JUL 05, 2018

Is Testing Everyone for Hep C Necessary?

WRITTEN BY: Brenda Kelley Kim

Cases of Hepatitis C, known as Hep C or HCV, are on the rise. In the United States, the CDC reports that there were approximately 3,000 new cases of hepatitis C in 2016. In the US about 3.5 million people are living with the virus. Worldwide the number is estimated at 71 million.

The World Health Organization figures show that between 15 and 45 percent of those who contract HCV will recover within six months and many never realize they are infected. It's spread via contact with the blood of an infected person and needle sharing among IV drug users is a common cause. Those who do not recover from the infection often go on to develop chronic HCV which increases the risk of cirrhosis of the liver and liver cancer. Every year between 350,000 and 500,000 people die from HCV complications.

In Canada, the Canadian Treatment Action Council (CTAC) has launched an effort to end Hep C infections in Canada. They listed seven calls-to-action in a white paper  on the epidemic, one of which is "Increased access to testing, including point-of-care testing, rapid testing, and one-time cohort screening for all baby boomers." Dr. Jordan Feld is a liver specialist at Toronto's University Health Network and a co-author of the recently issued guidelines that recommend every patient born between 19945 and 1975 be tested for the virus. In an interview with CBC, Feld stated, "And the reason we've done this is it just happens that somewhere between two-thirds and three-quarters of people with hepatitis C were born between 1945 and 1975 in Canada. So just the way someone gets a blood pressure check or a cholesterol check or a colonoscopy based on their age, we would recommend that they get a hepatitis C test if they're born between those years."

Not everyone agrees, however. In 2017, the Canadian Task Force on Preventative Health Care recommended against testing all citizens, stating that only those at risk should be screened. In an interview with Reuters in April 2017, Task Force member Dr. Roland Grad stated, "For the average Canadian at average risk, don't screen." Liver experts in Canada disagree, saying that risk is difficult to assess and if patients are not screened and develop symptoms later, the disease has likely progressed too far for the use of newer drugs called "direct action antivirals" that can clear HCV from 95% of patients in 8-12 weeks. While the disease continues to be a problem in Canada and in other countries, the newer drugs are quite expensive and not always covered (https://www.labroots.com/trending/health-and-medicine/11754/insurance-denials-prevent-patients-getting-hep-medication) by insurance plans. In Canada, access to the drugs is guaranteed for Canadians under their national health plan.

The video below talks more about testing and who should consider it. As always, check with your doctor about your risk.

Sources: CBC Canadian Treatment Action Council  World Health Organization CDC