Hepatitis C: Proposed Expansion of Testing Recommendations

The Centers for Disease Control and Prevention has released the following new guidelines regarding Hepatitis C regarding 'baby boomers'. No vaccine against hepatitis C is currently available.

Hepatitis C is an unrecognized health crisis in the United States. This life-threatening infection affects an estimated 3.2 million Americans, most of whom are “baby boomers” (those born from 1945 through 1965). And while newly available treatments can cure the majority of hepatitis C cases, most people do not seek care because they do not know they are infected.

Diagnosing hepatitis C early is key, since the longer the virus goes undetected, the greater a person’s risk of developing serious liver disease, including liver cancer and cirrhosis. Deaths due to hepatitis C are increasing, reaching more than 15,000 in 2007.

CDC’s current public health recommendations focus on testing only individuals with known hepatitis C risk factors. To identify more hidden infections, provide prompt and appropriate care and treatment, and avoid tens of thousands of hepatitis C-related illnesses and deaths, CDC is proposing one-time hepatitis C testing for all baby boomers. The new draft recommendations will be available for public comment from May 22–June 8, 2012, and will be finalized later in the year.

Hepatitis C and Baby Boomers

More than 75 percent of

American adults with

hepatitis C are baby boomers



Baby boomers are five times more likely than other American adults to be infected with the

disease. In fact, more than 75 percent of American adults with hepatitis C are baby boomers.

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.

Baby boomers are five times more likely than other American adults to be infected with the disease. In fact, more than 75 percent of American adults with hepatitis C are baby boomers. 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.

Hepatitis C Testing: Proposed Expanded Recommendations

A blood test is the only way to identify these silent infections. CDC currently recommends testing for those who have a known risk for hepatitis C (see box, this page). While this is still important, too many infections are being missed — since individuals, and even doctors, may be uncomfortable discussing behaviors related to hepatitis C risk. In addition, standard, routine tests of liver function miss more than half of all cases of hepatitis C infection.

As a result, CDC is proposing an expansion of its current risk-based guidelines to include a simple, one-time blood test for all baby boomers. For those who test positive, the new draft recommendations call for referral to care and treatment and a brief screening for alcohol use, which can accelerate progression of liver disease in those with hepatitis C.

Who Should Be Tested For Hepatitis C? Proposed new recommendation: Anyone born from 1945 through 1965

Existing, risk-based guidelines:

Anyone who has ever injected illegal drugs

Recipients of blood transfusions or solid organ transplants before July 1992, or clotting factor concentrates made before 1987

Patients who have ever received long-term hemodialysis treatment

Persons with known exposures to hepatitis C, such as:

• Health care workers after needlesticks involving blood from a patient with hepatitis C
• Recipients of blood or organs from a donor who later tested positive for hepatitis C

People living with HIV

People with signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)

Children born to mothers who have hepatitis C

CDC Frequently Asked Questions about Hepatitis C: http://www.cdc.gov/hepatitis/C/cFAQ.htm

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Hepatitis C: Proposed Expansion of Testing Recommendations

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