The Enid News and Eagle, Enid, OK

Enid Features

May 9, 2014

Hepatitis C: Are you of screening age?

You may have seen the billboard: “Born from 1945 to 1965? CDC recommends you get tested for hepatitis C.”

If you were born between those dates, you belong to the group referred to by the media as baby boomers. But why is the Centers for Disease Control advising you to get tested for hepatitis C? Here are some answers.

Of the 3.9 million Americans infected with hepatitis C, 75 percent were born between these dates. The disease is five times more prevalent among that age group than among other Americans. And most of these individuals have no idea that they are infected until they suddenly develop severe liver problems. That’s good reason to heed the message on the billboards.

The Centers for Disease Control made this recommendation in August of 2012 following a survey of about five thousand patients that confirmed a high percentage of undiagnosed hepatitis C infections among those born between 1945 and 1965.

Hepatitis C is one of several hepatitis viruses that enter the body through various routes and attack the liver. The hepatitis C virus (HCV) is passed through contact with the blood of a person infected with this virus.

As a result, previous CDC recommendations focused on high-risk groups such as intravenous drug users, dialysis patients, anyone who received a blood transfusion prior to 1992 (when screening of blood for this virus was initiated) and health care workers who have been exposed to contaminated blood, usually through needle stick injuries.

Also at risk are persons who received tattoos or body piercings under non-sterile conditions and children born to mothers who are infected. Transmission can also occur through sexual activity.

The CDC does not know why baby boomers comprise such a high proportion of infected Americans. One reason is that birth rates before and after those dates were significantly lower. Baby boomers make up a large portion of the total population.

It’s also possible that a higher than average number of persons in this age group experimented briefly — or more extensively — with IV drugs. Many of these persons may be reluctant to reveal they are at risk because of past drug use.

Some baby boomers were also adults during the period when blood transfusions were more likely to be contaminated.

Another reason the CDC made the recommendation is that there is generally a lack of awareness of hepatitis C, even though it poses serious, life-threatening complications.

Infections are common, but the patient may experience no symptoms for many years. When symptoms do occur, they tend to be mild and vague — decreased appetite, fatigue, joint and muscle pain, nausea and weight loss. Yellowing of the skin and eyes (jaundice) should not be ignored as it is a sign of liver problems, whether hepatitis C is involved or not.

About three quarters of infected persons develop chronic hepatitis, and 60 to 70 percent of these develop liver disease. Over a period of 20 to 30 years, scarring (cirrhosis) of the liver starts to occur, making it difficult for the liver to function effectively. As many as five percent of persons with a chronic hepatitis C infection die of liver failure or liver cancer.

If detected before serious liver damage occurs, hepatitis C can be treated and new treatments have become available.

For many patients, combination therapy with interferon and ribavirin results in cure rates of about 60 percent. Interferon must be injected and has some serious side effects.

New antiviral drugs are emerging that are expected to be more effective and better tolerated. The U.S. Food and Drug Administration recently approved [December, 2013] sofosbuvir (Sovaldi), a nucleotide analog inhibitor that can be used in combination with ribavarin and/or interferon.

Some patients cannot tolerate interferon, and sofosbuvir is the first all-oral, non-inteferon medication approved for the disease.

Two weeks earlier, the FDA approved simeprevir (Olysio), a protease inhibitor that blocks a protein needed for the hepatitis C virus to reproduce. Other protease inhibitors approved in 2011 are boceprevir and telaprevir. There are additional HCV drugs now being tested, and it is believed they may prove to be even more effective.

The CDC estimates that more than 800,000 Americans with hepatitis C might be discovered through one-time screening of this age group. And, with early detection, most would be able to avoid the severe liver damage that comes with advanced disease.

The Long Term Care Authority of Enid Caregiver program makes no distinctions on the grounds of race, color, sex, age, national origin, religion or disability, and a portion of the project costs are met by state and federal Older American Act funds from the LTCA of Enid and OKDHS Aging Services.

Rupp is care coordinator for Long Term Care Authority of Enid Aging Services. Contact her at 237-2236.

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