Screening And Treating Patients
What’s at stake is the possibility of curing hepatitis C, or at least slowing its progression and preventing complications such as cirrhosis of the liver and death. Widespread treatment of infected Canadians would also be expected to reduce the demand for liver transplants.
Proponents say the guidelines offer the best hope for curing the infection and preventing complications. In a related also published in CMAJ, experts said 95 per cent of those receiving antiviral treatment have a sustained response, which is considered the equivalent of a cure.
Still, critics point to a Cochrane review that casts doubt on the effectiveness of direct-acting antiviral agents. That paper has been strongly criticized by groups such as the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America.
The authors of the guideline say there are gaps in knowledge. While the vast majority of people infected can be treated successfully, they can’t cure everyone.
There are limited treatment options for patients with advanced cirrhosis. Preventing new infections and screening younger patients are essential.
Making the new types of treatment available to all Canadians is another challenge.Some regions in Canada continue to limit access for those in whom the virus has caused scarring of the liver. These are restrictions the authors of the guideline say should be lifted based on current evidence.
It’s time that Canada step up to meet the challenge.
The Cdc Recommends All Baby Boomers Be Tested For Hepatitis C
On the eve of the first National Hepatitis Testing Day , the Centers for Disease Control and Prevention recommends that all U.S. baby boomers get a one-time test for the hepatitis.
According to the CDC, one in 30 baby boomersthose born from 1945 through 1965has been infected with hepatitis C. Most do not know they are infected.
Hepatitis C causes serious liver diseases including liver cancer, which is the fastest-rising cause of cancer-related deaths, and the leading cause of liver transplants in the United States.
The CDC believes this approach will address the largely preventable consequences of this disease, especially in light of newly available therapies that can cure up to 75 percent of infections. More than 2 million U.S. baby boomers are infected with hepatitis C.
Hepatitis C can damage the liver for many years with few noticeable symptoms. More than 15,000 Americans, most of them baby boomers, die each year from hepatitis C-related illness, such as cirrhosis and liver cancer.
Current CDC guidelines call for testing only individuals with certain known risk factors for hepatitis C infection. But studies find that many baby boomers do not perceive themselves to be at risk and are not being tested.
CDC estimates one-time hepatitis C testing of baby boomers could identify more than 800,000 additional people with hepatitis C. This could prevent the costly consequences of liver cancer and other chronic liver diseases and save more than 120,000 lives.
Why Some People Overlook The Risks Of Hepatitis C
After living in South Africa for more than a decade, I moved back to the United States in 2016. It was then that my new doctor reminded me that hepatitis C testing is recommended for all people born between 1945 and 1965.
At first, I didnt think much of it. Sure, I was a born in 1962, but beyond that, I considered myself to be the least likely person to have hepatitis C. I was in excellent health, I went to the gym regularly, and I never experienced any signs or symptoms of liver disease.
Even when my first blood tests revealed that my liver enzymes were elevated, it still never dawned on me that hepatitis C might be the cause. To me, the virus was spread by using drugs I didnt even drink alcohol.
How could I possibly have become infected?
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Baby Boomers Should Be Tested For Hepatitis C
Baby Boomerspeople born between 1945 and 1965have five times the risk of having hepatitis C, a disease that affects the liver. On today’s Health Minute, Dr. Tom Miller explains how hep C can be transmitted, and the available treatment and prevention options.
Baby Boomers: Get Tested For Hepatitis C
While Mays observance of Hepatitis Awareness Month that individuals born between 1945 and 1965 the so-called baby boomer generation to get a one-time screening for hepatitis C virus infection.Our HIV.gov colleague Linda Lawson shares this video message for her fellow baby boomers.The one-time hepatitis C screening for everyone born 1945 1965 is a covered preventive service under the Affordable Care Act, which means that most health plans must cover it no cost to you.The CDC estimates that half of people chronically infected with HCV are unaware of their infection. Hepatitis C can cause liver disease, liver cancer, and death. However, timely diagnosis and access to curative treatment can prevent these outcomes and improve overall health for individuals with HCV.Please share this information and video with friends and colleagues for whom it might be relevant.
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What Is Hepatitis C And How Common Is It In The United States
Hepatitis refers to inflammation of the liver. There are a handful of viral hepatitis types , but hepatitis C is the cause of the majority of serious liver disease in the United States. The hepatitis C virus is spread when blood from a person infected with the virus enters the body of someone whos not infected. There is no vaccine to prevent hepatitis C, which makes early detection so important.
In the United States, its estimated that between 3 and 5 million people have chronic hepatitis C, and most of those people dont know theyre infected. The majority of people with chronic hepatitis C are from the baby boom generation.
Why Baby Boomers Are At The Highest Risk Today
A CDC study suggested Americans in their 40s had an infection rate of three out of four people if born between 1945 and 1965. Why are baby boomers at such a higher risk? During this period of time, universal precautions and infection control procedures were just being adopted, and people had a higher risk of exposure due to contaminated medical equipment or blood transferring products. Also, some boomers youthful experimentation with drugs now puts them more at risk.
