North American Hepatitis C Epidemic Peaked around 1950, 15 Years Earlier than Previous Estimates

Results support routine HCV testing for all people born between 1945 and 1964.

Vancouver, BC [March 31, 2016] A study by the BC Centre for Excellence in HIV/AIDS (BC-CfE), in partnership with the US Centers for Disease Control and Prevention (US CDC), published in The Lancet Infectious Diseases, found the peak growth of the hepatitis C virus (HCV) epidemic in North America among individuals born between 1945 and 1964 (“baby boomers”) occurred when they were young children. Historically, stigma has surrounded the HCV epidemic among baby boomers because of the presumed link to risky behaviours, such as injection drug use experimentation, high-risk sexual practices or unsafe tattooing. Moreover, while North America does face a more recent HCV epidemic among people who inject drugs, the majority of those living with HCV are baby boomers – many of whom were infected through medical procedures or accidental exposures in hospitals decades earlier.

The BC-CfE study revises by 15 years previous estimates of the exponential growth phase of the North American HCV genotype 1a epidemic, the region’s most dominant form of HCV. The oldest members of the baby boomer cohort were roughly five years of age at the peak of the epidemic in 1950.

The peak exponential growth of HCV corresponds to an overall increase in medical procedures following World War II-much earlier than the peak in injection drug use that occurred in North America around 1969. A plateau in the spread of HCV was observed between 1960 and 1990, consistent with the hypothesis that changes in injection technology were a driving factor.

These findings suggest HCV spread among baby boomers was not associated with risky behaviour, but rather reuse of needles and syringes in health care settings before disposables became the uniform standard of practice. The results of the study strongly support routine HCV screening for all people born between 1945 and 1964, in line with recent US CDC recommendations.

“Hepatitis C among baby boomers has been previously linked to sex and drugs. As such, HCV testing has long carried a substantial stigma. Our results should go a long way to remove this persistent barrier to testing among HCV infected baby boomers,” said Dr. Jeff Joy, a Research Scientist with the BC-CfE and the study’s lead author.

“Reduced stigma will facilitate widespread testing and timely access to life saving HCV treatment. Any baby boomer could be living with HCV even in the absence of symptoms or any history of high risk behaviours, and as such they should be encouraged to proactively seek HCV testing,” said Dr. Julio Montaner, Director of the BC-CfE.

These findings are consistent with previous research from other parts of the world-including France, Italy, Japan and Russia-where reusable syringes and needles are recognized to have played a key role in the spread of HCV among baby boomers.

“The vast majority of North Americans with hepatitis C are baby boomers – and most are unaware that they have this infection,” said John Ward, M.D., Director of the Division of Viral Hepatitis at CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.”Over time, hepatitis C infection can lead to cirrhosis, liver cancer and other life-threatening conditions. All baby boomers need to be tested for hepatitis C so that those who are infected can receive life-saving care and treatment. This study demonstrates the importance of offering a test to all baby boomers rather than relying on risk based testing alone.”

For a summary of the study please click here

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