U.S. task force: Baby boomers should be tested for hepatitis C

Generation has highest rate of infection, likely contracted decades ago.

27 nov  2012—A U.S. task force suggests that people at high risk for the hepatitis C virus should be screened, which includes those with a history of intravenous drug use and those who received blood transfusions before 1992.

But, the guidelines also address another, lower-risk group—the baby boomer generation.

The new U.S. Preventive Services Task Force guidelines, released Monday and updated from 2004, take a somewhat softer stance than those of the U.S. Centers for Disease Control and Prevention, which say that all baby boomers should get screened for hepatitis C. By contrast, the task force suggests that clinicians "consider" screening for this age group, which includes those born between 1946 and 1964.

Screening for hepatitis C involves a simple, inexpensive blood test. Unlike other types of hepatitis, there is no vaccine available for hepatitis C. Treatment typically involves a course of antiviral medication.

Hepatitis C is considered a silent killer because it is often symptomless. Undiagnosed and untreated, hepatitis C can result in liver cancer, liver failure and liver transplants.

Risk factors for hepatitis C infection include a history of blood transfusions before widespread adoption of screening and infection control measures, long-term dialysis treatment, exposure to hepatitis C in health care settings, having HIV/AIDS, tattooing in unregulated or unsafe parlors and IV drug use.

"Our recommendations are that people who are known to be at high risk—such as people with a history of IV drug [use] and those who had blood transfusions prior to 1992—should be screened," said task force member Dr. Kirsten Bibbins-Domingo, an associate professor of medicine and of epidemiology and biostatistics at the University of California, San Francisco.

People at highest risk have about a 50 percent chance of being infected with hepatitis C; whereas people born between 1946 and 1964 have a 3 percent to 4 percent chance of being infected, she said.

Bibbins-Domingo said the task force took less a stringent stance on testing for all baby boomers because many people with hepatitis C will live for a long time without progressive disease, and current treatments don't help everyone. "We have effective treatments, but not everybody who has hepatitis C will go on to develop liver failure or liver cancer," she said. "We are in an era where treatments are rapidly evolving, and recommendations may change as treatments get better."

One liver disease expert weighed in on screening for the 47-to-67 age group.

Dr. David Bernstein, chief of hepatology at North Shore-LIJ Healthcare System, in Manhasset, N.Y, said baby boomers should get screened for hepatitis C. "I think the guidelines should have been a little stronger for people born from 1945 to 1965," he said.

"The current therapies have cure rates of 70 to 75 percent," Bernstein said. "In a couple of years, newer therapies may be available which will have much higher cure rates but this is [already] very high."

Get screened, he advised. "Hepatitis C is the most common reason for a liver transplant and development of liver cancer, but if you catch it, you can halt the progression of disease and cure it."

The task force guidelines are now open for a period of public comment.

More information: Get the facts about hepatitis C at the U.S. National Library of Medicine.