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Growing Older with Hepatitis B: Prevention and Precautions Still Matter

This September we are celebrating seniors for Healthy Aging Month. The Hepatitis B Foundation is doing a series on Growing Older with Hepatitis B, and we have adapted part two of their series. If a senior you know or love is living with hepatitis B, make sure to share!

Most people living with chronic hepatitis B today are over age 50, and like their younger counterparts, they need to keep themselves healthy and prevent spreading hepatitis B to their sexual partners, housemates, and neighbors.

Remember to take care of yourself. Hepatitis B can still affect your health even if you are older. A hepatitis B “carrier” can still get sick. Remember to see your doctor every year for a checkup, which includes checking on hepatitis B. You may need blood tests to see if the virus is still active and affecting your liver and an ultrasound to make sure there is no liver cancer or other liver problems developing. Your doctor can also make sure there are no other illnesses or medications affecting your liver and to see if you need any vaccinations (shots).

You’re never too old for safe sex: You may not have to worry about pregnancy anymore, but you still need to protect yourself and your partner against diseases that can be transmitted through sex, such as hepatitis B. Using a condom is important, because many seniors have not been immunized against hepatitis B. Your partner should be checked for hepatitis B—there is a vaccine available if he or she is not immune.

Seniors see doctors more often than young people, but they are less likely to discuss sex and ask about (or use) safe sex practices. According to the U.S. Centers for Disease Control and Prevention (CDC), syphilis, chlamydia and HIV infections are rising again, and about one-quarter of newly reported HIV infections are in people age 55 and older.

If you live with hepatitis B, make sure you practice safe sex and your partner is vaccinated.

You’re never too old for the hepatitis B vaccine. However, as our immune systems age, our response to immunizations can weaken. The hepatitis B vaccine is effective, but sometimes our aging immune systems don’t produce enough antibodies after vaccination to protect us.

If you or your partner are getting immunized against hepatitis B, about one or two months after you get the last dose, see your doctor and get tested for hepatitis B antibodies (called titers). If you don’t have enough antibodies to fight infection, you can get a fourth vaccine (booster) shot or you can get the entire three doses again. In the meantime, use safe sex to protect you and your partner.

Make sure all medical equipment is sterile. As we all know it’s easy to spread colds and germs when you live with people in close quarters, but spreading hepatitis B can occur when health care workers re-use glucose monitors, which check blood-sugar levels in people with diabetes.

Each year, the CDC reports outbreaks of hepatitis B in nursing homes and assisted living facilities. Remember, the hepatitis B virus can live for several days in dried blood on hard surfaces, so a little will go a long way if it’s on medical equipment used to poke or probe or collect blood.

What can you do? If you or a family resident has hepatitis B, remind health care staff who work in these facilities to be sure to practice universal precautions and make sure medical equipment is never re-used or shared.

Don’t assume your specialist knows about your hepatitis B. As you age and develop illnesses that require you to see specialists, make sure they know you have hepatitis B.

We all like to think doctors look carefully at our medical records, but sometimes information gets missed. Why should a specialist know about your hepatitis B? Because some of the medications they may prescribe can hurt our livers and weaken our immune systems.

For example, chemotherapy and other immune-suppressing drugs deliberately weaken our immune systems in order to fight cancer or rheumatoid arthritis. But when our immune systems weaken, hepatitis B can reactivate, resulting in the virus growing again and causing liver damage. To prevent this, doctors can prescribe antiviral medication to keep the hepatitis B virus under control during treatment with immune-suppressing drugs.

Make sure your specialists know about your hepatitis B, and ask them to monitor your viral load and liver health if you require immune-suppressing medication. It’s important to protect your health and speak up at every age.

Adapted from the Hepatitis B Foundation www.hepb.org. To read more blogs about hepatitis B, visit http://hepbblog.org. The Hepatitis B Foundation is a national non-profit organization dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide.

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Falls Prevention Awareness

September 23 is Falls Prevention Awareness Day. Falls can cause serious injury and even early death among older adults. According to the CDC, 1 out of 3 people age 65 and older fall each year. In fact, falls are more common than strokes and can be just as harmful.

Unfortunately, many everyday activities like walking and bathing can pose fall risks for older adults. The good news is that falls are largely preventable. If you know or care for an older adult, here are a few tips to share on fall prevent.

