Hepatitis C a Growing Concern

Aug 02, 2012 12:00 AM

Author: Robin D. Kim, MD


Hepatitis C is a growing health care issue in the United States. Two percent of the US population has hepatitis C, with 35,000 to 185,000 new cases a year. Yearly deaths from HCV are between 8,000 to 10,000 and will increase over the next few decades.

About 80 percent of those exposed to HCV develop a chronic infection, and after many years may then develop cirrhosis and liver cancer. About 10-30 percent of people develop cirrhosis over 30 years. Hepatitis C is the cause of 25 percent of cirrhosis cases and 25 percent of hepatocellular carcinoma.

Recently, a third class of drugs has been approved to treat HCV. Triple therapy consisting of the new protease inhibitor, in addition to ribavirin and interferon, have improved control rates. There is no vaccine against hepatitis C. About 50-80 percent of people treated are controlled. Those patients who progress to cirrhosis or liver cancer may require a liver transplant.

Only one quarter of patients with HCV in the US are aware. Testing is recommended in those at high risk, such as people with tattoos, people who have had blood transfusion before 1992, and people who have multiple sexual partners with unprotected sex. Screening is also recommended in those with elevated liver enzymes as this is frequently the only sign of chronic hepatitis.

As of May 2012, the U.S. Centers for Disease Control and Prevention (CDC) is considering a recommendation for a single screening test for baby boomers, as two million of them are infected. More than 15,000 Americans, most of them baby boomers, die each year from hepatitis C, and this figure will grow. The CDC estimates one-time hepatitis C testing of baby boomers could identify more than 800,000 additional people with hepatitis C and save more than 120,000 lives.