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Hepatitis
C testing
practices
and
prevalence
in a
high-risk
urban
ambulatory
care setting
Journal of
Viral
Hepatitis,
March 2011
Early View
(Articles
online in
advance of
print)
"we
found a very
high
estimated
prevalence
of HCV
infection in
a high-risk
urban
patient
population
with a high
prevalence
of risk
factors. We
found strong
evidence
that
physicians
are using a
risk-based
screening
strategy to
identify
patients
with HCV
infection,
using known
risk factors
and other
conditions
associated
with HCV to
guide
testing. We
also found
evidence
that
screening
recommendations
should be
expanded to
include the
high
prevalence
birth
cohort."
...20% of people
55-64 yrs old or 1
in 5' have
HCV.....age was
significantly
independently
associated....
http://www.latimes.com/news/local/la-me-boomers-hepatitis-20120502,0,4558891.story
Los Angeles Times
Wed 2 May 2012
The Centers for
Disease Control and
Prevention urges
people born
between 1945 and
1965 to be tested,
noting that roughly
75 percent of
people with the
disease are baby
boomers. The number
of baby boomers
dying from a "silent
epidemic" of
hepatitis C
infections is
increasing
so rapidly that
federal officials
are planning a new
nationwide push
for widespread
testing. Three in 4
of the estimated 3.2
million people
who have chronic
hepatitis C -- and a
similar proportion
of those who
die from the disease
-- are baby boomers.
Deaths from the
virus nearly
doubled between 1999
and 2007 to more
than 15 000,
according to a
recent Centers for
Disease Control and
Prevention study.
Hepatitis C is the
leading infectious
cause of cirrhosis
and liver
cancer and is the
most common reason
for liver
transplants in the
United States,
according to the
CDC. In 2007, deaths
from the disease
surpassed those
linked to HIV, and
the numbers of
fatalities are
expected to continue
increasing,
researchers
reported. "We have
sort
of a perfect storm
of an age wave of
people who are
moving through
time who are
progressively
becoming sicker from
an infection that
was
acquired several
decades ago," said
John Ward, director
of the
Division of Viral
Hepatitis at the
CDC. "We think we
are at a very
critical juncture."
Many boomers
unknowingly
contracted the virus
in younger years
from
using drugs or
having blood
transfusions before
screening was
improved
during the AIDS
crisis. Unaware of
the risk and without
symptoms, most
have never been
tested for hepatitis
C and don't know
they have it.
The disease --
primarily contracted
through blood --
often remains
hidden for decades
while it slowly
destroys liver
cells. There is no
vaccine. [There are,
however, now
effective therapies,
depending on
the virus genotype.
- Mod.CP]
"Hepatitis C is
really a stealth
virus," said
Elizabeth Bancroft,
medical
epidemiologist with
the Los Angeles
County Department of
Public Health. "It
can live in you for
many, many, many
years."
There are at least
530 000 people
living with
hepatitis C in
California,
including an
estimated 134 000 in
Los Angeles County,
according to health
officials. Concerned
about the disease
among baby
boomers, the CDC
plans to issue a
recommendation this
year [2012] that
everyone born
between 1945 and
1965 be tested. Up
until now, the
federal agency only
urged screening for
those believed to be
at risk.
That strategy hasn't
worked, in part
because of the
stigma; doctors
don't ask about
previous drug use,
and patients don't
offer up the
information.
The CDC
recommendation is
coming in an era
when safer, faster
and more
effective drug
treatments are
becoming available,
and more are being
tested. The new
medications still
have side effects
but increase the
odds of suppressing
the virus and its
complications,
according to
research. Health
officials say the
new medications,
although they
aren't cheap, are
far less costly than
liver transplants
and liver
cancer treatment,
which can climb into
the hundreds of
thousands of
dollars.
The disease is "a
significant and very
costly problem" in
California,
said Gil Chavez,
deputy director of
the center for
infectious diseases
for the state public
health department.
In California,
officials said
hospitalization
charges for liver
disease, cancer and
transplants
totaled more than
USD 2 billion in
2010. The state
adopted a plan in
2009 to improve
education about the
disease and to
increase access to
testing and care,
but Chavez said much
more needs to be
done. The
expected federal
recommendation for
screening baby
boomers will help
providers and
patients understand
the dangers, he
said.
The WHO Factsheet
on hepatitis C can
be accessed at:
http://www.who.int/mediacentre/factsheets/fs164/en/index.html |
