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CDC recommends hepatitis C tests for all baby boomers: Hepatitis C is an unrecognized health crisis in the United States
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"Because of the enhanced transmissibility of HCV by percutaneous injection, compared with that of HIV, the prevalence of HCV infection can exceed 85% among HIV-infected injection drug users"

Proposed new recommendation:

Who Should Be Tested For Hepatitis C? Anyone born from 1945 through 1965

Many baby boomers were infected with hepatitis C when they were in their teens and twenties

Some may have become infected through blood transfusions or other health care exposures before universal precautions and widespread blood screening began in 1992. Others may have become infected from experimentation with drug use, even if only once decades ago. Because these exposures were often long ago, many baby boomers may not recall - or may be unwilling to discuss - the events that could have placed them at risk. As a result, many have never been tested for hepatitis C

CDC Fact Sheet on the new Recommendations, pdf attached: "Up to 75 percent of those with hepatitis C are unaware that their livers are being slowly damaged. .....Deaths from hepatitis C are on the rise. As baby boomers age, the likelihood that they will develop serious, life-threatening complications from the disease will continue to increase - unless those infections are diagnosed and treated.....The number of Americans who die from hepatitis C-related conditions is increasing, totaling more than 15,000 in 2007.

-- New treatments can cure up to 75 percent of hepatitis C cases. Identifying silent cases of hepatitis infection has the potential to save more lives than ever before, and the research pipeline indicates that even more effective therapies may be available in the future.....Testing is cost-effective. One-time hepatitis C screening for baby boomers, with treatment for those found to be infected, is comparable in cost-effectiveness to other routine preventive health services, such as screening for cervical cancer or cholesterol screening and treatment.....Finding and treating them will cost about $30,000 for every year of life saved - a pricetag comparable to detecting and treating cervical cancer or high cholestero, John Ward, CDC, says
......The draft expanded recommendations were developed by a working group including experts from CDC and other federal agencies, professional associations, community and advocacy groups, and local and state health departments. They will be available at, docket number CDC-2012-0005, for a public comment period starting May 22.......CDC estimates that implementing the proposed new testing recommendations could identify 800,000 additional hepatitis C virus infections; providing these patients with appropriate care and treatment could prevent more than 120,000 deaths."

Meta-Analysis: Increased Mortality Associated with Hepatitis C in HIV-Infected Persons Is Unrelated to HIV Disease Progression - (05/07/12)

"Hepatitis C virus infection is often asymptomatic or causes nonspecific symptoms (depression, arthralgia, and fatigue) for decades (25, 26). Therefore, the current goals of secondary prevention and control of this condition are based on screening persons at risk and identifying affected persons and referring them to care. However, because we found that almost 75% of HCV-related deaths occurred in persons aged 45 to 64 years, screening efforts that target middle-aged persons may be profitable."

"All 4 of the comorbid conditions that we evaluated were significantly associated with a listing of HCV infection as a cause of death (Table 2). Chronic liver disease (adjusted OR, 32.1 [CI, 31.0 to 33.3]) and HBV co-infection (adjusted OR, 29.9 [CI, 26.5 to 33.6]) were the most strongly associated, followed by alcohol-related conditions (adjusted OR, 4.6 [CI, 4.4 to 4.8]) and HIV infection (adjusted OR, 1.8 [CI, 1.6 to 2.0])."

End Stage Liver Disease Leading Cause of Death in HCV/HIV ...

End Stage Liver Disease Leading Cause of Death in HCV/HIV Coinfected in France; 46% Had Cirrhosis; 37% had >200 Cd4s & <500 copies/ml viral load

Wash Post By David Brown, Published: May 18

The federal government Friday called for all baby boomers to be tested for hepatitis C, which kills more Americans each year than AIDS and is the leading reason for liver transplants.

The Centers for Disease Control and Prevention made the recommendation to find hundreds of thousands of people who have the infection, which greatly increases their chances of developing cirrhosis and liver cancer, but don't know it.

The hepatitis C virus is transmitted by blood, usually through intravenous drug use or transfusions, before a blood test for it became widely available in 1992. Extremely small amounts of the virus are able to cause infection. Some experts believe that rolled-up dollar bills used to snort cocaine and passed person-to-person can carry enough infected blood to transmit the virus.

"Many baby boomers may not even remember the behaviors that put them at risk," said John W. Ward, head of the CDC's division of viral hepatitis.

Epidemiologists estimate that about 3.2 million Americans are infected with hepatitis C, three-quarters of them baby boomers. The disease kills at least 15,000 people a year.

The CDC's strategy calls for a one-time voluntary blood test for everyone born from 1945 to 1965. The test would be done by doctors, clinics and hospitals as part of routine medical care. Hepatitis C tests now target mostly people who report high-risk activities or show signs of abnormal liver function.

The strategy could identify 800,000 new cases in baby boomers and prevent 120,000 hepatitis-related deaths in that age group, Ward said.

Treatment of hepatitis C infection takes at least six months and consists of pills and a weekly injection. The cure rate used to be less than 30 percent; with a new three-drug strategy, it can be as high as 75 percent.

About 80 percent of people infected with hepatitis C remain so for their lifetimes. Most have no symptoms, although blood tests might reveal low-grade liver inflammation. Up to 30 percent eventually develop cirrhosis, a scarring of the liver that is often fatal. Cirrhosis also greatly increases the risk of developing liver cancer, which few people survive more than six months.

Baby boomers are being targeted simply because they are the population group with by far the largest number of undetected cases. Finding and treating them will cost about $30,000 for every year of life saved - a pricetag comparable to detecting and treating cervical cancer or high cholesterol, Ward said.

A government call for such broad testing is unusual but not unprecedented. Several years ago, the CDC recommended that essentially all Americans be tested for the AIDS virus.

Deaths from hepatitis C surpassed those from AIDS in 2007 and are rising, according to a study published this year, this is the study:

The Increasing Burden of Mortality From Viral Hepatitis in the United States Between 1999 and 2007: HCV had superseded HIV as a cause of death in the United States, Hepatitis Receives Little Attention/Funding - (02/22/12)

"few diseases of such morbidity and mortality in the United States have received so little public attention and funding as chronic viral hepatitis"......"HCV had superseded HIV as a cause of death in the United States, and deaths from HCV and HBV disproportionately occurred in middle-aged persons. To achieve decreases in mortality similar to those seen with HIV requires new policy initiatives to detect patients with chronic hepatitis and link them to care and treatment"....'underestimated:hepatitis often not reported on death certificate'....."This analysis shows the rapidly increasing number of deaths among HCV-infected persons, which now surpass deaths among HIV-infected persons. In addition, the relatively young age of most HCV-infected persons who are dying (that is, 45 to 64 years of age) portends a large and ever-increasing health care burden (18) from what the current U.S. Assistant Secretary of Health has dubbed the "silent epidemic" (19)."

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