The Center for Disease Control and Prevention (CDC) has requested that all individuals born between 1945 and 1965 be tested for the presence of the hepatitis C virus. This is a clear cut change in their policy which had previously asked that only high risk patients be tested.
Hepatitis C is a viral infection usually transmitted by blood to blood transmission. High risk patients include intravenous drug users who share needles, men and women receiving hemodialysis, patients with an impaired immune system such as HIV patients and patients who received blood transfusions before 1992 because the system was not tested for hepatitis C at that time. Additionally, the disease may be seen in health care workers who were exposed to blood and in life partners of infected individuals due to sexual transmission or common use of grooming items such as razors and toothbrushes. Individuals who received tattoos with non sterile equipment are additionally at risk.
During my training years we only knew of hepatitis A and hepatitis B. We were aware of a third form which we named “non A, non B hepatitis.” With improved technique and technology the “C” virus was isolated. It is believed that there are 1.5 million baby boomers infected who have no idea that they have the illness. It is important to detect them because the virus can lead to chronic liver disease, liver failure and liver cancer – all of which can be prevented with the treatments now available.
The disease is common in baby boomers because they were the participants in the 1960’s -70’s “ free love” generation which included IV drug use and sex with multiple partners both, of which are risk factors for the disease. Since only 1 in 10 infected individuals become acutely ill with the infection and develop fever, malaise, jaundice, darkening urine, light clay colored stool; it is highly likely that many carriers have no idea they have the infection. We want to find those people and treat them before they become clinically ill with the stigmata of chronic liver disease. To identify them requires a simple non fasting blood test which can be performed by a physician or the health department.
If a screening test suggests that you are infected, additional testing will be performed to determine the genetic type of the virus you have and to assess the ability of your liver to function. You will require a liver biopsy at some point. With this data, physicians who specialize in liver diseases called hepatologists and/or infectious disease experts can tailor the treatment to your genetic type of virus.
Experts do not want baby boomers to panic over this disease. Infected patients can interact with the public and loved ones without fear of transmission of the virus unless they are bleeding or intimate. The hepatitis C virus is in fact much less likely to be transmitted sexually than the hepatitis A or B viruses are.
Low risk individuals who have donated blood recently, are not IV drug users and have not been intimate with a hepatitis C patient have little to be concerned about. I recommend you talk about hepatitis C screening with your physician at your next scheduled visit.
Steven Reznick is an internal medicine physician and can be reached at Boca Raton Concierge Doctor.
