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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
CANADA: Experts Worry Tsunami of Liver Disease Looms in Hepatitis C-Infected Boomers
By Helen Branswell
October 30, 2013
Ottawa Citizen (10.29.2013)

The Ottawa Citizen recently reported that Canadian physicians feared an imminent increase in liver disease among people ages 38–68 who were unaware they had chronic hepatitis C. Dr. Jordan Feld and Dr. Morris Sherman, both hepatologists, warned that a large number of baby boomers with irreversible liver damage caused by the “silent epidemic of hepatitis C” could overwhelm the Canadian medical system. Baby boomers could have contracted hepatitis C in various ways: blood transfusions before screening began in 1992; medical procedures in parts of the world where needle reuse was accepted; tattoos; or needle sharing during injection drug use. However, approximately 30 percent of hepatitis C cases had no known risk factor. Based on high hepatitis C incidence, CDC recommended in 2012 that all US baby boomers have one-time screening to identify hepatitis C-infected individuals before the disease caused cirrhosis or liver cancer. Although treatment cost tens of thousands of dollars, it was much less expensive than the costs of lost productivity, treating liver cancer, or providing liver transplants. CDC estimated that 1–1.5 percent of the US population had hepatitis C. Liver experts and the Canadian Liver Foundation urged the Public Health Agency of Canada to recommend hepatitis screening for Canadian residents born between 1945 and 1975 to catch infections among baby boomers and high-risk immigrants. However, the agency—believing that fewer Canadians (0.8 percent) were infected—has delayed making hepatitis C screening recommendations until a working group could present suggestions. Earlier models suggested only 20 percent of hepatitis C-infected Canadians were unaware of their infections. Dr. Howard Njoo, director general of the agency’s Centre for Communicable Diseases and Infection Control, acknowledged the agency might revise that figure to 30–40 percent and change its guidance. Feld noted that screening baby boomers would provide data about hepatitis C prevalence among Canadians and help in choosing the best strategy.

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