Improving Hepatitis C Outcome for Baby Boomers

by Nicole Cutler, L.Ac.

As individuals born between the years 1946 and 1964, baby boomers are currently between the ages of 46 and 64. Constituting a majority of documented Hepatitis C infections, a recent study has found that this generation is less likely to triumph over Hepatitis C than younger generations. Despite the scientific data that implies an uphill battle for baby boomers with Hepatitis C, most experts believe that there are ways to achieve a positive outcome. Healthcare practitioners have the liberty of being hopeful because they know that a myriad of strategies can effectively boost Hep C treatment success, regardless of a person's age bracket.

Described as those who were born soon after World War II, there are an estimated 75 million baby boomers in the United States, or about 29 percent of America's total population. It is inevitable that this large proportion of the workforce is approaching the age where health issues typically escalate. Unfortunately, boomers with Hepatitis C face an additional challenge; a new study claims that they are less responsive than younger generations to antiviral treatment.

According to a report prepared by the actuarial firm Milliman, Inc., baby boomers account for two out of every three cases of chronic Hepatitis C. Thus, a significant proportion of people with Hepatitis C are close to or over 50-years old. Based on a study published in the October 2009 edition of Journal of Viral Hepatitis, individuals with genotype 1 chronic Hepatitis C who are older than 50 have a lower rate of treatment success with pegylated interferon and ribavirin, compared to patients under age 50.

In this study, data was evaluated from over 550 patients with genotypye 1 chronic Hepatitis C taking pegylated interferon alfa-2a (Pegasys) and weight-based dosing of ribavirin for 12 months. Known as a sustained virologic response (SVR), successful treatment is assumed if a person has no detectable Hepatitis C viral load six months after the completion of therapy. Upon looking at SVR, the researchers found the following:

· 52 percent of patients aged 50 or younger achieved SVR.
· 39 percent of patients over 50 achieved SVR.
· 41 percent of patients over 50 relapsed. This means the 41% of the 39% above relapsed.
· 25 percent of patients aged 50 or younger relapsed. This means 1/2 of the 52% above relapsed.

Even though this data shows a statistical advantage for those under age 50 in fighting Hepatitis
C, the researchers also found these variables improved SVR in those over age 50:

· Lower baseline viral load
· Absence of cirrhosis

In addition, SVR rates were high among patients over 50 without liver cirrhosis who were able to maintain adequate drug dosage levels.

Based on this information, it is especially important for baby boomers with Hepatitis C to employ strategies for lowering viral load and preventing cirrhosis so they can better tolerate interferon/ribavirin therapy at full dosage. Improving the liver's strength so that it can better fight the Hepatitis C virus and tolerate antiviral therapy can be accomplished via:

· Supplementing with high quality  - Because this herb strengthens liver cell walls, it protects the liver from increased scarring that could lead to cirrhosis.

· Boycotting alcohol - Since those over 50 have a greater chance of achieving SVR if their baseline viral load is low, alcohol must be avoided. This is because alcohol not only increases scarring of the liver, but it also fosters viral replication - which magnifies Hepatitis C viral load.

· Choosing your food carefully - Eating nutritious foods loaded with fiber, antioxidants and protein while reducing potentially harmful foods (those containing refined sugar, fat and chemicals) reduces unnecessary drag on liver function. By eliminating this burden, the liver's health is supported.

· Exercising regularly - While exercise does not cure Hepatitis C, it does help maintain adequate circulation through the liver. By stimulating blood to flow in the liver, there is less of an opportunity for toxins to stagnate and further damage liver cells.

Even though research demonstrates that baby boomers have a lower chance of achieving SVR, those in this age bracket needn't be discouraged. Anyone diagnosed with Hepatitis C can improve his or her chances of successfully beating the virus by taking , eating well, exercising and avoiding alcohol. Baby boomers are particularly encouraged to employ these strategies for reducing their viral load and preventing cirrhosis so that their age will no longer hinder their chance of a successful treatment outcome.

References:

http://www.bbhq.com/whatsabm.htm, So What's a Boomer, Anyhow?, Retrieved December 8, 2009, Baby Boomer Headquarters, 2009.

http://www.hcvadvocate.org/news/HepC%20Baby%20Boomers%202009.html, New Report Forecasts Hepatitis C Virus Epidemic Among Baby Boomers; Untreated HCV Progressing to Severe Liver Disease Seen Driving U.S. Costs to $85 Billion, Retrieved December 8, 2009, Hepatitis C Support Project, 2009.

http://www.hivandhepatitis.com/hep_c/news/2009/120109_b.html, Hepatitis C Patients over Age 50 Are Less Likely to Achieve Sustained Treatment Response, Liz Highleyman, Retrieved December 8, 2009, hivandhepatitis.com, 2009.

http://www3.interscience.wiley.com/journal/122279540/abstract?CRETRY=1&SRETRY=0, Peginterferon alfa-2a (40kDa) and ribavirin: comparable rates of sustained virological response in sub-sets of older and younger HCV genotype 1 patients, K. R. Reddy, et al, Retrieved December 8, 2009, Journal of Viral Hepatitis, March 2009.

