Hepatitis C a growing concern for boomers

PHOTOGRAPHER: Sara Foss

In February, the Family Health Center at Ellis Medicine in Schenectady began using a brand-new test to screen for hepatitis C. Patients over age 40 were given a 10-question survey to determine whether they were at risk for the disease; if they answered yes to any of the questions, they were invited to take the test.

“The very first test came back positive,” recalled Dr. Christopher Murphy, a family practitioner at the center.

Last month, the U.S. Centers for Disease Control and Prevention recommended that all baby boomers — the generation born between 1945 and 1965 — get tested for hepatitis C, a blood-borne disease that can cause serious liver diseases such as cancer and cirrhosis.

According to the CDC, more than 2 million baby boomers are infected with hepatitis C, accounting for more than 75 percent of all American adults living with the virus.

“It’s a very common disease,” said Dr. Peter Ells, a professor of medicine in the division of gastroenterology at Albany Medical College. “It affects as much as 3 percent of the population.”

Ells said about half of the approximately 2,000 patients with liver disease he sees each year have hepatitis C.

“There’s a lot of hepatitis C out there,” Ells said.

According to the CDC, more than 15,000 Americans die each year from hepatitis C-related illnesses. These deaths have been increasing for more than a decade and are projected to grow significantly.

In New York, the number of people infected with hepatitis C has been steadily rising. In 2008, there were 6,437 cases of chronic hepatitis C confirmed statewide, up from 3,791 cases in 2001, excluding inmates.

In the 17-county area that includes the Capital Region, 930 cases of chronic hepatitis C were confirmed in 2008, up from 615 in 2001. According to the state Health Department, by 2009, there had been 69,429 chronic cases of hepatitis C reported upstate.

The majority of people infected are unaware that they have it, because it is possible to live with the disease for years with few recognizable symptoms. But in the past year, it has become much easier to determine who is infected.

A new test for the disease, called the OraQuick HCV Rapid Antibody Test, recently became available and has been distributed to programs that serve at-risk populations through the Health Department’s Statewide Hepatitis C Screening Program. In the past, testing was done via blood work that had to be sent off to a laboratory; the OraQuick test collects specimens through a finger stick and makes the results available within 20 minutes.

The Family Health Center at Ellis began using the OraQuick test in January, thanks to a grant from the pharmaceutical company that developed the drug. After the health center received 300 test kits, Murphy developed a research project for resident physicians that entails using the 10-question survey to screen for at-risk patients and give them the test.

The center began testing and treating hepatitis C and HIV in 2003. Murphy said the center serves a large low-income population and many of these patients are less likely to seek testing and treatment if it involves travel.

“The more steps there are in the process, the more likely you are to lose them,” he said, adding that the center is open to people from all income brackets.

In recent years, the center has been treating more patients with hepatitis C. About 21⁄2 years ago, it served about 30 patients with the disease, but that number has risen to 90, thanks to a grant that enabled the organization to expand services for patients with hepatitis C.

The disease is spread by direct contact with an infected person’s blood. At-risk groups include anyone who has ever used intravenous drugs, people from areas of the world where the disease is especially prevalent, such as Cameroon and Egypt, people who received blood transfusions prior to 2002 and people with multiple sex partners.

Many adults do not consider themselves at risk for the disease and do not get tested, which is why the CDC’s recommendation that all baby boomers get tested will help doctors find and treat people, Murphy said.

“If you only do risk-based testing, you end up missing people,” he said. One issue is that people who have engaged in risky behavior such as intravenous drug use sometimes lie about it. Focusing on baby boomers will help diagnose the disease in people who have likely had hepatitis C for decades but been unaware of it, he said.

The center has administered 40 OraQuick tests so far, and two tests have come back positive.

The state Health Department recently made an effort to raise awareness of the infection and promote testing. In January, the agency launched a one-month media campaign that consisted of bus ads, platform posters and a radio announcement featuring the slogan “Over 200,000 New Yorkers have hepatitis C. Are you one of them?” and providing information about a toll-free hotline, 1-800-522-5006, with information about various forms of hepatitis, as well as referral locations for testing.

Peter Constantakes, a Health Department spokesman, said the agency is also developing a new palm card that will feature the slogan “Get Tested — Hepatitis C — You Need to Know” and will provide information about free screenings.

The disease can be treated, and new therapies have made it easier. Until recently, hepatitis C was treated using the antiviral drug ribarvirin and the immune-boosting protein interferon, a treatment regimen that only cured 40 to 50 percent of cases. But last year, a new class of drugs, called protease inhibitors, became available to be used in combination with interferon shots. This regimen cures about 80 percent of cases, Ells said.

Symptoms of the disease include jaundice, fatigue, dark urine, abdominal pain, loss of appetite and nausea.

The CDC recommendation that baby boomers get tested for hepatitis C is included in guidelines, currently in draft form, that are open for public comment through Friday.