Liver doctors seek hepatitis C screens for baby boomers

Baby boomers and those born up to 1975 should be screened for the hepatitis C virus and treated if needed, say researchers who argue Canada is probably underestimating its prevalence.

Hepatitis C infection (HCV) can be eradicated if treated early and successfully, liver specialists say. In Monday's issue of the Canadian Medical Association Journal, three doctors say there's a clear rationale to identify and treat the infections before symptoms appear.

In North America, hepatitis C is the most common indication for liver transplantation, a previous study suggests.

"Canada should follow the lead of the U.S. and begin birth-cohort screening for HCV infection, even if only to collect the data that we need to determine whether we should be screening at all," Drs. Hemant Shah, Jenny Heathcote and Jordon Feld from the Toronto Centre for Liver Disease concluded.

The U.S. Centers for Disease Control and Prevention recommends routine screening of all baby boomers for hep C with a one-time test as well as screening based on risk factors.

Currently, Canada screens based on risk factors, including people who engage in risky behaviours or have been potentially exposed to the virus and people whose clinical signs or symptoms suggest they may be
infected.

But studies from other countries suggest that approach is not effective. Before France introduced an intensive national program, 75 per cent of those infected in the country weren't aware of it, which fell to 44 per cent afterwards.

The Canadian Liver Foundation recommends screening people born from 1945 to 1975 because it says this would include about 77 per cent of infected Canadians

Hepatitis C screening involves an inexpensive blood test. The cost of the test is covered by provincial health care plans.

The study's authors noted that a wider screening program will be more expensive up front, but say the long-term benefits could be significant.

Current treatment for Hep C infection costs about $65,000 for a complete course of weekly injections that cure about 65 to 75 per cent of cases, the authors said. They expect that within three to five years, better oral treatments will be available.

"Screening of people born between 1945 and 1975 coupled with a strategy for follow-up treatment and education is probably the best method to identify and provide care to affected people in Canada," the article said.

The authors have previously received consulting or speaking fees or grants from pharmaceutical companies.