwiththevirusforlife.Anotherspe-cialbloodtest,HepatitisCRNAisthenorderedtoseeifoneis currently infected with the virus. According to AmericanCollegeofGastroenterology (ACG)approximately15-25%ofpeopleinfectedwithHepatitisCspontaneouslycleartheviruswithouttreatment. According to ACG, symptoms can include fatigue, ab-dominaldiscomfort,nauseaoritching.Onceapatientdevel-opscirrhosis,symptomsaremoreprominentandcanincludejaundice(yellowishcoloroftheskin),weightloss,abdominalswelling,vomitingofblood.Thevirusisslowlydamagingtheliveroveryearstodecades.UntreatedHepatitisCcanleadtolivercancerandevendeath. ThegoalofHepatitisCtreatmentistocleartheHepatitisCvirus.PriortostartingtreatmentthehealthcarespecialistwillspendtimediscussingHepatitisCanddevelopaplanofcare.Today’sHepatitisCtreatmenthaslesssideeffectsandiseasiertotakethantreatmentfromyearsprior.Theendgoal issus-tainedvirologicresponse(SVR).InotherwordsHepatitisCvirusisclearedaftertreatment. HepatitisCistreatedbyaspecialist,suchasaGastroenter-ologist,HepatologistorInfectiousDiseaseDoctor.ThesehealthcareprofessionalshavebeentrainedandhavetheknowledgetobesttreatandmanageHepatitisC.Thefirststeppriortotreat-mentistoorderspecificbloodteststoconfirmactiveHepatitisC.Anabdominalultrasoundisalsoorderedtoassesstheliverstatus. After careful reviewofblood test, ultrasound, currentmedicationsthespecialistwillcomeupwithatreatmentplan. Direct Acting Antivirals (DAA) are medications currentlyusedtotreatHepatitisC.Thesemedicationsaretakenbymouthandhavelesssideeffectsthanpriortreatments.Averagetreat-mentlast8-24weeks,dependingonthelabresults,liverstatusandpriorhistoryofanytreatments.Treatmentholds90-100%curerates.CurrentlythereisnovaccineforHepatitisC. InsummaryitisimportanttodiscussHepatitisCwithyourhealthcareprovider.Gettestedifyouareatrisk.IfyoudotestpositiveforHepatitisC,thereisacurewithahighcurerate90-100%. The major barrier why most people avoid discussingHepatitisCwiththeirhealthcareprovideristhesocialstigmaofhavingHepatitisC.AlsoavoidhighriskfactorsthatincreasesriskofcontractingtheHepatitisCVirus.Don’t letthispreventyoufromgettingtreatment,preventinglivercancerorliverfailure.Knowthefacts,itcansaveyourlifeoraloveone’slife. Ifwecanbeofhelpwithanyquestionsorscreening forHepatitisCpleasecontactouroffice.256.430.4427

} H E A L T H F E A T U R E

by Dr. Michael Dohrenwend Board Certified, Gastroenterology Center for Digestive Health Karen Fox, CRNP

Ins ide Medic ine | s u m m e r 2017 57

by Traci McCormick, MD

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