Should you be screened for hepatitis C?

You may have read articles in the news or seen TV commercials about new treatments for the hepatitis C virus and wondered, “Am I at risk for this disease?” According to the Centers for Disease Control and Prevention (CDC), approximately 2.7 million to 3.9 million people in the U.S. are living with active, chronic hepatitis C infections, with 1 in 30 baby boomers estimated to be infected. However, nearly half of those people are not aware they are infected because the disease usually produces no or very mild symptoms in its early stages, which can last for several years.

For this reason, groups including the American Association for the Study of Liver Diseases and the CDC, have developed screening guidelines for people who may be at an increased risk of chronic hepatitis C infection. They recommend screening for people:

• Born in the United States between 1945 and 1965
• Who received clotting factors made prior to the introduction of sensitive screening (1987 in the United States) to treat blood coagulation disorders including hemophilia, liver disease, Von Willebrand disease, and other clotting factor diseases
• Who received blood or organs before the introduction of sensitive screening of the supply (July 1992 in the United States)
• Who have been informed that they received blood from a donor who later tested positive for hepatitis C virus
• With evidence of liver disease, which usually shows up as persistently elevated liver tests on routine labs
• With a history of illicit injection drug use or intranasal cocaine use, even if only used once
• Who were ever on chronic hemodialysis (kidney dialysis)
• Infected with HIV
• Who are incarcerated or have a history of incarceration
• Children born to hepatitis C-infected mothers
• Who experienced a needle stick injury or mucous membrane exposure to hepatitis C-positive blood
• Who are a current or past sexual partner of a hepatitis C-infected person, though the risk of sexual transmission of the disease is believed to be relatively low

How does hepatitis C affect your health?

Hepatitis C is a virus that causes inflammation of the liver. Long-term infection is called chronic hepatitis C infection. Some studies have found that in 14% to 50% of acute infection (when you are first infected), the body is able to clear the virus without treatment. However, the CDC reports that hepatitis C infection becomes chronic in about 75% to 85% of people infected. Untreated chronic infection may lead to serious health problems, including liver scarring (cirrhosis), an increased risk of liver cancer, and liver failure.

Approximately 70% to 80% of people who become infected do not experience symptoms. The 20% to 30% who do experience symptoms usually do so two weeks to six months after exposure to the virus.

Symptoms can include:

• Fatigue
• Sore muscles
• Joint pain
• Fever
• Nausea or poor appetite
• Stomach pain
• Itchy skin
• Dark urine
• Jaundice, a yellow discoloration of the skin and whites of the eyes

Screening tests for hepatitis C infection can be done as part of any routine blood draw. The first test is a blood antibody test and if that is positive, more sensitive viral level testing is done. If you’re diagnosed with hepatitis C, the latest treatment options, a class of medications known as direct acting antivirals, are better tolerated, cause fewer side effects than previous treatments, and have a high success rate of clearing the virus from the body for many people.

Talk with your doctor or health advisor to find out if you’re at risk for hepatitis C, if screening is appropriate, and what the potential risks and benefits of treatment are.