  • Exercise regularly. Focus on exercises that improve balance and leg strength. Tai chi is a great option.
  • Review medications (both over-the-counter and prescription) with your doctor. Some can make you dizzy, drowsy, and more likely to fall.
  • Get your eyes checked each year. Make sure you’re seeing the best you can to avoid falling.
  • Keep your home safe. Hazards are everywhere, from wet, slippery bathroom floors to poorly lit hallways. Make your home safer by adding grab bars by the toilet and tub/shower, adding lighting to dark rooms, and removing clutter.

Half of falls happen at home. Here are more ways to ensure that your home is safe.

  • Have handrails on both sides of the staircase.
  • Place frequently used items in places you can reach without a stepstool.
  • Wear shoes inside the home—avoid wearing slippers or going barefoot.
  • Remove throw rugs or use tape to make sure they don’t slip.

For more information about home safety, check out the CDC’s Home Falls Prevention Checklist in English and Chinese.

Preventing falls is important for healthy aging. Take steps toward falls prevention for you and your loved ones.


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Growing Older with Hepatitis B: Why Testing for Liver Damage Still Matters

This September we are celebrating seniors for Healthy Aging Month. The Hepatitis B Foundation is doing a wonderful series on Growing Older with Hepatitis B, and we are sharing part one of their series. If a senior you know or love is living with hepatitis B, make sure to share!

Around the world, older adults bear the greatest burden of hepatitis B. Born before the childhood vaccination became available, about 4.7 percent of U.S. adults over age 50 have been infected and their chronic hepatitis B rate is nearly two-fold higher than in younger adults.

The 50-plus generation has lived with chronic hepatitis B for decades, and over time their risk of liver damage, cirrhosis, and cancer has steadily increased. That is why it is very important that older adults living with this infection see their physicians regularly and have tests for liver damage and cancer performed as needed.

Our immune system and liver weaken with age: With age, our immune system loses its edge. Think chicken pox—that virus stays dormant in the body and emerges as shingles later in life when aging immune systems can no longer keep the virus in check.

As our immune systems age and weaken, they may no longer be able to suppress reproduction of the hepatitis B virus and you may notice an increase in your viral load (HBV DNA). Even when there is no notable increase in viral load, you can still experience liver damage, scarring (cirrhosis) and even cancer as you age. This is why getting your alanine aminotransferase (ALT) tested regularly for tell-tale signs of liver damage is essential.

When estrogen declines, women may be at greater risk of liver damage: Estrogen appears to confer some protection against liver damage, but as women age and estrogen levels decline, their risk of liver damage increases, which means monitoring may need to occur more frequently.

The liver loses its resiliency with age: According to researchers, over time our livers lose some of their ability to regenerate and their blood flow and screening capacity declines, leaving them more vulnerable to inflammation, scarring and cancer from the hepatitis B virus that hijacks liver cells to replicate.

Decades of exposure to environmental toxins take their toll: The cumulative effect of decades of exposure to environmental toxins impacts our liver health over time. It is the liver’s job to screen out those toxins, and the older we are, the greater the impact those toxins have had on our livers.

Other medical conditions affect hepatitis B: As we age, we often develop other medical conditions that weaken our immune system and impact our hepatitis B, which is why it’s always important to remind all of your doctors, including specialists, that you have hepatitis B, especially when they prescribe new medications. Immune-suppressing drugs, such as chemotherapy or rheumatoid arthritis treatments, can cause hepatitis B to reactivate.

Weight gain matters! As we age, we become less active and our metabolism slows, which is why so many of us pack on the pounds. In addition to risking diabetes, we also risk developing a fatty liver if we consume fatty foods, sugary drinks and alcohol. Fatty liver disease by itself increases the risk of liver damage and cirrhosis, when combined with hepatitis B, it can be deadly.

How often your hepatitis B is monitored depends on your medical history, and whether you have had elevated viral loads and ALT levels and other signs of liver damage in the past. Now that you’re older, talk to your doctor about whether more frequent screening is needed. For a summary of medical guidelines to monitor and manage hepatitis B click here.

For an in-depth description of managing hepatitis B in the elderly, read Viral Hepatitis in the Elderly.

Reprinted courtesy of the Hepatitis B Foundation www.hepb.org. To read more blogs about hepatitis B, visit http://hepbblog.org. The Hepatitis B Foundation is a national non-profit organization dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide.