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Thelma King Thiel, RN, BA has dedicated her life to promoting liver health for the past 47 years since the loss of her infant son Dean to biliary atresia. Ms. Thiel has served as the CEO of both the American Liver Foundation and the Hepatitis Foundation International for a total of 35 years, and has trained thousands of healthcare providers about liver health. Ms. Thiel recently came out of retirement to organize the Liver Health Initiative, to fill the enormous liver health knowledge gap and empower individuals to understand why and how to protect their miraculous life sustaining liver. Promoting primary prevention through liver health education is Ms. Thiel's ultimate goal.

Seniors at Increased Risk for Hepatitis and HIV

JUN 22, 2017 | THELMA KING THIEL, RN, BA
Some individuals would argue that one of the benefits of being over 50 (senior) is no longer having to worry about an unwanted or unexpected pregnancy. Despite the removal of this concern, the risk of becoming infected with a sexually transmitted disease remains high. Three sexually transmitted diseases, in particular, are the focus of major senior-focused awareness campaigns from the Centers for Disease Control and Prevention (CDC); hepatitis B (HBV), hepatitis C (HCV), and HIV.
 
Hepatitis viruses are the most common cause of inflammation of the liver (hepatitis), with HBV and HCV accounting for the majority of hepatitis virus-related infections. The hepatitis B virus can be found in all body fluids, including seminal fluids, vaginal secretions, and blood, and is 50 to100 times more infectious than HIV.  The virus attacks and kills liver cells causing scarring (cirrhosis) and the infection can lead to liver cancer.
 
A vaccine for preventing HBV has been available since the early 1980's; however, without required immunization programs for adult populations, most seniors are still at risk of being infected by hepatitis B if they are exposed through sexual contact, snorting drugs, or even unsafe tattoos and body piercings. According to the CDC, the incidence of HBV infections increased for individuals in both the 40-49 and the 50-59 age groups from 2010 to 2014.
 
Found mainly in blood, HCV is rarely transmitted through sexual contact. Sharing contaminated needles or other drug paraphernalia are thought to be the primary cause of HCV infections. Unfortunately, there is no vaccine available to prevent HCV infection, and therefore, educating individuals about protecting their liver from harm is essential to increase screening and early detection, or even preventing the infection in the first place. To this end, the CDC has mounted a major awareness campaign alerting baby boomers (those born between 1946 and 1964) of prior risk behaviors that may have exposed them to HCV.  
 
Hepatitis is not the only disease individuals over 50 need to be mindful of contracting. Seniors are also at risk of contracting HIV, mainly through sexual contact. According to the CDC, in 2014, individuals age 50 and over accounted for 17% (7,391) of an estimated 44,073 HIV diagnoses in the United States. The CDC states that, “Older Americans are more likely to be diagnosed with HIV infection later in the course of their disease,” and there is concern for co-infections with HBV or HCV.
 
In many cases, infections with HBV, HCV, and HIV can go undetected for months and even years before individuals show any outward symptoms. Unless a patient specifically asks for the test, or a provider requests the test based on a patient’s history and clinical exam, the viruses can go unidentified through routine blood tests for years resulting in extensive health issues.
 
Preventing these infections, and liver damage overall, is critically important to the health of individuals of all ages. Liver damage impairs function and can severely compromise the effectiveness of medications that must be processed through the liver. 
 
Because the over-50 patient population may not be aware that they are still at risk for these infections, it is imperative that healthcare providers educate their patients on behaviors that can increase their risk of infection and ensure that patients know their status. Patients also need to be made aware that unhealthy foods, misuse and abuse of drugs, alcohol, and even environmental pollutants can have a detrimental impact on the liver.
 
Patients who are over 50 have reached the time in life when they should be able to relax; however, it is critical that they be mindful of the importance of their liver, and how their behaviors may be putting them at additional risk for liver damage.
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