CDC Proposes HCV Testing for All Baby Boomers

Emma Hitt, PhD

May 18, 2012

May 18, 2012 — The US Centers for Disease Control and Prevention (CDC) has proposed expanded hepatitis C virus (HCV) testing recommendations, calling for all baby boomers in the United States (individuals born from 1945 through 1965) to get a 1-time test for the virus.

The proposed new recommendations, says the CDC, could identify an additional 800,000 people living with HCV infection and prevent more than 120,000 HCV-related deaths during the current baby boomer cohort lifespan.

"While risk-based testing continues to be important, unfortunately, it misses too many infections," John Ward, MD, director of the CDC's Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said today during a media briefing. "Most of these missed infections are among baby boomers," he added.

The new guidelines, which also call for all baby boomers diagnosed with HCV infection to be linked to care and treatment, expand the CDC's existing, risk-based testing guidelines.

Baby Boomers Carry Most of the HCV Burden

According to the CDC, HCV can go undetected for decades and is the most common reason for liver transplantation and the leading cause of liver cancer, which is the fastest-rising cause of cancer-related deaths in the United States. More than 15,000 Americans die each year from HCV-related illness, including cirrhosis and liver cancer.

More than 75% of American adults infected with HCV are baby boomers, representing an estimated 2.1 million people. In addition, baby boomers are 5 times more likely to be infected with HCV than other American adults. However, "approximately 1 in 30 baby boomers has been infected with the virus, but most don't know it," the CDC states in a news release.

According to Dr. Ward, most baby boomers were infected when they were in their teens or twenties. Some may have been infected through receiving transfusions before the development of modern blood screening procedures in 1992, or experimentation with injection drugs.

"Because these exposures were often so long ago, many baby boomers may not even remember the events that could have placed them at risk, and many healthcare providers are reluctant to ask patients about past behaviors," he said. "[A]s a result, many baby boomers have not been tested for hepatitis C."

Benefits of Testing Have Increased With New Treatments

Newly available treatments, such as telaprevir and boceprevir, are estimated to cure up to 75% of HCV infections, the CDC notes. "The advances in treatment do drive the new recommendations...because treatments have become more effective," Dr. Ward told Medscape Medical News during the briefing. "There are also a fairly sizeable number of new therapies in the pipeline, which may even increase the effectiveness of treatment even further," he said.

He advised that clinicians and their patients "should recognize the large burden of hepatitis C as a health condition in the United States." The availability of a screening test, and also adequate treatments for individuals infected with HCV, when taken together, make "a compelling case for HCV testing in this age group," he said.

He noted that the cost-effectiveness of 1-time testing for baby boomers, including treatment for those found to be infected, is comparable to other routine preventive health services, such as screening for cervical cancer or abnormal lipid levels.

The draft recommendations will be available on http://www.regulations.gov (docket number CDC-2012-0005) for a public comment period from May 22 through June 8, 2012, and are expected to be finalized later this year.

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