Screen All Baby Boomers for Hepatitis C, Expert Panel Says

This generation has highest rate of infection, likely contracted decades ago

By Steven Reinberg

HealthDay Reporter

MONDAY, June 24 (HealthDay News) -- All adults born between 1945 and 1965 -- the baby boom generation -- should be screened for the hepatitis C virus along with injection-drug users and anyone transfused before 1992, according to new recommendations from the U.S. Preventive Services Task Force.

The guidelines, released Monday, mirror recommendations from the U.S. Centers for Disease Control and Prevention and provide a long-awaited policy from the task force, an independent panel of experts.

"For everyone born between 1945 and 1965 we recommend a one-time screening," said task force member Dr. Kirsten Bibbins-Domingo, an associate professor in residence at the University of California, San Francisco, School of Medicine.

People in this age group account for three-quarters of all hepatitis C cases in the United States, Bibbins-Domingo said. Many contracted the disease decades ago but don't know it.

Hepatitis C -- a leading cause of liver damage and liver disease in the United States -- is considered a silent killer because it progresses without any indications of illness. More than 30 percent of U.S. patients needing liver transplants have end-stage liver disease related to hepatitis C.

"The challenge is that many people have hepatitis C and don't have signs and symptoms of the disease," Bibbins-Domingo said. "Those people should be identified and consider treatment."

An estimated 3.9 million people are infected with hepatitis C in the United States, the task force said. Unlike other types of hepatitis, there is no vaccine for hepatitis C.

In its 2004 statement, the task force advised against routine screening of adults without symptoms and high risk of infection. It also said it had too little evidence to recommend for or against routine screening for adults with high risk of infection.

It became apparent, however, that two-thirds of infected people weren't getting screened, while treatment was becoming more successful.

"Many people appear to benefit from treatment," Bibbins-Domingo said. "That is what led the task force to conclude that it is beneficial for people to find out they have hepatitis C in order to seek treatment."

Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said he welcomes the new guidelines, which were published June 25 in the Annals of Internal Medicine.

"I am absolutely thrilled that the U.S. Preventive Services Task Force, which has had a head-in-the-sand approach toward screening, has come out for a one-time screening for hepatitis C," Siegel said.

Siegel encourages everyone at risk to get tested.

Screening for hepatitis C involves a simple, inexpensive blood test. Those who test positive usually receive a course of antiviral medication over several months. Most people have no detectable virus following treatment, Bibbins-Domingo said.

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Half of People With Hepatitis C Don't Complete Needed Tests: CDC

TUESDAY, May 7 (HealthDay News) -- Only about half of Americans who are infected with hepatitis C undergo follow-up testing to determine if they are still infected, federal officials reported Tuesday.

"Many people who test positive on an initial hepatitis C test are not receiving the necessary follow-up test to know if their body has cleared the virus or if they are still infected," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in an agency news release.

"Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences," Frieden said.

A blood test, called an antibody test, is used to check if a person has ever been infected with hepatitis C. For people who have had a positive result, a follow-up test -- called an RNA test -- can determine if they are still infected so they can receive necessary care and treatment.

Some people's bodies can clear hepatitis C infection on their own, but about 80 percent of people with hepatitis C remain infected and can develop major health problems.

In this study, researchers analyzed data from eight regions across the United States. Only 51 percent of the hepatitis C patients reported in these regions had a follow-up test, according to the Vital Signs report from the CDC.

"Hepatitis C has few noticeable symptoms, and left undiagnosed it threatens the health of far too many Americans -- especially baby boomers," Dr. John Ward, director of the CDC's Division of Viral Hepatitis, said in the news release. "Identifying those who are currently infected is important because new effective treatments can cure the infection better than ever before, as well as eliminate the risk of transmission to others."

About 3 million Americans are infected with hepatitis C, and as many as 75 percent do not know they are infected. The study found that 67 percent of all reported cases of current hepatitis C infection were among baby boomers, which includes people born from 1945 through 1965.

All people born in the United States during those years should be tested for hepatitis C, the CDC advised. The agency also recommended testing for other people at increased risk, including injection-drug users and people who received blood transfusions or organ transplants before widespread screening of the blood supply began in 1992.

May is Hepatitis Awareness Month, and May 19 is National Hepatitis Testing Day.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. Centers for Disease Control and Prevention, news release, May 7, 2013

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CDC: 87 Now Sickened in Hepatitis A Outbreak Tied to Frozen Berry Mix

All infections traced to product sold at Costco stores, agency says

By Robert Preidt

HealthDay Reporter

TUESDAY, June 11 (HealthDay News) -- The number of people sickened in a hepatitis A outbreak that may be tied to a frozen berry/pomegranate mix now stands at 87, U.S. health officials said Tuesday.

