Baby Boomers Most at Risk for Hepatitis C

Despite breakthrough drugs that changed the prognosis for patients with hepatitis C over the last decade, disease-related deaths remain at an all-time high, according to the U.S. Centers for Disease Control (CDC).

Hepatitis C, which is caused by a virus that infects the liver, kills more people in the United States (nearly 19,659 in 2014) than any other infectious disease including HIV, pneumococcal disease and tuberculosis. CDC officials believe the numbers are low because of underreporting.

Just as disturbing is the fact that people most at risk are unaware they may have been exposed. Baby boomers, the estimated 75 million Americans born between 1945 and 1965, are at highest risk. Technologies that improved the safety of routine injections and blood transfusions did not exist for many years after World War II. Without treatment, patients could develop liver cancer and other life-threatening diseases. However, most experience no symptoms.

“Chronic hepatitis C patients may often have no symptoms to prompt them to have testing done. At times, liver enzymes may be elevated, but often can normalize and such mild abnormalities may go unnoticed,” said Melissa Franco, D.O., a family medicine physician with Baptist Health Primary Care.

Who Should Be Tested?

To prevent hepatitis C deaths and spread of the disease, CDC guidelines call for testing everyone born between 1945 and 1965 at least once in their adult lives, Dr. Franco said. Unfortunately, she said, patients sometimes decline to have the test, while some healthcare providers are not aware of the guidelines.

“It really should be part of the regular physical exam regardless of risk,” Dr. Franco said. “People need to be aware that you may have been exposed in some way and you should screen for it like cholesterol, diabetes and other conditions.”

Hepatitis C is spread by exposure to blood infected with the virus. The public largely views the condition as a sexually-transmitted disease or associates it with intravenous drug use, she said. Some 30,000 new cases are estimated each year, although CDC officials also believe these cases are underreported.

“I think there’s still a stigma in doing these types of tests,” Dr. Franco said. “Patients are not really coming out and asking for it. They may not think they’re at risk.”

According to the American Liver Foundation, about 70 to 80 percent of people with the infection show no signs. Those who do, experience flu-like symptoms including fatigue, sore muscles, fever, joint and stomach pain and jaundice. Symptoms often occur within two to six weeks of exposure. However, people commonly carry the disease for 15 years or more before being diagnosed. Most develop chronic hepatitis C.

When Dr. Franco began practicing medicine ten years ago, a hepatitis C diagnosis was extremely grim.

“The treatment was often worse than the symptoms,” she said. “There were a lot of side effects to the medications, and many patients would stop treatment due to the intolerable effects. Some would decide against treatment at that time due to their experience with the older medications.”

New Meds Have Fewer Side Effects

Beginning in 2013, new medications were approved that could be used once a day and carry few side effects. Today, she said, some medications cure more than 90 percent of patients within two to three months. Patients who remain disease-free for six months are considered cured.

“The new drugs are just amazing,” she said. “I’ve had a couple of patients that have completed their treatment. One woman ran a marathon in the middle of treatment.”

Researchers are now working on a vaccine for hepatitis C. Vaccines for hepatitis B, which have been given at birth since 1991, have almost eliminated that disease.

Meanwhile, Dr. Franco said, screening for hepatitis C, particularly among baby boomers, can save lives lost needlessly, and lower the statistics.

“We have options to treat it,” she said. “It’s very hopeful.”