Barb S

Hi Alexa, Thanks for your comment and you raise some great points. Certainly excessive alcohol intake can lead to cirrhosis and liver damage but I am not aware of any direct causality of alcohol with Hep C. Recreational IV drug use most definitely can be related, as well as increased risk at unlicensed tattoo places. I've had some discussions with several hepatologists that manage a large Hepatitis C Center in Philadelphia and are involved in a widespread community outreach targeting this age group. I was surprised to learn many of their patients contracted the virus through blood transfusions prior to 1992 before testing was available, which is one of the reasons it would impact the baby boomers age group, among other reasons you mentioned. CDC recommends all adults in this age group be tested. So appreciate your feedback! Regards, Barbara

Hepatitis is an inflammation of the liver with a few main genotypes (A, B, C and E), and Hepatitis C is responsible for the vast majority of liver disease among the US population. Over time, undetected Hepatitis C can severely damage the liver, possibly leading to cirrhosis, liver cancer, or death. An age group identified as being at high risk for Hepatitis C is the "baby boomer" generation: those born between 1945 and 1965. Individuals born during this period are five times more likely than other adults to be infected with the Hepatitis C virus (HCV) - 75 % of adults with hepatitis C were born within this timeframe, and an estimated 15,000 HCV-associated deaths of this age group will occur each year. In the United States, it is estimated that between 3 and 5 million people have chronic hepatitis C, and most of these people feel fine and do not suspect that they are infected. Most cases are insidious, and often a suspicion may only arise from a routine check preceding a blood donation or a lab test showing elevated liver enzymes done as part of a physical examination. Barriers to Testing The CDC highly recommends testing for Hepatitis C for these adults; however, certain barriers associated with this virus may delay or deter testing. In the years immediately following World War II, the number of surgical procedures greatly expanded nationwide, and the sterilization techniques for common procedures were not as advanced as they are today. As Hepatitis is transmitted via the blood, improper sterilization of equipment was a factor. Before widespread screening of the nation's blood supply began in 1992, the hepatitis C virus could spread via blood transfusions and organ transplant procedures. In the past, doctors had no protocol or screening method to check if a blood supply was virus-free. Most baby boomers were exposed decades ago and have little or no symptoms, so they do not perceive themselves as being at risk. When thinking about the transmission of the Hepatitis C virus, a common misunderstanding is that a positive result for someone indicates that they are or were a drug abuser. Many are reluctant to get tested as they feel they would be judged harshly and seen in a negative light, the effects of which can lead to a delay in getting tested and diagnosed, receiving treatment, and having an increased risk of complications and poor quality of life. Although IV drug use rose to a significant level in the '60s, it is not the only risk factor for contracting Hepatitis C. As outlined above, there are several explanations as to why they may have contracted Hepatitis C not related to the use of recreational drugs. Patients should not fear having a blood test to determine the presence of HCV due to exposure to tainted blood from whatever source. It is certainly not a reflection of a person's behavior. Recent advances in treatment over the last five years have shown remarkable results in eradicating the virus from the system in almost 95% of those treated and eliminating any further damage to the liver, and limiting spread. Treatment recommendations and evidence-based guidelines for healthcare professionals have been established through a collaboration of the Infectious Diseases Society of America, the American Association for the Study of Liver Diseases, and the International Antiviral Society for HCV management. They are available here. Nurses can play a key role in educating this population on the health impact of Hepatitis C. Encouraging patients to discuss their concerns with their personal healthcare provider and requesting a lab test is the first step in understanding and managing Hepatitis C. Incorporating this test with other screening protocols as part of an ongoing healthcare management plan for baby boomers is a practical and expedient way to identify new cases. Based on CDC estimates, expansion of testing for baby boomers could identify more than 800,000 cases of HCV and, when connecting those requiring treatment to appropriate care, could save more than 120,000 lives in the ensuing years. "Nothing in life is to be feared. It is only to be understood." --Marie Curie References/Resources Improving hepatitis C screening and diagnosis in patients born between 1945 and 1965 in a safety-net primary care clinic: Pub Med-National Library of Medicine Hepatitis C Treatments Give Patients More Options: U.S. Food & Drug Administration (FDA) Phylogenetic estimation of the temporal spread of hepatitis C genotype 1a in North America: a retrospective phylogenetic study: Pub Med-National Library of Medicine