People born between 1945 and 1965 are in the age group with the highest prevalence of hepatitis C. In 2010, the oldest baby boomers enrolled in Medicare. By 2030, 71 million older adults will account for roughly 20 percent of the U.S. population. Approximately one in 30 baby boomers has hepatitis C, the majority of whom are undiagnosed.

Hepatitis C is a curable disease, but you can’t be cured if you don’t know you have it. If current trends continue, the U.S. population will have record numbers of aging adults living with HCV. The burden on Medicare will be substantial.

Compared with younger people with hepatitis C, older adults are at a disadvantage:

  • People who are initially infected with hep C when they are older tend to have worse prognoses than those who acquire it while young. Adults over age 50 who acquire HCV have a high risk of developing cirrhosis within 15 years.
  • Damage from hepatitis C accelerates more quickly with age. A younger person may live for decades with little or no liver damage. In later years, the immune system declines and the fibrosis rate often accelerates.
  • Some transplant programs have age limits for liver transplantation. Adults over age 70 rarely receive a liver transplant.

Hepatitis C Treatment
There has been tremendous progress in the hepatitis C treatment arena. The newest medicines have high cure rates and mild side effects. These improvements mean that there is no upper age limit on who can take these drugs.   

Medicare and Health Insurance
Hepatitis C treatment is covered under Medicare. However, depending on your coverage, the co-pay amount may not fit your budget. If your doctor recommends treatment, it is important to know what your prescription coverage is before you start. If the co-pay is unaffordable, contact a patient assistance program and request help. Don’t despair; many Medicare recipients are able to get financial help without dipping into their savings.

If you are unable to find affordable hep C treatment, consider a clinical trial. Participating in a study has many advantages, such as more personal attention and helping to others. However, there are disadvantages to studies. Clinical trials can be time-consuming and some drugs have more side effects than others. Some clinical trials have age limits. You can read more about clinical trials here.

If you can’t afford the co-pay and a clinical trial isn’t an option, don’t give up. During the next Medicare enrollment period, consult with a patient assistance program such as the Hepatitis C CareLine, and ask about alternative coverage that you can enroll in for a year. It may mean higher insurance premiums for a year, but it may be worth it if your hep C treatment is covered.  

The Emotional Side of Hepatitis C
Older adults have different emotional issues than younger adults do. Loss is a central theme, such as loss of independence, strength, agility and the ability to perform certain tasks. Death and finding meaning in life take on more importance as people age. Loneliness and grief are more common occurrences for older adults, as they are more likely to lose friends and family members to illness and death. An HCV diagnosis is unwelcome news at any age, and may feel like a double whammy to an aging adult hoping to live in good health during retirement.

It may help to talk about your thoughts and feelings. You may find it especially helpful to talk to others who have hep C, such as those on the Hep Forums.

Cognitive Issues
Patients with chronic hepatitis C occasionally report mental or cognitive impairment. Patients refer to this as “brain fog.” This can be especially disconcerting for older adults, since cognitive impairment is a common concern for the aging.Mental sharpness is affected by multiple factors, such as medication, stress, depression and fatigue. If you are experiencing brain fog, talk to your doctor. If there is no apparent cause for cognitive impairment, find ways to cope with this limitation.

Here are some tools to try:

  • Be organized; keep lists, calendars, and notes
  • If you have a mobile phone with a camera, take pictures of lists, where you parked your car and any other important info
  • Always put your keys, money, and eyeglasses in the same place
  • Don’t try to multitask
  • Develop a mindful meditation practice
  • Try not to get frustrated, as this makes matters worse.

Last Reviewed: March 5, 2019