c attn:baby boomers hepatitis · according to the cdc, baby boomers are the largest group at risk,...

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

ChepatitisHepatitis C...Know the facts not the myths...not only can people with Hepatitis C be treated, they can be cured.

attn:baby boomers