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Published: Saturday, August 25, 2012, 12:01 a.m.

Hepatitis C test urged for baby boomers

The potentially fatal virus can go undetected for years, and the rate of diagnosed cases between 2009-11 was higher among those ages 47 to 67.

Attention baby boomers: All women and men born between 1945 and 1965 should get tested for hepatitis C, federal health officials say.
The virus can go undetected for years, and if left untreated, can cause serious disease, and even death.
Testing is important because 10 percent to 20 percent of patients in this age group don't think they're at risk for the disease but come back with a positive test, said Dr. John Scott, who works at the hepatitis and liver clinic at Seattle's Harborview Medical Center.
In Washington, 5,500 new cases of chronic, or long-term, hepatitis C were diagnosed between 2009 and 2011, said Anne Brenner, viral hepatitis coordinator at the state Department of Health.
Sixty-two percent of the newly diagnosed cases were among baby boomers, those between 47 and 67 years old.
In Snohomish County, 541 people were diagnosed with the disease during the same two-year period; 61 percent were in the baby boomer age group, she said.
"They really want to save lives," Brenner said of the Centers for Disease Control and Prevention's recommendation for testing, announced Aug. 16.
Yet it might be a tough sell.
"You'd be surprised what a battle it is," said Dr. Deb Nalty, who works at Providence Physician Group's Monroe clinic.
Three of her patients have asked about the test since hearing about the new recommendation that requires a blood sample. All three declined to be tested.
Part of the reason may be stigma.
There's a long list of things that can put people at risk for the disease, including: being a long-term kidney dialysis patient; getting a blood transfusion before 1992, when there were no tests conducted to check for the virus; or sharing a razor with someone who has the virus.
But it's the association of the disease with injection drug users that may be off-putting to people thinking about getting tested.
"When they hear about the unlikelihood of being positive in their situations, they don't feel like it's worth the effort," Nalty said.
Dr. Gary Goldbaum, health officer for the Snohomish Health District, said he understands such concerns.
Many people may not feel as if they've had any potential exposures to the disease, he said. "There's a concern that there may be people who aren't remembering any (potential exposure) in the past or had an exposure that they aren't bringing up," he said.
If everyone is asked to be tested, it removes the issues of stigma, he said. "They don't have to acknowledge participating in behaviors they don't want to reveal."
Another barrier to testing may be cost, which can range from about $40 to $100.
Medicare doesn't cover the costs of the test. "The guidelines just came out; it may take time for a coverage decision to be made," said Stephanie Magill, a spokeswoman for the Centers for Medicaid and Medicare Services.
Group Health has more than 200,000 Washington members in the age group recommended for testing.
"Trying to identify who is at the highest risk makes the most sense, particularly when the disease is not very common," said Dr. David Grossman, Group Health's medical director for preventive care.
"In terms of routinely screening everyone, we'll want to take some time to digest this recommendation and review it with our experts to see if it makes sense for our population," he said.
Premera Blue Cross members who want the test could be subject to a copay or deductible, said spokeswoman Amy Carter. She advises members to call Premera's customer service department for more specifics about cost.
Regence BlueShield, with about 200,000 Washington members in the age group recommended for testing, does cover test costs, said spokeswoman Georganne Benjamin.
The nonprofit Community Health Center of Snohomish County will provide the test on a sliding fee scale to its patients.
Nalty, the Monroe physician, said she thinks many of her patients will weigh their risk of the disease before deciding whether to be tested.
"When people get more information on why it's being done, they may choose not to proceed," she said.
"They're talking about testing an ocean of people for a drop of positives."
Scott, Harborview's hepatitis specialist, said that the test can potentially prevent the need for a liver transplant, which can cost $250,000 or treatments for liver cancer, which typically cost $90,000.
New rapid tests can allow patient to have preliminary test results before they leave a medical clinic, he said.
Testing can help identify people who can benefit from new treatments for hepatitis C, which can increase the rates of curing the disease by up to 75 percent, said Brenner, with the state Department of Health.
"We've seen a rise in deaths across the country" from hepatitis C, she said. Federal health officials were trying to alert the public, especially those in the baby boomer age group to the problem, Brenner said.
"The figures are scary," she said. "If you look at the statistical information, it's definitely concentrated in that age group."
Sharon Salyer: 425-339-3486; salyer@heraldnet.com.
Are you at risk?
•An online set of questions to help determine your risk to hepatitis C:
www.cdc.gov/hepatitis/RiskAssessment
•More information on hepatitis C is available from the Seattle-based Hepatitis Education Project at www.hepeducation.org
Here's why federal health officials are urging baby boomers to get tested for hepatitis C:
•More than 75 percent of adults with hepatitis C are baby boomers, or those born from 1945 through 1965. Most of these adults don't know they are infected.
Baby boomers are five times more likely to be infected with hepatitis C.
Liver disease, liver cancer, and deaths from hepatitis C are on the rise.
As baby boomers age, there is a greater chance that they will develop serious, life-threatening liver disease from hepatitis C.
Early diagnosis and treatment can help prevent liver damage, cirrhosis, and liver cancer.
Source: Centers for Disease Control and Prevention

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