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Why Screen Baby Boomers For Hepatitis C
Why are we recommending screening of adults in the baby boomer generation? To understand this, its worth reviewing how we got here.
In 1998, the Centers for Disease Control and Prevention established HCV testing guidelines based on the presence of risk factors. These included receipt of blood transfusions prior to 1992, when blood donations began to be screened for HCV receipt of clotting factors before 1987 hemodialysis and injection drug use. However, not many cases of hepatitis C were diagnosed. This could likely be traced to a combination of doctors not being adequately engaged, and patients in denial of their risky behaviors.
To identify more cases, the CDC jettisoned its old approach and moved to a blanket recommendation to screen all adults born between 1945 and 1965, the baby boomers. The rationale for this was that more than three out of every 100 baby boomers were infected with HCV. This was at least five times higher than in any other group of adults, and accounted for about 75% of HCV cases.
Moreover, the diagnosis of HCV in this group would identify those with long-duration chronic disease, who were at risk for the most advanced forms of liver disease. So in 2012, the CDC and United States Preventive Services Task Force formally recommended that all baby boomers get a one-time blood test to check for HCV.
Why Should Baby Boomers Get Tested For Hepatitis C
Despite the high number of baby boomers with hepatitis C in the U.S., most people with the infection are not aware that they have it.
Undiagnosed hepatitis C is a significant issue, as the disease can lead to cirrhosis, liver cancer, and death.
For these reasons, in 2013, the U.S. Preventive Services Task Force recommended a one-time hepatitis C screening for all adults within the baby boomer age bracket.
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If you were walking around with a disease that was gradually destroying your liver, youd know it, right?
Maybe not, says Dr. Brian Pearlman, Medical Director of the Center for Hepatitis C at WellStar Atlanta Medical Center.
Pearlman says most people infected with chronic Hepatitis C have no idea theyre sick.
They feel fine, Dr. Pearlman says. They go to work. They raise their kids. Some will have a little fatigue, but then again, there are so many entities that could cause fatigue.
And, most patients will not have any symptoms, unfortunately, until theyre well beyond cirrhosis or even at the point of transplantation.
Hepatitis C is primarily spread through contact with blood from an infected person.
About 3.5 million Americans have the virus, and 75 percent of them are baby boomers.
Why baby boomers?
Pearlman says they were likely infected before universal safety precautions were put into place in hospitals and widespread screening of the blood supply virtually eliminated Hepatitis C back in 1992.
So Dr. Pearlman says anyone who received a blood transfusion, blood products or underwent organ transplant surgery before 1992 is at very, very high risk.
Sharing needles during IV drug use can also lead to infection.
If you were born between 1945 and 1965, the CDC says get tested for Hepatitis C,
and dont assume youre already being screened.
The good news, is Hepatitis C is treatable, and Dr. Pearlman says, curable.
Hepatitis C Experts Get Behind New Recommendations
Eugene R. Schiff, MD, directs the Schiff Center for Liver Diseases at the University of Miami School of Medicine, and is the vice president of the Chronic Liver Disease Foundation. He is 100% behind the new recommendation.
Former hepatitis C patient Martha Saly also lauds the new recommendation. “This is something we have been waiting for,” says Saly, who is the director of the National Viral Hepatitis Roundtable in Rohnert Park, Calif.
“Getting diagnosed is really important because there are many things you can do to maintain your health even if you have hepatitis C,” she says. “Stop drinking, stop smoking, lose weight, and you can really help your liver to not progress so quickly. … Alcohol is like putting gas on the fire when you already have liver damage.”
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Baby Boomers And Hepatitis C: Whats The Connection
- By Raymond Chung, MD, Contributor
Hepatitis C is a viral infection that is spread through contact with infected blood. Hepatitis C infection can be short-term or long-term . Most people with acute hepatitis C eventually develop chronic hepatitis C.
Hepatitis C usually does not cause symptoms, which is why most people with hepatitis C dont know that they are infected. Left untreated, hepatitis C can lead to cirrhosis, liver cancer, and liver failure.
Baby Boomers Should Get Tested For Hepatitis C
BILOXI, MS – There’s a nationwide push to get more adults tested for Hepatitis C in the U.S. The Veteran’s Administration in Biloxi was part of that effort Tuesday.
Hepatitis C is a serious blood-borne disease that affects millions, but many people don’t know they have it. In fact, thousands unknowingly live with the disease for years, even decades. By the time they develop symptoms, serious damage to the liver may have already occurred. That’s why the CDC is recommending that all baby boomers receive a one-time screening.
Veterans lined up to be tested in Biloxi during a special screening after learning that veterans from the baby boomer generation, specifically those born between 1945 and 1965, are at a higher risk of being infected with Hepatitis C than any other veteran group. A simple blood test will give them the answers they need.
