Birmingham News (05.26.12)
CDC's proposed recommendation that all baby boomers get tested for hepatitis C virus (HCV) is being assessed at three sites across the United States: the University of Alabama-Birmingham, Henry Ford Hospital in Detroit, and Mount Sinai Medical Center in New York.
Current CDC guidelines recommend that primary care doctors ask their patients about a dozen HCV risk factors, including blood transfusions, needle sharing, transplants, and unlicensed tattoos. 'The problem was the primary care physicians don't have time to ask about 12 risk factors, and the questions were sometimes embarrassing to doctors and patients both,' said UAB gastroenterologist Dr. Omar Massoud.
In draft guidelines issued in May, CDC proposed HCV screening for every American born between 1945 and 1965. Massoud and other researchers believe baby boomers comprise at least 75 percent of all HCV infections in the United States. CDC estimates one-time testing would detect an additional 800,000 infections and save more than 120,000 lives.
To determine the efficacy of the current guidelines, UAB examined the medical records for 39,000 patients of its Kirklin Clinic from 2005 to 2010. Half of these patients were baby boomers. If providers asked the right questions, and if patients gave honest answers, those who had risk factors should have been tested and the clinic should have found about 625 cases, said Massoud. Instead, just 72 infections were discovered. 'It proved that the current recommendations do not work,' he said.
In the second phase, to test the proposed guidelines, Kirklin Clinic will offer free HCV antibody screening to every baby boomer beginning in July. The hope is all these individuals will consent, since untreated chronic HCV can lead to liver failure and cancer, said Massoud. Those who test positive for antibodies will be given a second test to determine if the virus is still present. Massoud predicts that 85 percent of those getting the second test will have a chronic HCV infection.