As of June 10, cases had been reported in eight states: Arizona, California, Colorado, Hawaii, Nevada, New Mexico, Utah and Washington. The number of cases is expected to rise as the investigation continues, according to the U.S. Centers for Disease Control and Prevention.

The CDC said the hepatitis A cases may be connected to Townsend Farms Organic Antioxidant Blend frozen berry and pomegranate mix.

The agency said 36 people who were sickened have been hospitalized, and no deaths have been reported. Forty-six of 68 ill people interviewed (70 percent) reported eating Townsend Farms Organic Antioxidant Blend frozen berry and pomegranate mix.

On June 4, Oregon-based Townsend Farms recalled the frozen berry mixes, which were sold to Costco and Harris Teeter stores. The mixes were sold under the Townsend Farms label at Costco and under the Harris Teeter brand at that chain of stores, the Associated Press reported.

All of those sickened said they'd purchased the product from Costco markets. No cases have been traced to product bought at Harris Teeter, the CDC said.

Costco has removed the product from its shelves and is notifying members who purchased the product since late February 2013, the CDC said.

Preliminary laboratory analyses of specimens from two states suggest the hepatitis A strain responsible for the outbreak is rare in North America but is common in Africa and the Middle East. The strain was pinpointed as the cause of a recent hepatitis A outbreak in Europe linked to frozen berries, and to a 2012 outbreak in British Columbia associated with a frozen berry blend with pomegranate seeds from Egypt. But, there's no evidence that these outbreaks are related, the CDC said.

The label on the Townsend Farms product says it contains products from the United States, Argentina, Chile and Turkey.

According to the World Health Organization, hepatitis A illnesses typically arise within 14 to 28 days of infection. Symptoms may include nausea, fever, lethargy, jaundice and loss of appetite. There's a vaccine against hepatitis A, and it may ease symptoms if given soon after exposure to the virus.

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Experimental Drug May Work Against Hepatitis C

Miravirsen greatly reduced virus in patients in small study

By Maureen Salamon

HealthDay Reporter

WEDNESDAY, March 27 (HealthDay News) -- An experimental therapy for hepatitis C -- a "silent killer" linked to liver cancer and cirrhosis -- has shown promise in tamping down virus levels in early trials.

Experts caution, however, that it's too soon to know if the injectable drug will someday gain a standing among emerging oral medications against the disease.

New research suggests that the drug, miravirsen, could potentially be part of a drug "cocktail" that manages the hepatitis C virus in much the same way as similar combinations have transformed HIV/AIDS from a death sentence into a chronic, manageable condition.

Miravirsen suppresses molecules the hepatitis C virus needs to reproduce. The drug decreased viral loads by about 500-fold at the highest doses used in a small, phase 2 study by an international group of researchers. Drug resistance, a common problem with other hepatitis C medications, did not develop among patients taking miravirsen.

A phase 2 trial evaluates a drug's effectiveness while continuing to assess its safety.

"This is the first real clinical study of this approach and the results are encouraging," said Dr. Judy Lieberman, chairwoman of cellular and molecular medicine at Boston Children's Hospital. "What's exciting to me is that there doesn't seem to be any drug resistance developing. If there's a way to develop a drug cocktail that doesn't require a half a year of treatment ... that would be really exciting, but it's too early to tell."

Lieberman was not involved in the research but co-wrote an editorial accompanying the new study in the March 27 issue of the New England Journal of Medicine.

Hepatitis C is one form of liver disease and affects about 170 million people worldwide, according to study background information. It's transmitted by shared needles or, less frequently, through sex. Often symptomless, the infection is a major cause of liver cancer and cirrhosis, or scarring of the liver.

Led by Dr. Harry Janssen, a professor of medicine at the University of Toronto and Erasmus University Rotterdam in the Netherlands, researchers split 36 patients with hepatitis C into four groups. Nine patients in each of the first three groups received a dose of either 3 milligrams (mg), 5 mg or 7 mg of miravirsen per kilogram of body weight for 29 days, while the last nine patients received a placebo. All were followed for 18 weeks.

The so-called viral load of patients receiving the highest dose decreased by about 500-fold, Lieberman said, and the hepatitis C virus was below detectable levels in four of nine patients. Meanwhile, the treatment caused no significant toxic effects in any patients, aside from mild injection-site reactions and a brief increase in liver enzyme levels.

Calling the study "interesting," Dr. David Bernstein, chief of the division of hepatology at North Shore University Hospital in Manhasset, N.Y., said that as an injectable drug, miravirsen would be less desirable among patients than other new drugs for hepatitis C that can be taken orally.

"It's a novel concept, but it's only 36 patients and a phase 2 study," Bernstein said. "It's impressive that their viral loads came down, but most suffered a recurrence of the virus."

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