Hepatitis C killing more Americans than HIV

Hepatitis C has surpassed HIV as a killer of U.S. adults, and screening all "baby boomers" could be one way to stem the problem, according to two new government studies.
Hepatitis C is a liver infection caused by a virus of the same name that is usually passed through contact with infected blood. An estimated 75 to 85 percent of infections become chronic, which can eventually cause serious diseases like cirrhosis (scarring of the liver) and liver cancer.
In one of the new studies, researchers at the Centers for Disease Control and Prevention (CDC) found that by 2007, Hepatitis C was killing more Americans than HIV - the virus that causes AIDS.
In 2007, Hepatitis C killed 15,100 Americans, accounting for 0.6 percent of all deaths that year. That compared with a little over 12,700 deaths related to HIV.
Those numbers are based on death certificates, and almost certainly underestimate the real scope, according to the CDC. Compared with HIV, Hepatitis C infection is more likely to still be unrecognised at the time of a person's death.
"Hepatitis C mortality has, regrettably, been on the rise for a number of years," said Dr John Ward, director of the CDC's viral hepatitis division and an author of the new study.
But, he told Reuters Health, "many of those deaths could be prevented."
Of the estimated 3.2 million Americans with chronic hepatitis infection, about half of them don't know it, according to the CDC.
That's because the initial infection causes no symptoms in most cases. Instead, the virus silently damages the liver over the years, and people may only discover they are infected when they develop irreversible liver cirrhosis.
Chronic Hepatitis C is most common in "baby boomers" - about two thirds of U.S. infections are in people born between 1945 and 1964, Ward's team notes in their report, which is published in the Annals of Internal Medicine.
That predominance among boomers has a lot to do with casual injection-drug use back in the 1960s, 70s and 80s, since sharing tainted needles is a major route for passing on the virus.
Some people also contracted Hepatitis C through blood transfusions during that era. Since 1992, all blood donations in the U.S. have been tested for Hepatitis C.
Baby boomers with Hepatitis C are now getting to an age where the consequences of the infection would be evident, said Dr Harvey Alter, a researcher with the National Institutes of Health who wrote an editorial on the new studies.
"The big issue is that most people with chronic infection are still not identified," Alter told Reuters Health.
Right now, health officials recommend that certain people at increased risk have blood tests to be screened for Hepatitis C. That includes anyone who's used injection drugs, people who received blood transfusions or organ transplants before 1992 and people with HIV.
"But that approach hasn't been very effective," Alter said.
Another option, Ward said, would be to screen all baby boomers.
Experts are only seriously considering that option now because of recent advances in Hepatitis C treatment.
Before 1990, the infection was virtually incurable. Then researchers found that a combination of two medicines, interferon and ribavirin, could boost the cure rate to 45 percent ("cure" meaning the virus is cleared from the body).
The downside is that the regimen is hard to take. Interferon has to be injected, and the whole treatment course takes about a year. The drugs can also have side effects ranging from flu-like symptoms to sleep problems to depression.
Less than a year ago, the U.S. approved two new oral drugs that, when added to the old regimen, send the cure rate to 70 percent. Adding either one of the drugs - boceprevir (Victrelis) or telaprevir (Incivek) - can also cut the treatment time to about six months in some people.
The side effects are still there with the triple-drug approach. But with the high possibility of a cure, more people with chronic Hepatitis C may want treatment, both Ward and Alter said.