testing for
boomers
Jeannie Keve, Houston Chronicle
.
So many baby boomers are infected with hepatitis
C - and so few of them know it - that the Centers for Disease
Control and Prevention may recommend
everyone born between 1945 and 1965 be screened for
the disease.
Many baby boomers were infected decades ago,
before the blood supply was screened for the virus, and for some, through drug
use when they were younger.
About 3.2 million people in the United States,
including an estimated 300,000 Texans, have chronic hepatitis C. They often
don't know they're sick until the virus has caused serious
liver damage.
Deaths from hepatitis C increased by 50 percent
between 1999 and 2007, most of them among baby boomers, said Dr. John
Ward, director of the division of
viral hepatitis at the CDC.
Three out of four people with hepatitis C were
born between 1945 and 1965, Ward said, so directing testing of that group would
be the most effective way to get people
into treatment.
He said the cost vs. benefit would be comparable
to screenings for breast cancer, colorectal cancer
and hypertension.
The CDC will solicit public comments before
making a final decision, Ward said.
Blood transfusions
Many people were infected with hepatitis C
through blood transfusions before 1992, when a screening test for the virus was
developed. Others were infected through
drug use.
"The 1960s, '70s and '80s were a time of drug
experimentation, including drug injection, and that carried a high risk of
hepatitis C transmission," Ward said.
A baby born to an infected mother also can
acquire the virus. Less commonly, it can be transmitted through
sexual contact.
About 17,000 people are infected with hepatitis C
every year, and 80 percent of the cases become
chronic infections.
Hepatitis C can cause liver damage, liver failure
and liver cancer. About 12,000 people a year die from hepatitis C-related
liver disease.
Texas tracks only acute infections, although
spokesman Chris Van
Deusen said the Department of State
Health Services estimated in 2006
that up to 300,000 Texans had a chronic hepatitis
C infection.
Traditional screening strategies, which rely on
people requesting screening or health providers recommending it based on a
patient's risk factors, may miss too many people, suggested Dr. Michael
Fallon, chief of gastroenterology at
the University of Texas
Medical School at Houston and
Memorial Hermann-Texas
Medical Center.
"Some people may not remember their risk factors,
or they may not want to broadcast their risk factors,"
Fallon noted.
New treatments also make this a good time to push
testing, he said.
Earlier standard treatment cleared the virus for
less than half of patients. Adding two new drugs can increase the success rate
to as high as 75 percent, he said.
Treatment time halved
The new regimen also can cut the treatment time
in half, to about six months, Fallon said, but it is more complicated and has
more side effects.
"But with a near doubling of efficacy, it's taken
many people who were on the fence about therapy and made them more enthusiastic
about taking treatment," he said.
It also has helped some patients who didn't
respond to the earlier treatment,
Fallon said.
Treatment is expensive for people without health
insurance - between $50,000 and $100,000, said Rachel
Nahan, coordinator for St. Luke's
Episcopal Health
System's Liver
Health Outreach.
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