Sunday, May 20, 2012

HCV

Hepatitis C VirusBecause the US government (CDC) is suggesting that all persons born between the years of 1945 and 1965 (that is  70 million people) be tested for the virus and this recommendation is making the news airways, I have a few questions and their answers.

What is it? A viral infection which targets the liver
What does it do? It causes inflammation and scarring as the virus attacks the liver.
How do you get it? It is blood borne.  Sharing needles with an infected person or receiving a blood transfusion from a person with the virus are the primary causes.
What is the test for it?  A simple blood draw.
What is the treatment?  An injection and oral medication can clear most but not all of the virus.
What is the prognosis? It has an acute and chronic phase and there are no symptoms.  It can progress to cirrhosis or liver cancer.  These illnesses can be fatal.  Liver cancer and cirrhosis kill about 8 to 10 thousand people  each year (USA), but hepatitis C is not the only cause of these two illnesses . (furthermore, greater than 400,000 people die from tobacco related illnesses a year, more than 400,000 people die from obesity related diseases a year, and heart disease and cancer account for over 500,000 deaths per year separately)

What are the Hep C numbers? I am not a math person, though I am getting better, so if these calculations feel wrong to you, I welcome corrections.  Either way - these are just my out loud musings.
There are 70 million people in the group that the CDC considers to be at risk and in need of testing.  That is 30% of the adult population of approx 234,564,000.  In general, 2% of that larger number has hepatitis C.  The number I read was a little less than that, 1.36% - or 3.2 Million (from a WSJ article on Thursday).  The target population, those boomers, have 2/3 of the cases, 2/3 of the 3.2 Million.  Not very many.  I am not sure how to wrap my mind around the boomers having a five time greater risk of hep c than the general 2% risk.  I am not sure if the risk for the new group is  2.1% or 3%  (but it is low).  Also, the average baby boomer, I suspect, has not had a blood transfusion and did not use IV drugs, so I am not buying this 'crisis'.  I did read that the CDC is concerned that those boomers who DID engage in recreational IV drug use might not want to admit it now that they are 50 - 65 years old.  The strategy then, "why not just test everyone to save some lives and remove the embarrassment factor."  It probably is cost effective.

The evidence to support hep c transmission from tattoos, piercing, sex, etc is quite limited.  The primary ways are again IV drug use and transfusion - blood is the common denominator.

There are at least 3 hepatitis viruses, Hep B has a vaccine, Hep A usually clears itself from the body without harm and Hep C can be acute or chronic. It is important to have the disease diagnosed in order to protect the liver and increase survivability.  See this CDC website page for more information.

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