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July 28th is World Hepatitis Day

Could You Have This Disease and Not Know It?

At this very moment, 90 percent of those living with hepatitis B and 80 percent living with hepatitis C are not aware of their status.

The World Hepatitis Alliance reports that viral hepatitis is one of the leading causes of death globally, accounting for 1.34 million deaths per year—that’s as many as HIV/AIDS, tuberculosis, or malaria. Together, hepatitis B virus and hepatitis C cause approximately 80 percent of liver cancer cases in the world.

Viral hepatitis is not found in one location nor amongst one set of people; it’s a truly global epidemic that can affect millions of people without them even being aware. Currently, 90 percent of people living with hepatitis B and 80 percent living with hepatitis C are not aware of their status. This can result in the real possibility of developing fatal liver disease at some point in their lives and, in some cases, unknowingly transmitting the infection to others.

With the availability of effective vaccines and treatments for hepatitis B and a cure for hepatitis C, the elimination of viral hepatitis is achievable, but greater awareness and understanding of the disease and the risks is a must, as is access to cheaper diagnostics and treatment.

What is Hepatitis?

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis, or liver cancer, says the World Health Organization (WHO). Hepatitis viruses are the most common cause of hepatitis in the world, but other infections, toxic substances (such as alcohol or certain drugs), and autoimmune diseases, can also cause the disease.

Five main hepatitis viruses, referred to as types A, B, C, D, and E, have been identified. These five types are of greatest concern because of the illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Symptoms of the disease can include:

  • Jaundice (yellowing of the skin and eyes);
  • Tiredness;
  • Stomach ache;
  • Nausea;
  • Muscle aches;
  • Diarrhea;
  • Loss of appetite;
  • Fever; and
  • Headaches.

Baby Boomers and Hep C

Hepatitis C can lead to damage of the liver which is the largest organ in the body. This important organ helps the body digest food, store energy, and remove toxic materials. Hepatitis C can cause serious long-term health problems of the liver including liver failure, liver cancer, or even death. The disease is the leading cause of cirrhosis and liver cancer and is the most common reason for liver transplantation in the U.S. Approximately 19,000 die each year due to hepatitis C-related liver disease.

The Centers for Disease Control and Prevention (CDC) confirm that more Americans die from hepatitis C than from any other infectious disease. In 2015, nearly 20,000 Americans died from hepatitis C related causes and most were age 55 and older. In fact, Baby Boomers are six times more likely to have the disease; three of four people with hepatitis C were born between 1945 and 1965.

The disease may be more common for this generation because transmission was highest during the 1960s through the 1980s. Some may have gotten infected from contaminated blood transfusions before blood products were universally screened for hepatitis, while others may have gotten infected as the result of injecting drugs. The bottom line: Many were exposed at a younger age, but don’t realize it. Unfortunately, many of them have never even been tested.

Hepatitis C is called the “silent disease” or “silent epidemic” for a reason—you could live for years without knowing you’re infected. Hepatitis C often does not generate noticeable symptoms (or at least not for a long time) so you might not even know your liver is getting progressively more damaged. You can also spread the virus even if you don’t exhibit any symptoms.

Millennials and Hep C

New reports from the CDC are warning that hepatitis C infections in the U.S. have nearly tripled over five years, rising from 850 new cases in 2010 to 2,436 in 2015. It’s no longer primarily Baby Boomers being affected. The age group impacted the most from these new infections is those aged 20 to 29 years–Millennials. It’s believed to be stemmed from the growing use of injected drugs linked to the current opioid epidemic.

“Recent CDC research has identified increasing injection drug use—tied to the U.S. opioid epidemic—in rural and suburban areas across the country,” says Dr. John Ward, director of the division of viral hepatitis at the CDC.

He confirms the hardest hit areas in terms of new infections are parts of Appalachia and rural areas of the Midwest and New England. Rural areas in other states are also experiencing a similar, though smaller, rise in new hepatitis C cases.

Seven states—Indiana, Kentucky, Maine, Massachusetts, New Mexico, Tennessee, and West Virginia—have rates at least twice the national average, according to CDC researchers. In addition, 10 states have rates above the national average: Alabama, Montana, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, Utah, Washington, and Wisconsin.

“These new infections are most frequently among young people who transition from taking prescription pills to injecting heroin, which has become cheaper and more easily available in some cases,” says Ward. “In turn, many—most, in some communities—people who inject drugs become infected with hepatitis C.”

But all hope is not lost. “By testing, curing, and preventing hepatitis C, we can protect generations of Americans from needless suffering and death,” says CDC’s Dr. Jonathan Mermin. “We must reach the hardest-hit communities with a range of prevention and treatment services that can diagnose people with hepatitis C and link them to treatment. This wide range of services can also prevent the misuse of prescription drugs and ultimately stop drug use, which can also prevent others from getting hepatitis C in the first place.”

Prevention is Possible

Safe and effective vaccines provide protection against hepatitis A and B. The CDC recommends that all newborns and individuals up to 18 years of age and adult participating at risk of infection be vaccinated. Three injections over a six to 12-month period are required to provide full protection. There is no vaccine available for hepatitis C, but treatment is possible with medication.

To protect yourself from any type of hepatitis, remember to:

  • Wash your hands after going to the bathroom and before preparing food or eating;
  • Use latex condoms to lower the risk of transmission;
  • Avoid tap water when traveling to certain countries or regions. Ask your doctor about risks before you travel;
  • Avoid sharing drug needles; and
  • Avoid sharing personal items—such as toothbrushes, razors, and nail clippers—with an infected person.

So, if you’re a Baby Boomer, please talk to your doctor about getting screened for hepatitis C if you were born between 1945 and 1965—even if you don’t think you fall into one of the other at-risk categories. If you don’t know your status, you won’t know if you should undergo treatment.

If you are struggling with opioid or heroin issues, or know someone who is, please make every effort to connect with a physician to be tested for hepatitis C before the damage is too far gone. A coordinated effort is needed to get patients plugged into care so they beat their addictions and avoid hepatitis C.

For further information about whether you might be, or have been, at risk and how you can get tested, contact the providers at CCHC Southern Gastroenterology Associates in New Bern by calling (252) 634-9000 or visiting www.cchchealthcare.com.


(Sources: National Institutes of Health; World Health Organization; Centers for Disease Control and Prevention; World Hepatitis Alliance; Observer Media; Live Science; and the American Liver Foundation.)