New Hep C Screening for Baby Boomers

If baby boomers weren't special enough,  now the U.S. Preventive Services Task Force has singled them out as a special group to be screened for Hepatitis C virus (HCV).  Individuals born between 1945 and 1965 are recommended to undergo this one-time blood test screening because they are at high risk for the virus.

What is it about this age group that gets special notice?  According to the Centers for Disease Control, baby boomers account for three out of four people with HCV.   Many of them contracted hepatitis C from blood transfusions or needle procedures before we had a screening test for the virus.  Others may have caught it from high risk behaviors like injecting drugs, HIV or piercing or tattoos in unclean environments.  It is less common to contract it through sexual relations but it can happen.

We have had a test that could screen for Hepatitis C antigen for many years but only recently are we able to treat chronic Hepatitis C with anti-viral medications.  There is an increased incidence of hepatocellular carcinoma (liver cancer) in people who acquired HCV two to four decades earlier and many people have no idea that they are carrying the virus.  It is hoped that by screening patients in this age group, patients can be identified at earlier stages of disease and receive treatment before developing complications from liver damage.

HCV infection is the leading cause of complications from chronic liver disease.   More than 30% of U.S. adults that receive liver transplants have HCV.

Baby boomers just need to undergo screening once.


KM said…
If you are a blood donor each time you donate they screen for Hep C among many other things so if it was found to be posative you would not be allowed to donate and the orginal blood would not be used. Since I'm a donor in this age range my doctor didn't have to test me.
FancyScrubs said…
Interesting, are your own doctors supposed to recommend this or are patients supposed to ask for it? We had our yearly physicals and it was NOT brought up. Thanks!
FancyScrubs said…
Interesting, are doctors supposed to recommend this to patients, or are patients supposed to ask for it? We had our yearly physicals recently and it was NOT brought up. Thanks!
I read your full article and it was really helpful for me. I'll back to your blog again to read your upcoming article.
Hahaha, I'd like to know the guy in the bottom photo.
The USPSTF was originally not endorsing massive screening as the CDC did, but they liberalized their recommendation.

Does this make sense? Consider that the majority of Hep C patients are asymptomatic and will never develop severe liver disease or cancer. There are millions of these folks here in the U.S. The treatment is very toxic and costs around $40,000 a person. Do the math and decide if this is our best use of scarce health care dollars.
Toni Brayer, MD said…
Michael Kirsch, MD : I agree with you. There certainly are guidelines for which strains of Hep C respond to the expensive and toxic treatments and at the very least these should be enforced. I do not think these recommendations ever go through a "value" cost-benefit analysis. That should certainly factor in if we ever hope to really promulgate quality in our society.
Toni, since I do GI, these reps are in my office all the time. They are dismissive of the toxicity and have never once mentioned the cost, which is astronomical. As I indicated, I think that the benefits of treatment to the individual and to society are grossly overstated. If I had Hep C and was asymptomatic, I wouldn't take today's treatment. I'd wait.

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