Baby Boomers Urged by CDC to Get Tested for Virus that Kills More U.S. Citizens than HIV

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According to a recent report issued by the CDC and published in the 16 August, 20102 issue of Annals of Internal Medicine, baby boomers are currently dying off faster from hepatitis C in the U.S. than from HIV infection. They report that an estimated 2.7 to 3.9 million persons are infected and living with hepatitis C virus (HCV) infection in the United States, the majority of which was contracted during the 1970s and 1980s.

Hepatitis C infection is responsible for over half of the hepatocellular carcinoma cases in the U.S., which makes it the fastest growing source of cancer-related deaths. Furthermore, HCV infection is also the leading cause of a growing number of patients requiring a liver transplant as they grow older—many of whom unknowingly carried the virus for decades as their livers were slowly being damaged. Signs and symptoms of HCV liver damage do not manifest until severe damage is already done.

Computational modeling predicts that significant numbers of people living with hepatitis C will be adversely affected as they grow older and that without care or treatment 1.76 million persons with HCV infection will develop cirrhosis, more than 400 000 will develop HCC, and more than 1 million will die of HCV-related disease.

The report is the result of systematic reviews of multiple medical databases that addressed the prevalence and clinical outcomes of individuals infected with HCV. Their findings led health officials of the CDC to make the following two recommendations to the public:

HCV Recommendation # 1:
Adults born during 1945 to 1965 should receive one-time testing for HCV without prior ascertainment of HCV risk.

Previously, recommendations for HCV testing was focused on individuals who were considered high risk for infection such as drug and substance users. Other high risk individuals included people on blood clotting medications, on or having ever received long-term hemodialysis, blood transfusions, organ transplantations as well as health care, emergency medical, public safety workers, and children born to HCV-infected mothers.

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HCV Recommendation # 2: All persons identified with HCV infection should receive a brief alcohol screening and intervention as clinically indicated, followed by referral to appropriate care and treatment services for HCV infection and related conditions as indicated.

Alcohol use—even in moderate amounts—can cause progression of liver disease in individuals with hepatitis C infection. The recommendation for alcohol screening is to identify individuals with HCV who drink and need to be made aware of the danger and initiate programs to help the individuals control or completely cease drinking alcohol.

There is no cure for HCV infection. Rather, treatment that can be successful is limited to what is referred to as “Sustained Virologic Response” (SVR). SVR involves being treated with medications such as interferons and ribavirin that can suppress the virus to undetectable levels in the blood for an extended period of time. Typically, you are considered to have a sustained virologic response if when six months following treatment you have no detectable virus. Unfortunately, however, in some people this response is not permanent and is subject to relapse.

The good news is that the liver does possess some regenerative abilities and if the HCV infection is caught early enough followed by SVR treatment, then there is a good chance of the liver recovering and a lowered risk of developing a hepatocellular cancer in the future.

The CDC urges people born with 1945 to 1965 to go to their physician and request a simple HCV test to determine whether or not they are among the millions carrying an infection and therefore at risk of liver disease that may be curtailed if not prevented.

Image Source: Courtesy of Wikipedia

Reference: “Hepatitis C Virus Testing of Persons Born During 1945 to 1965: Recommendations From the Centers for Disease Control and Prevention” Annals of Internal Medicine (16 August, 2012); Bryce D. Smith, PhD; Rebecca L. Morgan, MPH; Geoff A. Beckett, PA-C, MPH; Yngve Falck-Ytter, MD; Deborah Holtzman, PhD; and John W. Ward, MD.

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