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People Born 1945-1965 & Hepatitis C

Key Facts about People Born 1945-1965 (Baby Boomers) and Hepatitis C

  • Of the estimated 3.2 million people chronically infected with hepatitis C in the U.S., approximately 75% were born during 1945-1965, or are baby boomers.
  • National prevalence data show that people born during these years are five times more likely than other adults to be infected.
  • Hepatitis C is a leading cause of liver cancer and the leading cause of liver transplants; people born during 1945-1965 account for 73% of all hepatitis C- associated mortality.

 

Hepatitis C Testing Recommendation for All Adults Born 1945-1965

In addition to testing adults of all ages at risk for hepatitis C infection, CDC recommends:

  • Adults born during 1945–1965 should receive one-time testing for the hepatitis C virus (HCV) without prior ascertainment of HCV risk (Strong Recommendation, Moderate Quality of Evidence).
  • Testing should be initiated with anti-HCV. A reactive result should be followed by nucleic acid test (NAT) for HCV RNA.
  • All persons identified with HCV infection should receive a brief alcohol screening and intervention as clinically indicated, followed by referral to appropriate care and treatment services for HCV infection and related conditions (Strong Recommendation, Moderate Quality of Evidence).

 

Rationale for Recommendation

  • There is a high prevalence of hepatitis C in people born during 1945–1965, with 75% of people with hepatitis C born during these years.
  • There is increasing HCV-associated morbidity and mortality, as annual HCV-associated mortality in the US increased more than 50% from 1999 to 2007. People born 1945-1965 with hepatitis C face increasing hepatitis C-associated morbidity and mortality.
  • A high proportion of people with hepatitis C do not know that they are infected (estimates range from 45%-85%).
  • Testing based solely on elevated ALT levels is estimated to miss 50% of chronic infections.
  • For those who are chronically infected, clinical preventive services including regular medical monitoring, hepatitis A and B vaccination, and behavior changes like alcohol reduction/cessation and achieving and maintaining a healthy BMI can improve health outcomes for people with hepatitis C.
  • New therapies, including interferon-free regimens, can halt disease progression cure most infected with hepatitis C. These treatment options increase the effectiveness and reduce the duration of therapy for many patients.
  • One-time testing of those born 1945-1965 is estimated to identify 800,000 infections and, with linkage to care and treatment, avert more than 120,000 HCV-related deaths.  This strategy is estimated to save $1.5-$7.1 billion in liver disease-related costs.

 

Guidelines and Recommendations

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965 (MMWR 2012;61(RR04);1-18).

U.S. Preventive Services Task Force (USPSTF) - Screening for Hepatitis C Virus Infection
USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection and offering one-time screening for HCV infection to adults born during 1945-1965. Grade: B Recommendation.

CDC Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease (MMWR 1998;47(RR19).

 

Healthcare Provider Resources

 

Patient Resources

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