A US government advisory panel today recommended that individuals born between 1945 and 1965 be screened for the hepatitis C virus. The announcement, which strengthens the panel’s earlier advice, increases the likelihood that health-care payers, including Medicaid, will cover screening costs for baby boomers, and that physicians will follow the guidance.
The US Preventive Services Task Force (USPSTF), a group of health experts assembled by the US Department of Health and Human Services, had before only weakly endorsed generational screening. In a draft recommendation released in November, the USPSTF said that screening the country’s more than 72 million baby boomers would generate a marginal net health benefit, grading the recommendation a ‘C.’ Since many health-care payers follow only recommendations dubbed B or higher by the panel, experts were concerned that physicians would not implement hepatitis C screening for baby boomers.
But in its final statement, the USPSTF upgraded that recommendation to a B. Acknowledging that not all people who test positive for hepatitis C will develop disease, and treatments often have significant side effects, the panel said that new studies helped make the case that generation-wide screening would be substantially beneficial.
“This is a rapidly moving field and the treatments are always advancing,” says USPSTF panel member Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco.
The move aligns the USPSTF with the US Centers for Disease Control and Prevention, which in August unequivocally recommended that people between the ages of 48 and 68 years old be tested for the blood-borne virus, which causes liver disease and cancer. Experts estimate that about 4 million people in the United States are infected with hepatitis C, and three-quarters of those infected are members of the baby-boom generation — possibly owing to intravenous drug use or past transfusions of unscreened blood.
Overall, up to 75% of those infected with hepatitis C may be unaware of their status owing to the slow onset of diseases caused by the virus. Proponents of routine testing for US baby boomers have argued that the cheap, non-invasive screening could identify more than 800,000 new cases of hepatitis C — which could then be treated using new drugs that are highly effective at eliminating the infection.
David Thomas, a viral-hepatitis specialist at Johns Hopkins University in Baltimore, Maryland, said the USPSTF decision was “a major step forward in the public-health response to hepatitis C infection”. Regardless of what factors influenced the panel’s opinion, “the major message”, says Thomas, “is that we have everyone on board”.