TORONTO — The average Canadian adult does not need to be screened for infection with hepatitis C, a blood-borne virus that can in time cause cirrhosis or cancer of the liver, says a task force that develops practice guidelines for primary-care providers.
In its first hepatitis C screening guidelines released Monday, the Canadian Task Force on Preventive Health Care recommends against widespread testing of adults unless they are considered to have an elevated risk for the disease.
Canadians at high risk include those who: have a history of IV drug use; were born, travelled or resided in countries where hepatitis C is endemic; received blood transfusions or had an organ transplant before 1992, when blood donations weren’t tested for the virus; or could have been exposed through potentially hazardous sexual behaviours or by getting a tattoo.
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“The burden of disease related to hepatitis C in North America is currently increasing and in fact is larger than the burden of disease posed by all other reportable infectious diseases,” including tuberculosis and HIV, said Dr. Julio Montaner, director of the BC Centre of Excellence in HIV/AIDS.
Montaner said there has been a prevailing notion that baby boomers infected with the virus likely contracted it during their teens or early 20s, due to such behaviours as IV drug use or sexual experimentation.
But a study last year by his research team in conjunction with the CDC found that a high proportion were infected as children and the virus was largely spread “iatrogenically” — meaning it resulted from exposure through inadequately sterilized reusable syringes and needles, for instance, those used in dental freezing and vaccinations.
An estimated 250,000 Canadians are infected with hepatitis C, according to the Canadian Liver Foundation. Many people who become infected never develop symptoms and recover completely. Others get a brief, acute illness with fatigue and jaundice, in which the skin and eyes turn yellow.