Hep C Tests Are A Good Idea For Baby Boomers

Providers Will Be Offering Them

November 01, 2016

Are you a baby-boomer? If you were born between 1945-65, your healthcare provider will be talking to you about something that may surprised you - Hepatitis C.

Why? We often reminisce about the “good old days” when people helped each other without reservation. During this same time, however, there were no standard precautions for infection prevention and blood used for transfusions wasn’t tested regularly until 1992.

First responders, good Samaritans, healthcare workers and those who worked around them cleaning, repairing or providing support may have been exposed to things they didn’t know existed. Patients receiving life-saving blood may have been exposed, too.

One of those “things” is Hepatitis C. And in some accidental way, a person may have been exposed without knowing it. Hepatitis C is transferred through blood and can live outside of the body at room temperature for three weeks.

Hepatitis C, or Hep C, is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the Hepatitis C virus, which is spread primarily through contact with the blood of an infected person.

Hepatitis C can be either “acute” or “chronic.” Acute is short-term that occurs within the first six months after exposure. Chronic is a long-term illness that occurs when the Hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis, scarring of the liver, or liver cancer. Acute can also turn into chronic if left untreated.

Most people who get Hep C won’t have any symptoms.

“On Sept. 18, a law went into effect that requires physicians and inpatient healthcare providers to offer Hep C screenings for those born between 1945-65,” according to Megan Devlin-Bussard, pharmacist and quality program director of Penn Highlands Healthcare Practice Management. “We are asking all of our providers to encourage patients to get screening done, but the mandate is geared toward primary care.”

“This age is targeted because 75 percent of people infected with Hep C tend to be baby boomers and they are not aware of their diagnosis,” Dr. Tuesdae Stainbrook, internal medicine and infectious disease physician of DuBois, said. “They are five times more likely to have Hep C than other generations.”

Some people may think they are safe if they’ve been vaccinated against Hepatitis, but there are vaccinations for only Hepatitis A and B. “C is the only one without a vaccine,” Devlin-Bussard said. Each type is caused by a different virus.

Is the test covered by insurance? “Medicare pays for it,” Stainbrook said. “All insurances should pay for it. Gov. (Tom) Wolfe made it a law. We have never had an insurance deny testing.”

“Most of the payers view this as any other preventive screen, like a colonoscopy or mammogram,” Devlin-Bussard said. “If you are in the age range, it is likely that your insurance will cover a one-time screening. We encourage patients to check with their insurance companies first. Medicare will cover it once.”

If a person does not have insurance, there is help. The Clearfield-Jefferson Drug and Alcohol Commission at 814-371-9002 and the Cameron-Elk-McKean Counties Alcohol and Drug Abuse Services Inc. at 814-642-2910 also does free testing. Call for information. Drug and alcohol use doesn’t have to be a factor to get tested.

What does the screening consist of? “We order a Hep C screening,” Devlin-Bussard said. “That test is just looking for the antibody for Hep C. The first test done tells you if you’ve ever been exposed to it. If it comes back reactive, meaning there are antibodies, the same tube of blood is looked at again for the actual virus.”

Could a patient have antibodies but not actual virus? Yes, he or she can. It just means that the body fought off the virus and the virus is dead. “A positive antibody could also been seen if you were treated in the past for chronic hepatitis C. The hepatitis C antibody is life-long and has a very small false positive rate,” Stainbrook said.

What is the concern? “The government is predicting this will find 800,000 new cases of Hep C,” Devlin-Bussard said. “It is already the tenth leading cause of death,” Stainbrook said.

With Hep C, there are no symptoms to concern you to go for testing or treatment. “Many times, patients don’t know if they have ever been exposed until the virus starts to affect their livers,” Devlin-Bussard said.

One example, Stainbrook gave, was of a person who had a cough and was treated with antibiotics. It didn’t go away, so an x-ray showed pleural effusion, an abnormal amount of fluid around the lung. She went to a lung specialist who could not drain the fluid because of the patient’s low platelets. Further testing and a trip to a blood and cancer specialist led to more testing which finally showed Hep C. The patient’s long six-months ended with a trip to Stainbrook’s office and treatment that solved it all.

There are medications to treat Hep C. “There are hardly any side effects,” Stainbrook said. “About 15 percent of the people experience fatigue and headaches, but most feel better on the medicine.” Treatment takes about 8-12 weeks. “Hep C has a 97 percent cure rate,” Stainbrook said.

“If we can identify it before there is end stage liver damage or cirrhosis, then we can prevent further disease, illness, pain and possibly death from Hep C-related diseases. Untreated, Hep C can lead to liver failure and liver cancer.”

“The liver is one of the few organs that can improve itself,” Stainbrook said. “These new medications have taken people off the transplant list. A patient has to have some good cells to start, but it can actually get better.” Getting tested sooner is better than later.

“Sometimes people are scared to know,” Devlin-Bussard said, “But that doesn’t change the results.” A screening test identifies a disease that is not showing symptoms, like a mammogram shows breast cancer. It only makes sense to know and be treated.

Also, some people may already have their liver functions checked regularly and think they are Hep C-free. That’s not so. The function tests do not check for Hep C in the blood which can lead to future ailments. “You won’t know if you have Hep C or not from routine tests and blood work,” Devlin-Bussard said. Seventy-five percent of people with chronic hepatitis C can have normal liver function tests sometime during their disease.

The Centers for Disease Control is predicting that this strategy will save $1.5 -1.7 billion in liver disease related costs for patients. That’s a lot of money to save with a small tube of blood.

“It was because of a lack of knowledge in sterilization a long time ago that this is needed now. We were not even aware Hep C existed then. Even those born before 1945 also can be checked,” Stainbrook said.

The good news is now we know and lives can be saved.