Hepatitis C Kills More Americans than Any Other Infectious Disease

New CDC studies underscore the urgency of hepatitis C testing and treatment, especially for baby boomers

Deaths associated with hepatitis C reached an all-time high of 19,659 in 2014, according to preliminary surveillance data released by the Centers for Disease Control and Prevention (CDC).

A second CDC study, published online in Clinical Infectious Diseases, shows that annual hepatitis C-related mortality in 2013 surpassed the total combined number of deaths from 60 other infectious diseases reported to CDC, including HIV, pneumococcal disease, and tuberculosis. Further, both studies use data from death certificates which often underreport hepatitis C, so there likely were even more hepatitis C-related deaths than these numbers suggest.

About 3.5 million Americans are currently living with hepatitis C and roughly half are unaware of their infection. CDC and the U.S. Preventive Services Task Force recommend one-time hepatitis C testing for everyone born from 1945 to 1965 and regular testing for others at high risk.

A Local Problem

"Last year there were over 500 cases of chronic hepatitis C reported in Tulare County," said Tulare County Health Officer Dr. Karen Haught.

"Screening for hepatitis C is recommended for adults over age 45 to 65," she advised. "Screening should also be considered for seniors. Chronic hepatitis C can cause cirrhosis and increases the risk of liver cancer.

"If hepatitis C is detected, it is important for individuals to be monitored and to avoid alcohol and medications that are toxic to the liver. It is also important to talk with your doctor about whether treatment is recommended. There are new treatments for hepatitis C which are more effective than before and better tolerated."

Why Are Boomers at Risk?

The greatest hepatitis C burden falls on baby boomers – those born from 1945 to 1965 – many of whom have unknowingly been living with the infection for many years.

According to a study published in The Lancet Infectious Diseases last year, many baby boomers were infected via medical procedures in the years after World War II, when injection and blood transfusion technologies were not as safe as they are today. Without diagnosis and treatment, they increasingly suffer from liver cancer and other life-threatening hepatitis C-related diseases, and they may unknowingly transmit the disease to others.

"A recommendation came out in 2012 from the CDC to screen people born between 1945 and 1965 for hepatitis C," said Haught. "This recommendation was made because national surveys had revealed that 75% of all cases of hepatitis C were born during that time period. In addition it was found that the prevalence of hepatitis C in people born during those years was five times higher than the prevalence in adults born during other periods. Because hepatitis C can exist for many years with no symptoms, many people may not have been tested and did not know that they had it and were missing an opportunity for treatment."

"Once hepatitis C testing and treatment are as routine as they are for high cholesterol and colon cancer, we will see people living the long, healthy lives they deserve," said Jonathan Mermin, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

Once diagnosed, patients can take advantage of new, highly effective treatments that can cure the vast majority of infections in two to three months and take other steps to protect their health.

The preliminary surveillance data also point to a new wave of hepatitis C infections among people who inject drugs. Acute cases of hepatitis C infection have more than doubled since 2010, increasing to 2,194 reported cases in 2014.

"Because hepatitis C often has few noticeable symptoms, the number of new cases is likely much higher than what is reported. Due to limited screening and underreporting, we estimate the number of new infections is closer to 30,000 per year," said John W. Ward, M.D., director of CDC's Division of Viral Hepatitis. "We must act now to diagnose and treat hidden infections before they become deadly and to prevent new infections."

Addressing viral hepatitis risk among people who inject drugs is an important public health priority and a key concern for CDC. CDC recommends that comprehensive prevention programs be implemented to avert drug-related hepatitis C transmission. These prevention programs should include regular testing for hepatitis C (as well as hepatitis B and HIV).