Veterans, like Donald Husley, now know how serious the disease can be.
“They say it’s pretty bad, so I wanted to be tested to know for sure,” said Donald.
Another veteran, Robert Husley, also wanted to make sure he’s not infected.
“Curiosity. I went to Vietnam. You never know. Never know what’s going on around here either, so I was curious,” Robert said.
The Centers for Disease Control and Prevention reports 75 percent of Americans who have Hepatitis C are baby boomers. Tracy Crevier is a Hepatitis C case manager at the VA. She says they’re targeting those born between 1945 and 1965.
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Why Are Baby Boomers At A Higher Risk
While injection drug use is a risk factor, the biggest reason baby boomers are more likely to have hepatitis C is probably due to unsafe medical procedures at the time. In the past, there was no protocol or screening method to check if a blood supply was virus-free. A 2016 study by points to unsafe medical procedures of the time rather than drug use as the primary reason behind hepatitis C transmission in baby boomers. Researchers behind the study found that:
- the disease spread before 1965
- the highest infection rates happened during the 1940s and 1960s
- the population that got infected stabilized around 1960
These findings refute the stigma of drug use around the disease. Most baby boomers were far too young to knowingly engage in risky behavior.
Intravenous drug abuse is still considered a significant risk factor for this disease . But according to Hep C Mag, even people who didnt contract hep C by injecting drugs still face this stigma. A person can also carry the virus for a long time before it causes symptoms. This makes it even more difficult to determine when or how the infection occurred.
The increased risk baby boomers are subject to is also a matter of time and place: They came of age before hepatitis C was identified and routinely tested for.
Hepatitis C Screening Is Now More Important Than Ever
HCV screening is more important than ever. Why? First, it is critical that we identify everyone with chronic HCV because they are at increased risk for early death due to liver disease. There is also mounting evidence that chronic hepatitis C is associated with increased risk for diseases outside the liver, including heart and kidney disease, as well as diabetes. In addition, recent dramatic advances in antiviral therapy allow us to cure the vast majority of HCV infections using short courses of well-tolerated oral medications.
Indeed, the World Health Organization has committed to a global effort to reduce new cases of HCV infection by 90%, and to reduce HCV-related mortality by 65% by 2030. To be sure, this goal can only be accomplished if we identify cases of existing HCV infection. Some countries are on track to achieve this target, and have done so by enacting widespread population screening campaigns coupled with access to antiviral therapy. We can and must do better with screening in the United States if were to come close to the WHOs goals.
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Hepatitis C Alert: Baby Boomers Should Be Tested
In the United States, an estimated 3.2 million people are living with chronic hepatitis C virus infection, the potentially fatal liver disease.1 While anyone can get HCV, more than 75% of these are baby boomersthe generation born between 1945 and 1965.2 In 75% to 85% of persons initially infected with HCV, the disease becomes chronic progression of liver fibrosis is more rapid in those who acquire the infection at an older age.3,4
HCV is considered a silent killer, since the disease can progress for decades without any indications of illness.1,2 Though it is silent, its destructive capacity renders it a leading cause of liver disease and liver cancer.2,5 HCV is the leading cause of liver transplants in the U.S. the virus recurs almost universally following liver transplantation, resulting in chronic hepatitis or cirrhosis in 90% of patients within 5 years.2,5,6
Deaths attributed to HCV were as high as 16,600 in 2010, according to the CDC had these patients been diagnosed and treated earlier, many deaths could have been prevented.7 HCV prevalence varies with geography and other risk factors.8 The CDC recommends testing for HCV in high-risk individuals , which includes anyone born from 1945 to 1965, the age group that is five times more likely to have HCV.2Currently, there is no vaccine for HCV.1
Are Baby Boomers More Prone To Hepatitis C
When Alan Franciscus was diagnosed with hepatitis C in 1996, his first question was, “Am I going to die?” When his doctor assured him that many treatment options were available, he had a second question: “What is hepatitis C?” Looking back, Franciscus, a 61 year-old San Francisco resident says: “One of the most disturbing things to me was I had never heard of it. I really did not know a thing about it.”
Franciscus’ question, it turns out, is not such a bizarre one to ask. Despite affecting 1 percent of the population, hepatitis C remains a disease generally misunderstood by the general public with little in financial commitments from the federal government. The CDC’s National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention had a budget of almost $1 billion for 2008. Only 2 percent of that was allocated to hepatitis B and hepatitis C despite both viruses being five times more prevalent. “No one really knew what hepatitis C was,” Franciscus remembers. “A bunch of coworkers thought I got it from eating bad food.”
A newly-published Institute of Medicine Report on hepatitis B and C, published today, underscores how this lack of understanding and attention has played out. Although the risk factors for hepatitis C are widely known and completely preventable, the IOM estimates that between 2.7 million and 3.9 million Americans have contracted hepatitis C.
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