Hepatitis C Virus (HCV): A Hidden Epidemic
The Centers for Disease Control and Prevention (CDC) has issued draft guidelines recommending that all baby boomers be tested for Hepatitis C virus (HCV). Individuals who were born between 1945 and 1965 are five times more likely than other U.S. adults to be infected with the virus. The CDC estimates that more than two million baby boomers are infected with HCV.1
Some 15,000 Americans die from HCV-related diseases each year, but CDC officials hope that the proposed screening will prevent tens of thousands of projected deaths from the disease.1 Without intervention, experts anticipate that the number of HCV infections will grow rapidly in the future. Below John M. Vierling, MD, FACP, Professor of Medicine and Surgery, Director of Baylor Liver Health, Chief of Hepatology at the Baylor College of Medicine and Director of Advanced Liver Therapies at St. Luke's Episcopal Hospital in Houston, Texas, talks about the CDC's draft guidelines and the implications of those guidelines.
The CDC estimates that as many as one in 30 baby boomers are infected with HCV. In many cases, these people are unaware that they have the virus. Because HCV infections can be associated with a high-risk lifestyle, do you think this creates a stigma that becomes a testing barrier for some individuals?
Although there may be a stigma associated with some risk factors for HCV, such as injection or nasal drug use, it is unlikely to be a barrier to testing in persons born between 1945 and 1965. Since any risk factors in this age group likely occurred in the 1960s and 70s and would also include transfusions of blood products prior to 1992, I believe that universal testing will be successful.
It is important that physicians talk to their patients in this age group about the CDC draft recommendations and about the potential benefits of testing. Patients should be made aware that a positive anti-HCV antibody screening test requires additional blood tests before reaching a conclusion about the presence of HCV infection.
While baby boomers are the target of CDC testing efforts, are there other groups of individuals who physicians should also encourage to get tested for HCV?
Patient groups at high risk for HCV infection include anyone diagnosed with a hepatitis B virus infection or HIV infection. All three viruses are transmitted by the same types of exposures. Physicians should also recommend HCV screening for any individual — regardless of age — who has had a history of parenteral exposures. These include past or current injection or nasal drug use, transfusion of blood products prior to 1992, sexual contacts with people who may have had HCV infection, men who have sex with men, healthcare workers exposed to blood or bodily fluids, and patients on long-term hemodialysis.