Patients come and go at a temporary health clinic at the middle school in… (Jim Cole / Associated Press )
I consider myself to be a fortunate person. I have a good education, a great job and excellent health insurance. I am a baby boomer who has aged reasonably well and can look forward to a fairly comfortable retirement. I am also fortunate because I was diagnosed with hepatitis C by a proactive and knowledgeable doctor in the late 1990s and had the opportunity to be treated and cured. The odds are that if I had not been diagnosed and treated, I would be on a liver transplant list right now, have liver cancer or even be dead from this disease.
The odds were against my being diagnosed early or at all, since testing wasn't routinely done back when my hepatitis was caught. That's why I was happy to learn that the Centers for Disease Control and Prevention has released its new screening guidelines calling for all baby boomers to get tested once for the disease. For more than 95% of boomers, that means a simple blood test followed by reassuring news. But for the 3% to 5% of people who are infected, the test could mean the difference between life and death.
The recommendations are aimed at baby boomers because that generation has the highest likelihood of having been infected with the hepatitis C virus. According to the CDC, an estimated 2 million baby boomers have the disease. Many of us contracted the blood-borne virus more than 30 years ago, through injection drug use, or through blood transfusion or organ transplants before 1992, when measures to test donated blood and organs were adopted.
There are a lot of ways to contract hepatitis C, and not only baby boomers are susceptible. These days, transmission still occurs from shared syringes, including those used for performance enhancement drugs. But thanks to better knowledge about the risk of sharing needles, the advent of needle exchange programs and legalization of needle purchases in pharmacies in many states, this route of transmission has been curbed to a great degree.
Hepatitis C can also be transmitted when tattoos are done with crude homemade devices or unsterile equipment. That may be how I acquired the disease. When I was 18 years old, I went to a party, where we got group tattoos done. About 5% of babies born to moms who have hepatitis C also have it.
Less probable, but still possible, methods of transmission are sharing toothbrushes or razors with someone who is infected (if the blood of an infected person gets onto the razor or toothbrush), and, in rare cases, through sexual transmission. I had been married for more than 20 years when I was diagnosed, and my husband doesn't have hepatitis C.
More than 15,000 Americans die of hepatitis C annually, yet most people who have the virus don't know they do, because often symptoms are unnoticeable or mild. I had walked around feeling tired for years before I was diagnosed, but dismissed it, thinking I just needed more sleep. It wasn't until I finished 48 weeks of treatment that I realized that feeling that tired wasn't normal.
When I was treated in 1999, the routine was three interferon shots a week for nearly a year, along with an oral medication. There was only about a 30% cure rate with that regimen. I was one of the lucky ones. Soon thereafter, a longer acting interferon was introduced, which meant one shot a week and the oral medication. This raised the cure rate to about 50%.
Last year the Federal Drug Administration approved two protease inhibitors to treat hepatitis C, and when one of these drugs is added to the mix, the cure rate goes up to as high as 80%. Some people breeze right through treatment, but most have some side effects, including flu-like symptoms of headache, nausea and fever. There are several drugs in development that may eliminate the need for interferon entirely in a few years, so a lot of people are waiting for these drugs before getting treatment.
My advice is to anyone diagnosed with hepatitis C is to have a good medical work-up to determine how advanced your disease is, and then ask your doctor how quickly you need to get treatment. When I was diagnosed, the once-a-week shot was just on the horizon, and I thought about waiting for it, but my physician said my liver was already quite compromised. For a lot of people, care for hepatitis C patients means just taking it easy on your liver by quitting alcohol and tobacco, losing weight if you need to, and monitoring your condition.
There's another benefit to screening all baby boomers: elimination of the stigma that is attached to hepatitis C. By automatically adding age to the list of risks for hepatitis C, doctors don't have to ask embarrassing and invasive questions about a patient's distant past.
About 75% of people with hepatitis C don't know it. Offering a one-time hepatitis C blood test to baby boomers could identify more than 800,000 additional people with the disease and save lives along with billions in medical care costs. But this can happen only if we educate the public and providers.
Martha Saly is the director of the National Viral Hepatitis Roundtable, a coalition of more than 200 public, private and voluntary organizations dedicated to reducing the incidence of infection, morbidity and mortality from viral hepatitis in the United States.