Baby boomers warned to be on alert for hepatitis C

Attention, baby boomers. You are especially susceptible to a silent killer. One that may have hidden dormant and undetected in your system for decades, until it suddenly announces itself to the dreadful tune of liver cancer or cirrhosis.

But there’s something you can do.
"If someone was born between 1945 and 1965, they should go to their primary care doctor and ask for a test for hepatitis C," says Dr. Ben De La Rosa, infectious disease specialist at Holy Name Medical Center in Teaneck. "Baby boomers have an increased incidence of hepatitis C. Often, you don’t have symptoms. Over a period of years, it can slowly and very gradually cause liver damage to the point where you could need a liver transplant. When it gets to that point, there is a high rate of morbidity, and it is very expensive to take care of people."
An estimated 3.5 million people are infected with hepatitis C, a liver infection caused by the blood-borne hepatitis C virus. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs, according to the Centers for Disease Control and Prevention.
The reason why 75 percent of all those infected with the virus are baby boomers is not completely understood, says the CDC. Most boomers are believed to have become infected in the 1970s and 1980s, when rates of hepatitis C were the highest. Many baby boomers could have gotten infected from contaminated blood and blood products before widespread screening of the blood supply began in 1992 and universal precautions were adopted. Others may have become infected from injecting drugs, even if only once in the past. Still, many baby boomers do not know how or when they were infected.
Based on the high rate of infection, the CDC has recommended that people born between 1945 and 1965 be tested.
For some people, hepatitis C is a short-term illness. But for 70 percent to 85 percent of people who become infected with hepatitis C, it becomes a long-term, chronic infection. There is no vaccine for hepatitis C. The best way to prevent it is by avoiding behaviors that can spread the disease, especially injecting drugs, the CDC says.
Thanks to recent financial support from Gilead Sciences, a California-based biopharmaceutical company that discovers, develops and commercializes innovative therapeutics in areas of unmet medical need, patients coming into Holy Name Medical Center’s emergency department who were born between 1945 and 1965 are being offered a free hepatitis C blood test.
"The reason why screening is so important is that hepatitis C is usually not part of a typical annual physical," says Jean Park, project manager at Holy Name for the screening program, called Project Focus. "We are privileged to be the only hospital in Bergen County to receive this grant, which is enabling us to screen people and intervene early to prevent diseases of the liver, or even death. It is our goal not only just to screen but to link them to a physician so they can receive treatment. It’s soup to nuts."
She said the program started about a month ago and will be offered all year. Based on the number of baby boomers who come into the hospital’s emergency room, Holy Name could screen as many as 9,000 individuals for hepatitis C this year, according to Park.
Holy Name received approximately $300,000 from Gilead to develop "best practices" of screening for hepatitis C that can be replicated at different hospitals. The grant includes systems development, training of emergency services educators and developing educational materials, in addition to covering costs for screening.
"This is an exciting time for people with hepatitis C. There are drugs that are very effective," De La Rosa says. "If you can capture those people [who test positive], you can link them to care, they can see a specialist to see if there is liver damage, what stage of the disease they are in, and maybe have a chance to cure it, with adequate treatment."
He noted that treatment isn’t always without its complications, however. "Because of the extraordinary expense with these drugs, there is a lot of pre-authorization required. You really have to prove (to the insurance company) that these people need these drugs."
De La Rosa said the advancements in treatment are remarkable. "You can now take one pill once a day for anywhere from 12 to 24 weeks, and be cured," he said. "That is an amazing accomplishment. And all of these drugs are not only effective, but very tolerable."
Meanwhile, the state Senate Health, Human Services and Senior Citizens Committee approved legislation on Feb. 29 that would require hospitals to offer a hepatitis C screening test to all patients born between 1945 and 1965 in any setting of a hospital.
The bill, sponsored by Sen. Joe Vitale, D-Woodbridge, aims to increase awareness of the virus in the baby boomer population. While the New Jersey Hospital Association and Medical Society of New Jersey have said they support the intent of the legislation, they disagreed that a hospital setting is the most appropriate place to mandate the tests.
Vitale chastised the two organizations for their resistance. The NJHA said testing is important, but it should be handled in a doctor’s office, as testing in the emergency room or an inpatient unit is more expensive and could prolong the visit. The MSNJ has objected to the bill because it mandates hospital testing without funding it.
Proponents of the bill have maintained the testing is covered by Medicare and that follow-up testing and treatment would be handled by the patient’s doctor.