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Senior Lookout: Hepatitis C Becoming More Common in Elder Population
By Anne Springer, Gloucester Daily Times
March 26, 2008
As Baby Boomers age, elder care professionals can expect to see a rise in the number of consumers who have viral diseases that may have been incurred as the result of activity such as intravenous drug use.
In that cohort, illnesses such as bipolar disorder or schizophrenia were often not diagnosed early enough to intervene with therapies that could have prevented a young person from turning to alcohol or drugs to self-medicate. Mental illness was swept under the rug, as if it were somehow not the same as having diabetes or arthritis or any other medical condition.
Veterans of the Vietnam era often came back from the horrors of that war with a drug habit. In the 1980s, cocaine was the cool drug — until it hooked people so badly that a few sniffs up a straw turned into smoking crack from a pipe, or shooting it into one's veins.
Polite society often wants to turn its back on these issues, and assumes that the fault for certain illnesses lies with the individual. But, if a person received blood products as the result of a transfusion, or surgery, prior to the early 1990s, they are also at risk for blood-borne pathogens.
Even when a person acquires an illness as the result of risky behavior, he or she still needs to be cared for with respect. We have come a long way, but have further to go — and it's up to health professionals to lead the way.
HIV/AIDS gets a lot of publicity, but there is another disease lurking in our population. In fact, 80 percent of those infected have no idea that they have it.
Hepatitis C (HCV), in its early stages, often causes no noticeable symptoms at all. The Centers for Disease Control estimate that approximately 4.1 million (1.6 percent) Americans have been infected with HCV, of whom 3.2 million are chronically infected. Of those infected, 75 percent to 85 percent will have chronic infection and up to 20 percent of those people may progress to cirrhosis or cancer of the liver. One percent to 5 percent of those chronically infected may die of their disease. Symptoms of HCV are fatigue, dark urine, abdominal pain, loss of appetite, nausea and jaundice. Those with advanced disease may also suffer from cirrhosis, ascites (fluid build-up), a reversed sleep pattern (sleeping during day, awake at night), hepatic encephalopathy (confusion, and other symptoms, from accumulation of toxins in the brain), malnutrition, muscle wasting, or clotting difficulties.
Fortunately, the estimated number of new infections per year has declined from an average of 240,000 in the 1980s to about 19,000 in 2006.
Currently, a combination of drugs such as Interferon, Ribavirin and Actigall are the treatment of choice in those individuals who can handle the therapy. These drugs are contraindicated in some patients and are not always successful in eradicating the virus. HCV infection is the leading reason for liver
transplantation in the United States, but there are far more infected individuals than donor livers. Lahey Clinic in Burlington has a live donor transplantation program, but not all patients are eligible for such partial liver transplantation and must wait for a cadaver liver.
A new therapeutic DNA vaccine known as ChronVac-C is now in clinical trials, and there is evidence of its ability to invoke the desired immune response against Hepatitis C.
Inovio Biomedical Corp. (AMEX:INO) announced that its partner, Tripep AB of Sweden, has reported preliminary results from the first patient to complete treatment delivered using Inovio's electroporation-based DNA delivery system. In the clinical study, the treatment has so far been safe and tolerable.
Until better treatments or a preventive vaccine is fully available, however, universal precautions that keep workers safe should be stressed in both medical and social service environments, victims should be treated with respect regardless of how they acquired the infection (which often takes 20 years or more to progress to the point where symptoms become problematic), and people with risk factors for blood-borne illness, and hepatitis C in particular, should be encouraged to get tested, both to access treatment at the earliest possible juncture and to be proactive about warning the people in their lives to take precautions against infection as well. No one should share toothbrushes, razors or be tattooed by anyone who is not educated in safe practices.
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