October 29, 2013, 11:29 AM
By Matthew Heimer
Hepatitis C is a virus surrounded by a considerable stigma, with much of the general public associating infection with drug addiction and unsanitary living. But if a trend in the medical establishment continues to gain momentum, doctors will soon be telling millions of their otherwise healthy middle-aged patients to get tested for the disease, as Joseph Walker of The Wall Street Journal reports this week. (Walker discusses the phenomenon with Wendy Bounds of WSJLive in the clip below.)
About 3.2 million Americans carry the hepatitis C virus, or HCV, according to the Centers for Disease Control and Prevention, but the majority of them don’t know it; most don’t realize they’re carriers until the virus causes complications like liver cancer or cirrhosis, often decades after infection took place. The CDC estimates that HCV killed roughly 16,600 people in 2010. And this summer, the U.S. Preventive Services Task Force, a board that sets guidelines for medical practice, recommended that everybody born between 1945 and 1965 get screened for the disease at least once—an advisory that Walker estimates could affect as many as 60 million people.
Why single out the boomers? It’s partly a Me Generation issue: Intravenous drug users are among the highest-risk groups for infection, and boomers came of age during a time when experimentation with those drugs was relatively common. But the safety of the blood supply is a bigger factor: Blood donations weren’t routinely monitored and screened for many viruses before the early 1990s, and anyone who received a transfusion for any reason before then could potentially have been infected.
That task-force decision will mean some relief for boomers’ wallets. Testing can cost up to $200, not including follow-ups, but the fact that HCV screening has made the recommended list means that most private insurers are now required to cover the screening at no charge to the patient. (Medicare administrators say they’ll decide by next summer whether to cover screening.)
Still, as Walker reports, some doctors have misgivings about adding another blood test to older Americans’ medical to-do lists. HCV could be somewhat akin to prostate cancer as a midlife medical challenge: Since the majority of those infected won’t develop serious symptoms, many patients will have to decide whether to spend money, time and energy monitoring a condition that may never significantly affect them. (Then again, unlike prostate cancer, HCV can be transmitted from an infected person to someone else.)
On this front, at least, there’s some good news: Monitoring the liver for potential damage is now more likely to involve non-invasive procedures like blood tests, rather than more dangerous and complicated biopsies.