“To me, old age is always 15 years older than I am.” – Bernard M. Baruch
We baby boomers make a lot of noise about how many there are of us. However, according to population estimates released this year by the U.S. Census Bureau, millennials surpassed baby boomers as the nation’s largest living generation. This is because we are dying and they aren’t. Also, immigration is adding to their numbers, where some of us are retiring to Panama and other warmer, cheaper places to spend our retirement years.
There is another factor that defines us and may kill us, and that is hepatitis C. According to the Centers for Disease Control and Prevention (CDC), people born from 1945 through1965 are five times more likely to have hepatitis C. Of the more than 3 million people living with hepatitis C, 3 out of every 4 were born from 1945-1965. Thus, the CDC recommends everyone born from 1945-1965 get tested for hepatitis C.
If the test shows you have hep C, then treatment is available. If you are reading this, you may already know that you have hepatitis C, and you may be wondering if you should bother with treatment. Your liver may be in good shape, and why upset the apple cart?
The problem here is that hepatitis C may not damage the liver for decades, but as we age our immune systems deteriorate, and with it the liver’s ability to fend off hep C’s damaging effects. It is amazing how many people stay at stage one- or two-fibrosis for several decades, and then how quickly they get to cirrhosis when they are in their 70s and 80s.
The age that hepatitis C was acquired may have an impact on prognosis. A number of studies have reported that individuals who are infected with hep C at older ages tend to have a worse prognosis than those who acquire hep C while young. People over age 40 more likely to develop HCV-related liver cancer. Age can also have a negative impact on liver transplantation survival; older liver transplant recipients have a significantly lower survival rate than younger patients.
Back in the days when peginterferon was the backbone of hep C treatment, it made sense to weigh our options. With today’s direct-acting antivirals, it usually makes little sense. The treatment is generally gentle and safe enough that many people in their 80s are able to tolerate it and live their lives free of hepatitis C.