Simplified diagram of the structure of Hepatitis C virus (Photo credit: Wikipedia)
Just two weeks ago, the Centers for Disease Control issued a recommendation that all Baby Boomers should be tested for the Hepatitis C virus. The center even suggested a special “National Hepatitis Testing Day” on May 19 to get the word out and get as many boomers tested as possible. This is in addition to testing already in-place for persons who are known to be at risk for the disease.
According to the CDC, at least one in 30 boomers has been infected with this virus and doesn’t even know it! The most serious consequences of having hepatitis C include liver cancer, which is responsible for many deaths and liver transplants every year, and cirrhosis, another very serious condition. Between the two, these conditions are estimated to cause more than 15,000 deaths each year.
On May 22, the CDC formally invited the public to comment on the draft recommendation. Public comment is open until June 8, so it’s not too late to read the recommendation (look for docket number CDC-2012-0005) and to make your opinion known. I am trying to link to the document; however it appears the site is down temporarily for maintenance. It should be up again soon, according to the Maintenance page. Here, also, is the CDC fact sheet (PDF) that explains the problem and the recommendations. Please do, however, go back to the recommendation and let your opinion be known.
Now, the thing that I have been wondering ever since I read this recommendation is: how does the CDC have any idea that baby boomers might actually be more at risk for this condition than, say, the general public? Well, there’s a clue in the fact sheet:
Many baby boomers were infected with hepatitis C when they were in their teens and twenties. Some may have become infected through blood transfusions or other health care exposures before universal precautions and widespread blood screening began in 1992. Others may have become infected from experimentation with drug use, even if only once decades ago. Because these exposures were often long ago, many baby boomers may not recall — or may be unwilling to discuss — the events that could have placed them at risk. As a result, many have never been tested for hepatitis C.
So, it looks like the two big issues are 1) exposure through blood transfusions “or other health care exposures” and 2) exposure through drug use.
Was our generation really that bad? I am just kind of an average person, and I know many average people like me who never even considered drug use. Since I never had a transfusion and my biggest “health care exposures” were for immunizations (which I support), I am not buying that I am somehow at risk for a disease I have never been exposed to.
The PDF also shows the standard risk-based guidelines, which I urge you to read, and if you fit into any of those categories, I’d agree you should be tested, in line with the current recommendations.
So, the next question is: what exactly is the test involved? According to labtestsonline.org, there are a few tests that are used to screen for or detect Hepatitis C:
- Anti-HCV test detects the presence of antibodies to the virus
- HCV recombinant immunoblot assay (RIBA) is used to confirm a previous positive test or indicate a false positive.
The following three tests indicate a current infection and guide treatment:
- HCV RNA, Qualitative (distinguishes between current or past infection)
- HCV RNA, Quantitative (viral load) to tell how many viral RNA particles are present
- Viral genotyping determines the type of HCV virus present
Just in case you didn’t notice, all of these tests require “health care exposure” in terms of at least a needle stick. I am not a health professional, but I just bet that during the test, there is some significant exposure in terms of a large needle entering a vein. So, if you don’t have Hepatitis C and you don’t have any risk factors, why is it all of a sudden necessary to expose oneself to additional risk (of any sort) of infection?
So, the upshot of this is that just because you’re a baby boomer, a member of a generation that was infamous for irresponsibility and drug use many years ago (or maybe not so long ago), you’re supposed to have this test? I am not about to tell you you shouldn’t have this test, but for me, I will not take a test that exposes me to further risk to check for an infection for which I am at virtually zero risk to start with.
What about you? Will you be taking this recommended test? What will you say if your doctor requests you take it? In my case, I’ll be saying No, thanks,” but I’d be interested in hearing what you would say.
