Conference Coverage

VA study underlines need for universal hepatitis C screening in Baby Boomers


 

AT THE LIVER MEETING 2013

WASHINGTON – Implementation of recommended one-time screening of Baby Boomers would identify an additional 51,000 veterans infected with the hepatitis C virus, according to researchers with the Department of Veterans Affairs.

Investigators looked at records for all veterans in the VA health care system from 1999 to 2012 who had a VA outpatient visit in 2012.

Denise Fulton/IMNG Medical Media

Dr. Lisa I. Backus

Broken down by birth cohort, of the 5.5 million vets who were seen, hepatitis C virus (HCV) screening was performed for 42% of those born before 1945, 64% of those born in 1945-1965 (Baby Boomers), and 58% of those born after 1965, Dr. Lisa I. Backus of the VA Palo Alto (Calif.) Health Care System reported at the annual meeting of the annual meeting of the American Association for the Study of Liver Diseases.

In the Baby Boomer cohort, 13% of veterans screened had HCV antibodies and 10% were infected with HCV, compared with 3% and 1.7%, respectively, for veterans born before 1945 and 2% and 1% of those born after 1965. Dr. Backus noted that in excess of 95% of veterans who screen positive for HCV antibodies are subsequently tested for HCV viral load and/or genotyping.

Dr. Backus noted that the VA population in general has a higher HCV infection rate than the general public – 6.1% for veterans vs. 2.5% for all Americans.

When HCV infection prevalence rates were extrapolated to veterans in the Baby Boom cohort who were not yet screened – approximately 900,000 – the data suggest that as many as 51,000 additional veterans would be identified with HCV infection with full birth cohort screening, Dr. Backus reported.

This study underlines the need for one-time screening for individuals born during the Baby Boom years, she said.

The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force both recommend one-time screening for this birth cohort.

"Without care and treatment, 1.7 million Americans with HCV will develop cirrhosis, 400,000 will develop hepatocellular carcinoma, and more than 1 million will go on to die of HCV-related disease. And obviously, they can’t get into care if they don’t know they have hepatitis C," Dr. Backus said, citing CDC data.

"Our work should also serve as an example to other health care organizations to prompt them to assess their own HCV screening rates and HCV prevalence rates and to make such rates public," she said.

The study was funded by the Department of Veterans Affairs. Dr. Backus had no relevant conflicts of interest.

dfulton@frontlinemedcom.com

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