There's nothing more frustrating than mixed messages from leading public
health authorities--particularly when many lives stand a good chance of
being lost because of the disparity. This is proving to be the case
with hepatitis C, a chronic disease that affects roughly 4 million U.S.
residents and continues to infect approximately 17,000 people annually
in this country alone. Even more harrowing, it kills between 10,000 and
15,000 American residents a year--a rate that hasn't yet peaked (deaths
from HCV are projected to increase to 35,000 a year by 2030), given that
many people infected decades ago are just now becoming ill.
A key component of the solution is to get more people living with hepatitis C virus (HCV) conclusively tested. The reason? An astonishing 75 percent of people living with HCV do not know they're infected, do not (yet) have outward symptoms of the disease, and therefore have not been linked to the care and treatment they may need to cure the virus and halt the progression of its life-threatening complications.
A key component of the solution is to get more people living with hepatitis C virus (HCV) conclusively tested. The reason? An astonishing 75 percent of people living with HCV do not know they're infected, do not (yet) have outward symptoms of the disease, and therefore have not been linked to the care and treatment they may need to cure the virus and halt the progression of its life-threatening complications.
Approximately two-thirds of these unaware individuals are "baby boomers"
- those born between 1945 and 1965 - who may have received a blood
transfusion or related product prior to routine screening in the 1990s
or used illicit intravenous drugs decades ago. In fact, according to a recent study,
ensuring that EVERY baby boomer in the U.S. is tested just once for HCV
could identify more than 800,000 additional people infected with the
virus, thereby preventing the costly consequences of liver cancer and
cirrhosis requiring transplants, not to mention save more than 120,000
lives.
The CDC found these (and other) data compelling enough to issue screening guidelines on August 1, recommending that all U.S. baby boomers get a one-time test for HCV. The recommendation was a monumental leap forward, given that previous guidelines from the agency called for testing only individuals with certain risk factors for HCV infection.
Roughly
four months later, however, the United States Preventive Services Task
Force (USPSTF) - an independent group whose disease testing and
vaccination recommendations carry heavy weight with health organizations
and insurance companies - issued draft HCV testing guidelines
that failed to pack the same punch as the CDC's unequivocal
recommendation. Whereas the task force is currently prepared to
recommend HCV testing for injection drug users and others at high risk,
it says that there is only "small benefit" for testing all baby boomers
and is therefore suggesting a "C" grade for a more universal testing
recommendation.
A "C" grade isn't going to cut it, as it means many health care providers will fail to appreciate the gravity of the situation and the need for testing baby boomers--many of whom do not consider themselves at risk, either because of the stigma associated with hepatitis C or they've long forgotten risk factors from long ago--and, importantly, many public and private insurance programs may not cover necessary screening practices.
There's still time to make a difference. The USPSTF hepatitis C testing guidelines are still in draft form and a public comment period is open until 5:00 PM Eastern Time,December 24, 2012 January 4, 2013. I join the National Viral Hepatitis Roundtable
in urging people to comment on the guidelines--a process that shouldn't take more than 30 minutes to complete. NVHR has also developed a sign-on letter, though they urge submitting individual and organizational comments directly to the USPSTF as well.
The CDC found these (and other) data compelling enough to issue screening guidelines on August 1, recommending that all U.S. baby boomers get a one-time test for HCV. The recommendation was a monumental leap forward, given that previous guidelines from the agency called for testing only individuals with certain risk factors for HCV infection.
Roughly
four months later, however, the United States Preventive Services Task
Force (USPSTF) - an independent group whose disease testing and
vaccination recommendations carry heavy weight with health organizations
and insurance companies - issued draft HCV testing guidelines
that failed to pack the same punch as the CDC's unequivocal
recommendation. Whereas the task force is currently prepared to
recommend HCV testing for injection drug users and others at high risk,
it says that there is only "small benefit" for testing all baby boomers
and is therefore suggesting a "C" grade for a more universal testing
recommendation. A "C" grade isn't going to cut it, as it means many health care providers will fail to appreciate the gravity of the situation and the need for testing baby boomers--many of whom do not consider themselves at risk, either because of the stigma associated with hepatitis C or they've long forgotten risk factors from long ago--and, importantly, many public and private insurance programs may not cover necessary screening practices.
There's still time to make a difference. The USPSTF hepatitis C testing guidelines are still in draft form and a public comment period is open until 5:00 PM Eastern Time,
I have cronic Hepititus B, do not know how long I was infected till I developed systoms, in August of 2012. My viral load is undetectable as of 12/1/12. My partner has acute Hep-B undetectable viral load. Getting mixed messages on what is safe and unsafe sex between us. Anyone help me out? Thanks Michael. I'm 64, partner 49.
Hi Michael,
Your question should be posted in the Hep Forums (forums.hepmag.com).
Thank you.
Having Hepatitis C contracted from a 1978 blood transfusion, I would ask how ANY agency in the U.S. knows how ANY person got Hepatitis C. No one's asked my background and researched my medical history at all. I believe it might be true that a lot of Hep C patients are the result of something to do with a needle: kidney dialysis, vaccines from the military, paramedics, phlebotomists w/mishaps, police infected from bloody criminals, etc.
But, nobody's asked me questions. And I see no way anybody can know for sure. Somebody, somewhere stuck us all with "drug user" label which in turn makes it easier for agencies and individuals to ignore us and not be that concerned. USPSTF: 1 in 12 people in U.S. have Hepatitis C, that includes you and you and you.