Living Well Most people don't go to the doctor to get sick.
But the medical industry has a long history of inadvertently making life worse for some people – and sometimes intentionally (like the hundreds of black men involved in the Tuskegee syphilis study). There's even a term for this... They are known as iatrogenic factors – where a disease is induced in a patient by the treatment of a physician.
In the 1950s, one common medical practice led to a staggering decline in the health of everyday Americans.
Back then, doctors and nurses reused needles and metal and glass syringes... The invasive equipment was believed to be clean and would be used to pierce the skin of patient after patient. Unfortunately, the tools were not clean enough. And a harmful virus spread...
This caused a huge number of folks in the Baby Boomer generation to contract a disease known as the hepatitis C virus ("HCV"). So receiving a life-saving blood transfusion meant a whole new host of problems for thousands of young people in the Boomer population.
But for a long time, folks didn't realize this was the case. And because unprotected sex and intravenous drug use are other common ways to contract hepatitis C, a stigma surrounded those infected, and those who should have gotten tested didn't.
These days, it's not just the Boomer generation that's seeing high numbers of people infected with hepatitis C. The numbers of positive cases in folks aged 18 to 40 have been rising since 2013 – from 1.6 cases per 100,000 people to 2.9 cases per 100,000 people in 2020.
In 2018, boomers and millennials each made up 36% of number newly reported chronic infections. And generation X made up 23%.
So today I'm answering some basic questions about hepatitis C...
What is hepatitis? How do you get it?
Hepatitis C is one type of the liver disease hepatitis (from the Greek "hepat-," meaning "liver," and "-itis," meaning "inflamed"). The other types are A and B.
Hepatitis A comes from consuming food or beverages with the virus in it... This usually happens when feces contaminate the food or water. Hepatitis A is rare in the U.S., and your body fights it off in about three months.
Hepatitis B spreads through sex, sharing needles, and direct contact with infected bodily fluids (like blood). It usually lasts about six months but can stretch out for much longer. You can even have it and not have any symptoms.
Hepatitis C, like hepatitis B, is spread through sharing needles, direct contact with bodily fluids (most typically blood), and – to a much lesser extent – sex. It can last from six months to the rest of your life.
Overall, hepatitis causes symptoms like stomach pain, nausea, fatigue, loss of appetite, dark urine, and yellowing of eyes or skin. However, hepatitis (particularly type C) often doesn't cause any symptoms until it's already severely damaged your liver.
Out of every 100 people who have hepatitis C, 60 to 70 will develop chronic liver disease. This causes serious damage that affects how well you can get toxins out of your body and how well you can break down food. In addition, one to five out of those 100 will die from liver cancer or cirrhosis.
Hepatitis C carries dangerous – and sometimes fatal – complications including permanent liver damage and cancer. Hepatitis C death rates hit an all-time high in 2014 with 19,659 deaths. Here's the problem, though... Since so many folks have the virus and don't know it, the actual death toll is most likely much higher.
In fact, researchers estimate that if Baby Boomers get tested and start getting treated, it will prevent more than 300,000 deaths in the next 15 years.
Understand, though, the treatments for hepatitis C are severe. They can cause everything from itchy patches on your skin to flu-like symptoms, hair loss, and even drops in red blood cell counts. It depends on the type of treatment used.
If you haven't had the test yet, make an appointment with your doctor.
One thing to keep in mind... more than a decade ago, the false-positive rate used to be about 10% for these tests. Newer technology has brought that number down to about 3% in recent years. However, it's worth asking your doctor which tests he orders and what steps he takes to ensure the result isn't a false reading.
Who is at risk? Who should get tested?
Everyone should be screened for hepatitis C at least once in their lifetime. Those most at risk for developing the disease are:
- People with HIV
- People who ever injected drugs and shared needles, syringes, or other drug-preparation equipment, including those who injected once or a few times many years ago
- People with selected medical conditions, including:
- People who have ever received maintenance hemodialysis
- People with persistently abnormal ALT levels
- Prior recipients of transfusions or organ transplants, including:
- People who received clotting-factor concentrates produced before 1987
- People who received a transfusion of blood or blood components before July 1992
- People who received an organ transplant before July 1992
- People who were notified that they received blood from a donor who later tested positive for HCV infection
- Children born to mothers with HCV infection
- People who currently inject drugs and share needles, syringes, or other drug-preparation equipment
Is it curable?
Yes, hepatitis C is a curable disease. But the medications can come at a steep price – some 12-week courses of treatment come close to $100,000 (like Harvoni and Sovaldi)... And often, insurance refuses to pay or will only pay in the worst instances.
But these days, there are many different treatment options available. Your best bet is to meet the disease head-on and tackle it as soon as possible.
So don't wait. If you haven't already been tested for hepatitis C, get checked today.
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- Something different: Does a woman's fertility really plummet at age 35?
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
March 7, 2023