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Despite public health warnings, most baby boomers remain untested for hepatitis C

REUTERS/Lucy Nicholson
The CDC estimates that about 80 percent of the 3.5 million people in the U.S. infected with hepatitis C virus are baby boomers.

It’s been four years since a U.S. government advisory panel recommended that all baby boomers get tested for the hepatitis C virus (HCV).

And it’s been one year since the Centers for Disease Control and Prevention (CDC) reported that deaths from hepatitis C had reached an all-time high in the United States — and that baby boomers were at greatest risk.

Maybe last year’s CDC startling report spurred more baby boomers to request a one-time HCV blood test from their doctors. But the earlier recommendation from the advisory panel — the usually influential U.S. Preventive Services Task Force (USPSTF) — appears to have had little impact. For, according to a study released Wednesday in the American Journal of Preventive Medicine, hepatitis C testing among baby boomers increased only slightly in the two years after the USPSTF’s recommendation, from 12.3 percent in 2013 to 13.8 percent in 2015.

Of the estimated 76.2 million baby boomers (people born between 1945 and 1965), only 10.5 million have ever been tested for hepatitis C, the study found.

Individuals on Medicaid, Medicaid plus Medicare or military insurance were more likely to have been tested than people with private health insurance. HCV testing was also more common among men, college graduates and people who lived with someone who had been diagnosed with the disease.

Those findings are based on an analysis of responses from almost 24,000 baby boomers who took part in the annual National Health Interview Survey.

“Prevalence of HCV testing among baby boomers did not substantially increase and remains low two years after the USPSTF recommendation in 2013,” the study’s authors write. “These findings underscore the need for increased awareness for HCV testing among healthcare providers and baby boomers and other innovative strategies such as state-mandated HCV testing.”

A ‘silent’ disease

The study was not designed to determine why so few baby boomers are getting tested for hepatitis C, but the authors cite barriers to preventive care, incomplete insurance coverage and a lack of awareness among physicians about the USPSTF recommendations as possible reasons.

They also point out that most people are unaware that hepatitis C can be essentially symptomless for decades.

As I’ve noted here before, hepatitis C usually spreads when the blood from an infected person enters the body of someone who isn’t infected. If left untreated, the disease can lead to long-term and life-threatening health problems, including liver damage, liver cancer and liver failure. In the U.S., hepatitis C is a leading cause of cirrhosis and liver cancer, as well as the most common reason for liver transplant surgery.

Persons living with past or present HCV in Minnesota by age, 2015
Minnesota Department of Health
Persons living with past or present HCV in Minnesota by age, 2015

Half of Americans currently infected with hepatitis C are unaware that they have the disease, according to the CDC.  That’s because symptoms  — such as bruising and bleeding easily, fluid accumulation in the abdomen, swollen legs and weight loss —tend to appear only late in the course of the disease, when the virus has already done serious damage to the liver. 

Today, hepatitis C is most commonly spread by sharing needles or other equipment used to inject drugs, although it can also be spread through unsterile body piercing or tattooing as well as through unprotected sex with an infected person. In rare cases, a mother can pass the disease to her baby during childbirth.

Before 1992, however, when blood screening for the virus became available, the disease was primarily spread through donated blood and transplanted organs — the reason why so many baby boomers are infected.

Minnesota’s boomers, too

The CDC estimates that about 80 percent of the 3.5 million people in the U.S. infected with hepatitis C virus are baby boomers. More than 19,000 Americans die from the disease each year — a number that is almost 80 percent higher than in the early 2000s.

In Minnesota, about 46,000 people are living with a past or current hepatitis C infection, according to the Minnesota Department of Health (MDH).

The median age of Minnesotans with the infection is 56.

FMI: You can read the new study online on the American Journal of Preventive Medicine website. For quick answers to common questions about hepatitis C, go to the MDH website.

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