You’ve probably seen the recent headlines: The number of deaths in middle-aged white Americans has increased significantly from 1999 to 2013. But did you know that a treatable infection is contributing to that increase in death rates?
A lot has been written about it, but basically this information contrasts with a decrease in the death rate for the same group in many other developed nations and is quite surprising. The rising death rates in the U.S. primarily have three main causes: drug- and alcohol-related poisonings, suicides, and chronic liver disease and cirrhosis.
These findings certainly apply in Idaho, where our population is primarily white, not immune to problems related to drugs and alcohol, and has one of the highest suicide rates in the country. (We had the seventh-highest rates nationally in 2014 and are 47 percent higher than the national average.)
We’re also not immune to liver disease and a silent infection that lives among us in Idaho: hepatitis C.
Hepatitis C can lead to chronic liver disease and cirrhosis, which is the 10th-leading cause of death in the state.
Hepatitis C is caused by a blood-borne virus that infects the liver and often goes unnoticed for decades. It is a major cause of liver damage and can lead to permanent scarring (also called cirrhosis), disability and loss of liver function. This viral infection also can cause kidney problems, liver failure and liver cancer and death. Most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs, but it also can be spread through unprotected sex.
Some people may have become infected by receiving blood transfusions of other blood products containing the hepatitis C virus before 1992. After 1992, the United States universally screened all blood for the virus and removed any infected blood from the national supply chain.
For some people, the hepatitis C virus is a short-term illness, but it becomes a long-term — often silent — and chronic infection for 85 percent of people who are exposed to it. Up to 45 percent of people infected with the hepatitis C virus are not aware they have it because they do not feel sick and may not recall any risk of exposure.
According to the National Health and Nutrition Examination Survey, about 2.7 million people in the United States are living with a chronic hepatitis C infection, with the majority of cases affecting people born between 1945 and 1965. Baby boomers born during that time have an increased risk because the highest rates of the hepatitis C virus infection occurred during the 1970s and 1980s.
Overall, the number of people living with the hepatitis C virus has gone down over time, although a recent survey from the Centers for Disease Control and Prevention (CDC) noted that infection rates among people younger than 30 may be increasing. The majority of infected people in this survey were white (85 percent) with an even gender distribution.
Based on those findings, the CDC recommends that anyone born between 1945 and 1965 should be tested at least once for a hepatitis C virus infection, regardless of risk factors. The CDC also recommends that people with previous or ongoing risk factors are screened for hepatitis C virus, regardless of what year they were born.
Risk factors include:
▪ Any history of injecting drugs (even just once)
▪ Receiving a blood transfusion before 1992 or clotting factors before 1987
▪ Being a current sexual partner of a person infected with the hepatitis C virus
▪ Any evidence of liver disease
▪ Any accidental needle sticks that involved blood that was positive for the hepatitis C virus
▪ Anyone who has ever been on hemodialysis
▪ Anyone with a positive HIV status
▪ Children born to mothers who are infected with hepatitis C.
Appropriate screening for a hepatitis C infection is more important than ever. Treatment has gone through a dramatic shift in the last five years that makes it easier for people to receive it.
Standard treatment now consists of one or more pills daily, usually for only eight to 12 weeks, and 90-95 percent of people are cured. Previously, treatment lasted six to 12 months, included weekly injections, was less effective and had many severe side effects.
All standard treatment options are very expensive, but they may be covered by health insurance. If not, the drug manufacturers may offer patient medication assistance to help people get the medication they need.
Even people with advanced liver disease and cirrhosis respond well to current options and should consider treatment. If a person is treated and cured, he or she does not have to continue to take medications. It’s important to remember that treatment does not protect against repeat infections.
There is no vaccine for hepatitis C. The best way to prevent infection is by avoiding behaviors that can spread the disease, especially injecting drugs. If you know you are positive for hepatitis C, it is important to discuss the diagnosis with your doctor and consider being evaluated for treatment.
And it is important to avoid all alcohol and be aware of certain over-the-counter and prescription drugs (especially acetaminophen) that can further damage your liver.
Learn more about hepatitis C at the Idaho Department of Health and Welfare website: healthandwelfare.idaho .gov. There’s a link to the information on the department’s home page, or search for hepatitis C. The CDC also has lots of information about hepatitis C on its website at cdc.gov/hepatitis/C/ index.htm.
Elke Shaw-Tulloch, master of health sciences, is the state health officer and Division of Public Health administrator with the Idaho Department of Health and Welfare. Find out more about Department of Health and Welfare services at healthandwelfare.idaho .gov.