Senior Women's Health fellow scholar, Dr. Manisha Yadav and Dr. Holly L. Thacker discuss the Centers for Disease Control's new recommendation about Hepatitis C screening.
Are You At Risk For Hepatitis C?
Baby boomers (people who were born between the years 1945 and 1965) have always been in news for something or the other, the latest being for Hepatitis C. Did you know that you might be potentially at high risk for Hepatitis C?
Who thought in those times that a relaxing visit to the spa to get a pedicure or manicure (using possibly non-sterilized equipment) or getting a new tattoo (using same needles or ink) could potentially prove life-threatening? Blood products, transfusions, and/or organ transplants used to save lives can ironically transmit a life-threatening infection. True friendship expressed by sharing razors, needles, toothbrushes could prove to be not such a brilliant idea after all if done with a friend who was infected with the Hepatitis C virus (HCV).
Now you know better! However, based on many people being infected with hepatitis C and not knowing it, the new and current Centers for Disease Control's (CDC) guidelines are to screen for Hepatitis C based on an individual’s risk. Those risks include:
- Anyone who has EVER injected illegal drugs.
- Those who received clotting factor concentrates made before 1987.
- Those who received a blood transfusion or a solid organ transplant before July 1992.
- Those who have ever been on chronic hemodialysis.
- Those who have signs or symptoms of liver disease (abnormal liver enzyme levels, especially elevated alanine aminotransferase level).
- Those who are infected with HIV.
- Children born to mothers who are infected with Hepatitis C.
- Those who have known exposure to Hepatitis C like health care workers who work with needle sticks contaminated with blood from patients with Hepatitis C or recipients of blood/ organ from a donor who is later tested positive for Hepatitis C.
The universal precautions and blood products screening for HCV began in July 1992. However, the tattoo parlors recommendations did not come until January 1998 to use single-use needles and non-reusable inks, however this may not always be followed, so those getting or having a tattoo, please beware!
60-80 percent of people infected with HCV can develop chronic hepatitis (inflammation) and 20-30 percent of chronic hepatitis evolves into liver cirrhosis (scarring) over a 20-30 year period of time. In the United States, chronic hepatitis C is the most common cause of chronic liver disease and is the most frequent indication for liver transplantation.
The Good News Is There Is Treatment For Hepatitis C!
The CDC recently proposed to screen all baby boomers once in their lifetime for HCV. The rationale behind this step is that more than 75 percent of American adults with Hepatitis C are baby boomers and this will help to identify 800,000 additional cases which otherwise may go undiagnosed. Treating the infected is speculated to save about 120,000 lives, since the new treatment modalities for HCV has about a 75 percent cure rate. To justify the economics, the CDC has calculated the cost-effectiveness of this screening and has found it to be comparable to a cervical cancer screening, something that is still very important even though we are now lengthening screenings based on knowledge of HPV.
This new recommendation may facilitate in diagnosing more silent cases, as many patients are missed because their physicians do not routinely screen for behaviors related to Hepatitis C and the blood test for liver enzymes is not very reliable.
Those who test positive on the screening will be referred for treatment and a brief screening for alcohol use as alcohol can expedite the liver disease in people infected with HCV.
So, if you are a baby-boomer, make sure to discuss this with your doctor at your next appointment. Take charge of your health and stay healthy!
- Dr. Manisha Yadav and Dr. Holly L. Thacker
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