Test All Baby Boomers for Hepatitis C, CDC Urges
Rising deaths among baby boomers from hepatitis C prompted U.S. health officials to declare the entire age group a risk factor for the liver infection and recommend that all of its members be tested for the disease.
About 3.2 million Americans have hepatitis C and 75 percent of infected adults are boomers, which the Atlanta-based Centers for Disease Control and Prevention defined as those born from 1945 to 1965. Because symptoms of hepatitis C are often silent for years, most don’t know they have it, the agency said today.
Testing may help prevent cirrhosis and liver cancer, both of which result from infection, public health officials said. Baby boomers were infected in their teens and 20s, either through blood transfusions before HIV concerns prompted widespread screening in 1992, or with experimental injection drug use. Hepatitis C is often asymptomatic while it damages the liver, the CDC said in a statement.
“It’s a bold action that’s become necessary because there’s a large population that’s unaware of their illness, becoming ill, and dying in an era of effective treatment,” said John W. Ward, director of the division of viral hepatitis at the CDC, in a telephone interview.
There are an estimated 78 million baby boomers in the U.S., according to the 2006 Census. The CDC suggestion is included in draft guidelines for hepatitis C testing that will undergo public comment from May 22 to June 8. A study published in February in the Annals of Internal Medicine found that 15,000 people died from the virus from 1999 to 2007.
The standard treatment for hepatitis C for the past decade has been a combination of the antiviral drug ribavirin with interferon, an immune-boosting protein. Patients receive weekly shots of Interferon for as long as a year, which can cause side effects such as fatigue and flu-like symptoms.
A new class of drugs were introduced last year called protease inhibitors, including Victrelis from Whitehouse Station, New Jersey-based Merck (MRK) & Co. and Incivek by Vertex (VRTX) Pharmaceuticals Inc. of Cambridge, Massachusetts. These medicines attack the virus itself, and have been shown to cure more patients in less time with fewer side effects, although they still must be combined with Interferon shots.
A further breakthrough may come this year with the development of the experimental drug class called nucleotide polymerase inhibitors, which bind to a different part of the virus than the protease inhibitors, and could become the backbone for an Interferon-free combination.
Abbott Laboratories, Bristol-Myers Squibb Co. (BMY), Gilead Sciences Inc. (GILD), Johnson & Johnson (JNJ), Merck and Vertex are among the drugmakers acquiring and developing these new therapies as they seek a combination that may lead to a pill to control the disease, similar to the approach taken with HIV drugs.
One in 30 baby boomers have been infected with hepatitis C, according to the CDC. Just one test of all the members of that generation may identify 800,000 people with hepatitis C, preventing liver cancer and perhaps saving 120,000 lives.
“We believe this cost-effective public health approach can help protect the health of an entire generation of Americans,” Ward said today during a conference call.
The baby boomers are a new addition to the guidelines for who should be screened. Others at increased risk include anyone who has ever injected illegal drugs, recipients of blood transfusions or organ transplants before July 1992, and people with HIV.
Liver cancer is the fastest-growing cause of cancer death in the U.S. and hepatitis C is the leading cause of liver cancer, Ward said. A blood test is the only way to identify hepatitis C infections, according to the CDC.
“Most cancer deaths are going down and this is one of the few that continues to escalate,” Ward said.
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