Hepatitis C death rates rise, 1 in 33 baby boomers has disease
Hepatitis C deaths are on the rise, according to a new report from the Centers for Disease Control and Prevention. The report found baby boomers are especially at risk because they account for two-thirds of all hepatitis C cases.
The worrisome news has prompted health officials to wonder whether anyone born between 1945 and 1965 should get a blood test for hepatitis C, because many of these boomers may have had the disease for decades without even realizing it.
"One of every 33 baby boomers are living with hepatitis C infection," says Dr. John Ward, the CDC's hepatitis chief. "Most people will be surprised, because it's a silent epidemic."
Some baby boomers may not think they're at risk because sharing a needle while injecting illegal drugs is the biggest risk factor for becoming infected with this blood-borne virus. But before 1992, when widespread testing of the blood supply began, hepatitis C commonly was spread through blood transfusions. Plus, a one-time experiment with drugs way back when could have been enough.
"Asking someone about a risk that happened 20 to 30 years ago is a lot to ask," says Ward. That's why officials are seeking a new strategy.
About 3.2 million Americans are estimated to have chronic hepatitis C, but at least half of them may not know it. The virus, which affects 170 million people worldwide, can gradually scar the liver and lead to cirrhosis, liver failure, or liver cancer. It is a leading cause of liver transplants.
For the CDC's study, published in the Feb. 21 issue of the Annals of Internal Medicine, researchers analyzed a decade of death records and found an increase in death rates from hepatitis C. In fact, in 2007 there were 15,000 deaths related to hepatitis C, higher than previous estimates - and surpassing the nearly 13,000 deaths caused by the better-known AIDS virus. Perhaps more surprising, three-fourths of the hepatitis deaths occurred in the middle-aged, people 45 to 64-years old.
"Mortality will continue to grow for the next 10 to 15 years at least unless we do something different" to find and treat the silent sufferers, Ward says.
Current CDC guidelines recommend testing people known to be at high risk, and until last summer there wasn't much enthusiasm even for that step: the reasons are the year-long, two-drug treatment promised to cure only 40 percent of people; treatment was so grueling that many patients refused to try it and treatment could cost up to $30,000.
Two new drugs - Vertex Pharmaceuticals' telaprevir and Merck & Co.'s boceprevir - are starting to change that pessimism. Research suggests adding one of them to standard therapy can boost cure rates as high as 75 percent. While still full of side effects, they can allow some people to finish treatment in just six months. They add to the price, however, another $1,000 to $4,000 a week. Drugs that promise to work even better are also being tested.
Those advances are fueling CDC deliberations of whether to change testing guidelines to recommend that anyone born between 1945 and 1965 get a one-time screening. A second CDC-funded study, also published in the Feb. 21 Annals, analyzed models of that option, and concluded it had the potential to save 82,000 lives.
A third study published Monday from Stanford University looked more closely at the price tag, and concluded the new triple-therapy would be cost-effective for people with advanced disease. It's still cheaper than a transplant costing well over $100,000. But not everyone with hepatitis C will go on to suffer serious liver damage. For those with mild disease, that analysis concluded some gene testing to predict who might really need the costlier triple therapy rather than the older drugs would be a good next step.
It's not clear how quickly the CDC will settle the boomer-screening question. But doctors at Montefiore Medical Center in New York City have started raising the issue. Montefiore internist Dr. Gary Rogg also says a number of patients have sought testing after seeing hepatitis-awareness ads from the drugs' manufacturers.
"Now it's considered a curable disease, that makes all the difference," says Rogg, who was surprised at some longtime patients' test results. Even a nurse he knows learned she had it, and the only risk she could recall was a blood transfusion during surgery when she was 10 years old.
According to WebMD, symptoms of hepatitis C include feeling very tired, joint and belly pain, itchy skin, sore muscles, yellowish eyes and skin, and dark urine. Since many people with the disease don't show symptoms, it is common for people to have hepatitis C for 15 years or longer, before it's diagnosed as chronic hepatitis C.http://bit.ly/yWqMe3