Hep Savvy: All baby boomers should get screened for Hepatitis C

baby boomersUPDATE 5/19/16: CDC guidelines recommend Hep C testing for all people born between 1945 and 1965. Our Hepatitis C Test and Cure Coalition is making great progress and as a result, tens of thousands of King County baby boomers are protecting their health by getting a Hep C. test. Public Health is working with Harborview, Group Health, Swedish, Country Doctor, NeighborCare, HealthPoint and the Hepatitis Education Project on this initiative to increase screening and cure people living with Hepatitis C. Read on for more information.

Are you a baby boomer born between 1945 and 1965, or have a family member who is? Read on to learn about an important new screening your health care provider will be offering their baby boomer patients.

Viral hepatitis is an alphabet soup of diseases, defined by liver inflammation and caused by different viruses (Hepatitis A, B, C, D, & E). Hep A, B, and C are the most common forms (click the links for more information and signs and symptoms):

  • Hep A: Typically spread through contaminated water or food, including fruits, vegetables and shellfish.  It may also be spread through close contact with an infectious person. Children are routinely vaccinated for Hep A. Hepatitis A does not cause chronic infections (long term or lifelong).
  • Hep B: Typically spread through contact with blood or body fluids on an infected person. A vaccine is available and is typically given at birth and with subsequent vaccination. Hepatitis B can cause chronic infection.
  • Hep C: Typically spread contact with the blood of an infected person, such as through intravenous drug use, non-sterile medical equipment, and blood transfusions before 1992 (blood is now screened to prevent Hep C transmission). Less commonly, a person can also get Hep C through sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes or having sex with a person infected with the Hep C.

Hep C causes a chronic infection in most people and often doesn’t show symptoms until the disease is well advanced. People with advanced Hep C can develop cirrhosis (liver scarring), cancer, upper gastrointestinal bleeding, and is the leading cause of liver cancer and liver transplants. There is no vaccine, but there are very effective new treatment options.

Recent guidelines recommend that all baby boomers should be screened for Hep C. That’s right – all baby boomers, even those who haven’t had a transfusion or don’t think they’ve had a known risk factor.

Elizabeth Barash, manager of Public Health’s CDC-funded “Test & Cure” campaign, provides the details:

Who should be tested for HCV? Everyone born between 1945-1965 (a.k.a. baby boomers) should be tested for hepatitis C.

Why is the recommendation to test all baby boomers for HCV even if a patient does not have a known risk factor? One big reason is that almost half of the people with HCV do not recall a risk factor for getting infected. In addition, HCV is largely a baby boomer disease. People born during 1945-1965 are five times more likely to have HCV infection – making up 75% of people with HCV.  And routine screening of this age group will save lives. But it’s impossible to know whether you’ve got HCV unless you re tested because there are usually no symptoms until liver damage appears.

Why are baby boomers at higher risk for HCV infection?The reason is not completely understood. Researchers think that most baby boomers were infected in the 1970s and 1980s when rates of HCV were the highest. HCV is primarily spread through contact with blood from an infected person. Many baby boomers could have gotten infected from contaminated blood and blood products before widespread screening of the blood supply began in 1992. Others may have become infected from injecting drugs, even if only once in the past, or through contact with contaminated personal items or through sexual contact. Many baby boomers do not know how or when they were infected. The bottom line is that you only know for sure if you’ve got the virus if you get tested. And if you do, additional tests can see if there is liver damage. This helps determine how soon treatment should be started.

Is there a cure for this disease?  That’s the great news: New treatments can cure most people and in a shorter time than previous HCV treatments and with fewer side effects.

Who else besides baby boomers should get tested for HCV?
HCV testing is also recommended for people of any age who:

  • Ever injected drugs or currently inject drugs
  • Received clotting factor concentrates before 1987
  • Have persistently abnormal liver enzyme tests;
  • Have been on long-term dialysis;
  • Have HIV
  • Received blood or organ transfusions or transplants before 1992 or who were told that they received a transfusion or an organ from someone who later tested positive for HCV infection.

Drug treatment for HCV is expensive and I’ve heard it is often difficult to get insurance to pay for it. Why should I get tested if I can’t get cured right away?  Finding out about your HCV status will provide you with critical information. First, people with liver damage should be treated as soon as possible. But, if your disease is in the early stages and there are restrictions on insurance coverage for treatment, it is still important to know that you are infected so you can monitor for progression of illness and be treated promptly if the disease progresses and/or when eligibility criteria for coverage changes.  In addition, if you know you have HCV you can take other steps to keep your liver healthy.

Should I expect my healthcare provider to ask me about getting screened, or should I ask him/her? This recommendation is new and not all healthcare providers may be aware of the new expanded screening criteria. So, ask your provider the next time you go for a routine check-up. If your healthcare provider has any questions, refer him or her to Public Health’s Hepatitis C Test & Cure team at 206-263-2017.