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Canada should begin screening baby boomers for hepatitis C (HCV), a curable disease that is usually asymptomatic until liver damage is severe, argue several liver specialists in an analysis in CMAJ (Canadian Medical Association Journal).
"Unlike most chronic viral infections, HCV infection is curable," write Drs. Hemant Shah, Jenny Heathcote and Jordon Feld from the Toronto Centre for Liver Disease, University Health Network, Toronto, Ont. "Successful treatment leads to viral eradication, halting the progression of liver disease and decreasing all-cause mortality. Thus, there is a clear rational to identify and treat HCV infections during the asymptomatic phase."
Hepatitis C is a major cause of cirrhosis of the liver and is the most common indication for liver transplantation in North America.
In the United States, the prevalence of HCV infection is 3.6% among baby boomers (those born 1945 - 65) who account for 75% of all cases in the country compared with 1.6% in the overall population. Identifying infected individuals and getting them curative treatment prevents downstream costs from complications of liver disease. On the basis of these data, the Centers for Disease Control recently recommended screening this entire cohort.
The Canadian Liver Foundation recommends screening people born from 1945 - 75 because this would include about 77% of infected Canadians. Currently, Canada screens based on risk factors, including people who engage in risky behaviours or have been potentially exposed to HCV and people whose symptoms suggest they may be infected. Unfortunately studies from other countries have shown that this approach is not very effective, and as a result, many people have no idea they have the infection.
Hepatitis C screening involves an inexpensive blood test, the cost of which is covered by provincial health care plans in Canada.
Hepatitis C causes more years of life lost than any infectious disease in Ontario, and likely in Canada. Although a wider screening program will be more expensive up front, the long-term benefits could be significant.
"A properly executed birth-cohort screening program will be more expensive than risk-based screening in the short-term, but it will reduce morbidity and mortality in the long-term, thereby saving future HCV-related costs," write the authors.
"Canada should follow the lead of the US 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," they conclude.
A Canadian screening program for hepatitis C: Is now the time?
CMAJ 2013. DOI:10.1503/cmaj.121872
Authors: Hemant A. Shah MD MScCH HPTE,Jenny Heathcote MBBS MD,Jordan J. Feld MD MPH
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our Liver Disease / Hepatitis category page for the latest news on this subject.
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5 Dec. 2013. <http://www.medicalnewstoday.com/releases/266622>
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