HEPATITIS C & SENIORS

 

Sometimes elderly people are not diagnosed with hepatitis C because the symptoms are similar to what we tend to expect from the aging process: tiredness, achy joints, sleep problems, stomach and digestive problems, strange rashes, memory loss, and so on. The elderly should expect to feel good, and to investigate matters when they don’t. It may be that the problems can be remedied.

I've Been Diagnosed. Now What?

If you're diagnosed with hepatitis C, get informed. Check with your local support group.

Make sure that you:

Get re-tested to confirm the diagnosis.

Get vaccinated against hepatitis A and B, and get tested to see if the vaccinations took.

Ask about the pneumonia and flu vaccines.

Get sent to a specialist.

Get copies of all tests.

The specialist should:

Order an ultrasound yearly, if your family doctor didn't.

Order an alphafetoprotein test yearly to check for cancer.

Order a liver biopsy. (This is usually done by needle aspiration, but there are other options, for example, if there is a bleeding problem).

Discuss treatment options with you (Get a second or even a third opinion if you don't agree).

Am I Contagious?

Transmission of hepatitis C is rare, but can occur with blood-to-blood contact, such as when your blood comes into contact someone’s open cut, or by sharing of razor blades, toothbrushes and sharp personal grooming aids, like nail clippers. Yes, you may hug and kiss your grandchildren. Sexual transmission occurs rarely, and long-time couples are not advised to change their normal habits. All family members should be tested, just in case.

How can I avoid spreading Hep C?

-Keep your toothbrush, toothpaste, razors and nail clippers where no one can use them by mistake.

-Clean the sink personally every time you brush your teeth. Use a plastic spray bottle containing a bleach / water mixture along with paper towels, or wipes.

-Wipe up any blood spills carefully, using vinyl or rubber gloves, first with water and paper towels, and then with a 10% household bleach solution. If any glass is involved in the cleanup, pick up the pieces first and wrap them in newspaper before placing them in a plastic bag. Wrap the soiled towels in a plastic bag and put it in the trash. Do not use bleach on skin (or pets' claws). Use 70% Alcohol (rubbing alcohol) on skin. (This can also be used on colour-sensitive fabrics.) Remove and discard gloves. Wash your hands when you’re done.

Will I die from Hep C?

Hepatitis C can remain “dormant” for decades, but can also result in liver cancer, cirrhosis, liver failure, and serious bleeds. About 80-85% of people infected with HCV will develop chronic hepatitis; of those, 20-30% will progress to cirrhosis. Another 20-30% may develop chronic HCV infection without abnormal elevations of liver enzymes in the blood. –Source: Prevention, Diagnosis, and Management of Viral Hepatitis, AMA.

Liver cancer is thought to be produced by constant inflammation and regeneration of liver tissue over about 30 years. Most, if not all, cases of liver cancer occur in people with cirrhosis. In other words, if you don’t have cirrhosis, you probably don’t have to worry about liver cancer. Once cirrhosis begins, the chance of liver cancer is 1 to 4% a year. Source: National Institutes of Health Consensus Statement on Hepatitis C 1997

Some doctors think that most people who are infected during middle age will probably die of their underlying disease or of old age, rather than hepatitis C.

Source: Natural History and Clinical Aspects of HCV Infection, H.J. Alter, MD.

Other doctors think that progression of the disease is faster in older patients.

Should I be treated?

The only proven treatment is interferon and its various combinations. Treatment results are not as good for older people. Recent studies are being done on people with cirrhosis, with good results, however. Several things affect treatment results: age, sex (women respond better than men), mode of transmission (transfused patients are harder to treat), enzyme levels, genotype, viral load, and the amount of interferon taken. Source: Kim SR, et al, Prediction of efficacy of interferon treatment of chronic hepatitis C by Pathol Int 1998 Mar;48(3): 215-220

Remember: Not all interferons are created equal. Some are more effective than others.

Fact: Those over age 60 are often not treated. Doctors probably wish to protect their patients from the uncomfortable side-effects of interferon, but in many cases, the disease itself causes more discomfort than the treatment, and often older people do respond to treatment.

Most patients have had to fight to be treated in Canada. This is especially true for seniors.

Can I be transplanted?

Those over 65 are usually not transplanted. Exceptions are made.

Can diet help?

There is a more rapid development of cirrhosis and liver cancer alcoholics with chronic HCV infection. To be safe, don’t drink.
Tobacco makes liver cancer more likely in Hep C sufferers. There is nothing doctors will recommend in the way of special diet unless you have cirrhosis, but most people find they feel better on low fat diets.

Alternative Treatments

Check with your doctor before taking any alternative medicine. Some herbs are safe, and may help. Others can be toxic. It’s best to consult with a reputable naturopath or health food store, and have your blood monitored for possible liver damage any time you try a new treatment.

 

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