March 2, 2020 / 4:37 PM / a month ago

Experts recommend testing U.S. adults ages 18-79 for hep C

(Reuters Health) - With improved effectiveness of hepatitis C treatments, it’s worthwhile to screen U.S. adults for the virus, an expert panel says.

The recommendations from the U.S. Preventive Services Task Force (USPSTF), published in JAMA, come as hepatitis C infections are on the rise. The virus can raise the risk of liver cancer and cause cirrhosis, or scarring, of the liver, which can lead to the need for a liver transplant.

Experts currently estimate that 4.1 million Americans have hepatitis C and that half don’t realize they’re infected. Screening rates are still low, even though previous guidelines recommended screening for everyone born between 1945 and 1965.

The new recommendations, which call for screening of all adults aged 18 to 79, “are a huge step forward in our efforts to eliminate hepatitis C in the U.S. and they will allow us to pick up all those under-30-year-old folks who have hepatitis C mostly as a result of the opioid epidemic sweeping the nation,” said Dr. Douglas Dieterich, director of the Institute for Liver Medicine at the Mount Sinai Health System in New York City, who isn’t on the USPSTF panel. “Frankly, in the U.S., we’ve been losing ground in the last few years.”

The USPSTF review of evidence on newer antiviral therapies for hepatitis C found they were 95% effective at clearing the virus, said Dr. Roger Chou of the Oregon Health and Science University in Portland, a coauthor of the evidence review.

“The treatments are much better tolerated and much shorter than they used to be,” Chou said. “That is the main thing that is different between now and when we last reviewed the evidence in 2013.”

The new antivirals need to be taken for just eight to twelve weeks, and the side effects seem to be short-lived, he said.

“Hepatitis C is the most common blood-borne pathogen in the U.S. and it’s a major public health problem,” said Dr. Douglas K. Owens, chair of the USPSTF and a professor of medicine at Stanford University in California. “We have good tests to detect it and a very good treatment for it.”

“Given that more than 2 million people don’t know they have it, screening is an important preventive service we are recommending for all adults aged 18 to 79,” he added. “We are also recommending screening for anyone younger than 18 or older than 79 if they are at high risk, which would primarily be because they have a history of, or are actively injecting drugs.”

Currently there are about 45,000 new infections per year and that number is going up, Owens said. “So that’s more than three times as many per year as there were 10 years ago,” he added. “The consequences of this virus can be severe and that is why we are recommending a much broader screening so we can get people into treatment before they suffer those complications.”

SOURCE: bit.ly/2IoxN2J , bit.ly/39hpCRs , bit.ly/38dbIyf and bit.ly/2Tf0Dsf JAMA, online March 2, 2020.

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