All adults born between 1945 and 1965 should have a one-time blood test for hepatitis C, according to recommendations proposed by the Centers for Disease Control and Prevention.
People in this age group are being targeted because they are five times more likely to have hepatitis C virus infection than are the rest of the U.S. population. They also account for three-fourths of hepatitis C infections and deaths among U.S. adults every year, according to Dr. John Ward, director of the division of viral hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, at the CDC.
Courtesy U.S. Department of Veterans Affairs
Most people with hepatitis C born between 1945 and 1965 were infected when they were in their teens and 20s. They may have forgotten about their risk or be unaware that they are at risk.
But most of these adults, sometimes referred to as the "baby boomers," are not aware they are infected.
"We believe that by adding a one-time blood test for hepatitis C to every baby boomer’s medical checklist, we can identify hundreds of thousands of hidden infections and get these men and women the care and treatment they need to prevent life-threatening liver disease and death," Dr. Ward said during a May 18 telebriefing announcing the CDC’s proposal.
Dr. Ward explained that most people in this age group who have hepatitis C were infected decades ago when they were in their teens or 20s. Some of the possible causes of infection at that time might have been blood transfusions or other exposures in health care settings, or risky behaviors. People in the target age group may have forgotten about their risk or are not aware that they are at risk.
The CDC estimates that implementation of the one-time test for people born between 1945 and 1965 could detect infections in 800,000 people who would not otherwise be diagnosed based on the current risk-based testing strategy. This will prevent an estimated 120,000 deaths if those identified are treated appropriately. Dr. Ward compared the cost effectiveness of hepatitis C testing to that of cervical cancer or cholesterol screening.
Currently, hepatitis C testing is recommended for groups of people with known risk factors, which remains important but is missing too many infections, mostly among baby boomers, he said. The majority – about 75% – of the 3.2 million people infected with hepatitis C in the United States are not aware they are infected, and by the time they find out, they usually have irreversible liver damage. This is because hepatitis C slowly causes liver damage with few noticeable symptoms. Hepatitis C is the most common reason for liver transplants, is the leading cause of liver cancer, and is the fastest rising cause of cancer deaths, according to the CDC.
Currently, treatment for hepatitis C can cure up to 75% of patients, and those who are not cured can take precautions to reduce liver damage, such as reducing alcohol use and getting vaccinated against hepatitis A and B.
The CDC plans to issue final recommendations on testing later this year. During the briefing, Dr. Ward announced the availability of $6.5 million in funds to health departments, community health centers, and other organizations that provide testing for hepatitis and linkage to care, to expand hepatitis B and C testing. People born between 1945 and 1965, as well as intravenous drug users, people born in countries where the infection rates are known to be high, and other groups will be targeted.
The draft recommendations are open for public comment from May 22 through June 8 and are available at http://www.regulations.gov, docket number CDC-2012-0005.