[Upbeat]

when you get right down to it,  only about 20% of people over 50 achieve SVR.

[desrt]

The only thing funnier than a Licensed Acupuncturist trying to write a learned paper, is someone reading it and coming to that conclusion.

[epiphiny]

"This means the 41% of the 39% above relapsed"

I am a little confused.

Is this talking about people who achieved SVR? I was of the understanding that if one achieves SVR (ie HCV undetected 6 months post treatment end) then it is not common to relapse.

Perhaps they mean people who were UND at EOT but relapsed sometime between then and 6 months post.

Either that or all the docs telling us we won't relapse after SVR are not telling the truth OR Nicole Cutler, L.Ac. has the wrong info.

Any ideas anyone?

Epi

[GreatBird]

It's very confusing. For one thing you can't have a sustained viral response and relapse because relapsing means the viral response wasn't sustained.

[Bali05]

" Supplementing with high quality  - Because this herb strengthens liver cell walls, it protects the liver from increased scarring that could lead to cirrhosis"

Supplementing wth what ?

[portann]

Nothing to worry about that I can see, other than the article that Lloyd Wright attributes to Nicole Cutler on his website is a forgery.

Following  is Cutler's actual article, undistorted.  It says pretty much what we know:

http://www.hepatitis-central.com/mt/archives/2010/01/improving_hepat.html

Although not the most savvy of writers, Cutler doesn't wildly misinterpret data. Someone (LW, no less) took outlandish liberties with Cutler's article and essentially twisted it into something unrecognizable:

http://lloydwright.org/messages/content/improving-hepatitis-c-outcome-baby-boomers

My gosh, is Lloyd Wright still hanging around, doing his thing?

[epiphiny]

Thaks for that Portann :)

No wonder the quote that confused me as per my first post stuck out like dog's you know whats!  LW added in the incorrect information.

[GreatBird]

BTW-- L. Ac. means she's a licensed acupuncturist.

[Alek07]

39 percent of patients over 50 achieved SVR.
41 percent of patients over 50 relapsed. This means the 41% of the 39% above relapsed.

If 39% were SVR, then it can't be that the 41% were of the 39% SVRs because that would make them relapsers not SVRs.

Any easy slip up that any of us could have done

aleks

[Upbeat]

There might be some confusion on the use of SRV.  It could be they are talking about clearing tthe virus and then relapsing.  Any way you look at it the study is worth looking at. It makes since to me.

[Upbeat]

This report is also reported on the  Vertex page.

http://investor.shareholder.com/vrtx/releasedetail.cfm?ReleaseID=384497

This report is from milliman,  Well respected.  The numbers speak for themselves.

[Trish77]

Portann, thanks for the link.  That helps considerably.  Her information as posted is basically widely accepted in the link you provided.  One of my reasons for choosing to treat was that I was hitting that bell curve that reduces my odds of SVR as I get older.  

So this is what she ACTUALLY said:

52 percent of patients aged 50 or younger achieved SVR.
· 39 percent of patients over 50 achieved SVR.
· 41 percent of patients over 50 relapsed.
· 25 percent of patients aged 50 or younger relapsed.

Upbeat - where did you get your article from and did you add in the extra comments yourself to the portion above or were they added on by the source you took your version of her article from?

[Trish77]

Upbeat, if you SVR, you're done.  No relapse.  The percentage of those relapsing is NOT part of the percentage of those who SVR.

It's widely known that the odds of SVR decrease somewhat as you get older.  I wouldn't be too surprised to find out that's true for a number of health conditions.

[portann]

However, you slice it, the info as posted above in the OP is taken from Lloyd Wright's site and is distortedly dead wrong. Lloyd Wright attributes data to her that she in no way says in her actual article.

The incorrect, doctored version is from Lloyd Wright's site. The two links I provided show how Cutler's original article was fraudulently altered.

Lloyd Wright passes off his own incorrect numbers as Cutler's. Holy sheet.

On the fly here and never could keyboard like you. Hope all is well. XOXO

[Bill1028]

I'm sure it was an honest misunderstanding.  Why would he lie?  After all he cured himself didn't he?  Hahaha.