More Americans today die from hepatitis C than from HIV, according to a 2012 study by the Centers for Disease Control and Prevention (CDC). Although many people with hepatitis C (HCV) have no symptoms for decades, if left undiagnosed and unmanaged, hepatitis C infection can progress to chronic liver damage.
Over 2.7 million Americans are living with chronic HCV infection, which can cause long-term liver damage; without treatment, it is estimated that as many as half will develop cirrhosis and/or hepatocellular carcinoma, a type of liver cancer, both of which can be fatal. The CDC noted that the observed rise in deaths primarily affects those people born between 1945 and 1965, most of whom are unaware that they have even been infected by this slowly progressing disease.
Hepatitis C is spread by exposure to contaminated blood, for example, through sharing of needles during intravenous (IV) drug abuse. Though the risk is low, transmission can also occur through sexual activity and from an infected mother to her baby during childbirth. Prior to 1992, when HCV screening of donated blood became routine, it was also possible to become infected with HCV through blood transfusion or organ transplant. Health care workers who have been exposed to infected blood are also at risk.
- The CDC recommends one-time testing of all people born during the 1945-1965 time period, regardless of their risk factors for hepatitis C. Those who test positive should receive screening for alcohol use and intervention as needed, followed by referral to appropriate care for the hepatitis C infection and related conditions.
- Likewise, the United States Preventive Services Task Force (USPSTF) recommends screening for all adults at high risk of hepatitis C and for anyone born between 1945 and 1965, since prevalence is highest in this group.
Why get screening?
Many people who may have contracted the virus several years ago are unaware of their condition. A one-time test for older adults could detect infections contracted long ago, allowing for timely treatment and prevention of complications.
HCV-related disease and death is preventable if detected and treated. Before 2000, chronic HCV was curable in only 10% of cases. Now, treatments for HCV can cure over 90% of those detected before late complications occur.
Sources Used in Current Review
U.S. Preventive Services Task Force. Hepatitis C: Screening. Release date: June 2013. Available online at http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-c-screening. Accessed December 2015.
Ly K, et al. The Increasing Burden of Mortality From Viral Hepatitis in the United States Between 1999 and 2007. Ann Intern Med, February 21, 2012 vol. 156 no. 4 271-278. Available online http://www.annals.org/content/156/4/271.full. Accessed April 8, 2012.
Rein D, et al. The Cost-Effectiveness of Birth-Cohort Screening for Hepatitis C Antibody in U.S. Primary Care Settings. Ann Intern Med, February 21, 2012, vol. 156 no. 4, 263-269. Available online at http://www.annals.org/content/156/4/263-270. Accessed April 8, 2012.
Alter H.J, Liang T.J, Hepatitis C. The End of the Beginning and Possibly the Beginning of the End. Ann Intern Med, February 21, 2012, vol 156 no. 4, 317-318. Available online at http://www.annals.org/content/156/4/317. Accessed April 8, 2012.
Centers for Disease Control and Prevention. Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965. Prepared by Smith, Bryce D. et al. MMWR. August 17, 2012. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6104a1.htm?s_cid=rr6104a1_w. Accessed August 2012.
MayoClinic.com. Hepatitis C risk factors. Available online at http://www.mayoclinic.com/health/hepatitis-c/DS00097/DSECTION=risk-factors. Accessed August 2012.