Push to Screen, Treat Baby Boomers for Hepatitis C Virus
In 2012, theU.S. Centers for Disease Control(CDC) recommended one-time screening for hepatitis C virus (HCV) for all adults born from 1945 to 1965 – the “baby boomers.”1Pennsylvania and New York state legislatures have passed laws making it mandatory for health care providers to offer HCV screening or diagnostic testing for all baby boomer patients.2,3
According toThomas R. Riley, III, MD,gastroenterology and hepatology,Penn State Health Milton S. Hershey Medical Center, “We just aren’t seeing the numbers of HCV cases that we know are out there in this population; this tells us that it isn’t being detected.”
Some gastroenterologists may not be comfortable broaching the topic with their baby boomer patients, Dr. Riley says, “I suggest gastroenterologists bundle the HCV screening with other routine tests, like a screening colonoscopy, at age 50 or 60 years. Hospitals should also be developing compliance processes regarding applicable state laws of mandatory screening.” Baby boomers comprise 75 percent of all HCV cases among U.S. adults and are five times more likely than adults in any other age group to be infected (Figure).1
赖利博士进一步指出：“通过新的直接作用抗病毒疗法，整个治疗方案和保险范围景观已经大幅发展。”较新的治疗方法的治愈率大于95％，4making it more cost-efficient to detect this often silent killer.5,6正如赖利（Riley）博士指出的那样，保险公司也更有可能支付HCV治疗费用，“现在经常被商业保险或Medicaid/Medicare覆盖纤维化得分低至两个的患者。”筛查结果导致有效治疗有助于避免器官移植，长期维护方案以及残疾和疾病负担的个人成本。
The increased availability of insurance coverage has made lifesaving treatments accessible to more patients. However, not all patients with HCV have clinical features that qualify them for coverage, as Dr. Riley explains, “Even if anti-viral treatment is not yet covered, a positive HCV result is the gateway to appropriate ongoing monitoring and getting treatment at the earliest possible moment.” A positive diagnosis may also help to prevent the spread of HCV.
Many patients with a positive HCV diagnosis may also qualify to participate in clinical trials of new treatment protocols and potential ground-breaking experimental drugs. Researchers at Hershey Medical Center gastroenterology and hepatology are actively engaged in new treatment research for patients with chronic HCV (NCT02138253和NCT02613403).
Thomas R. Riley III, MD
医学教授
Medical Director, Liver Transplantation
电话：717-531-6261
电子邮件：triley@pennstatehealth.psu.edu
奖学金：Gastroenterology and Hepatology, University of Pittsburgh – University Health Center of Pittsburgh, Pittsburgh, Pa.
住院医师:Internal Medicine, University of Utah Hospital and Clinics, Salt Lake City, Utah
Medical School:The Ohio State University College of Medicine, Columbus, Ohio
与托马斯·R·莱利三世（Thomas R. Riley III）联系
参考
- United States Centers for Disease Control. 2012.Hepatitis C: Proposed expansion of testing recommendations, 2012。2016年7月31日访问。
- New York State Department of Health. 2013.Letter on HCV Testing Law。Accessed August 23, 2016.
- Pennsylvania General Assembly. 2016. 2016 Special Session 1. Accessed August 23, 2016.
- AASLD/IDSA HCV Guidance Panel. 2015.Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus。Hepatology。Sep;62(3):932-54.
- Younossi ZM，Park H，Saab S等。2015。慢性乙型肝炎病毒1感染患者的全口腔ledipasvir/ sofosbuvir方案的成本效益。Aliment Pharmacol Ther。Mar;41(6):544-63.
- Chahal HS, Marseille EA, Tice JA, et al. 2016.Cost-effectiveness of early treatment of hepatitis C virus genotype 1 by stage of liver fibrosis in a US treatment-naive population。JAMA Intern Med。1月; 176（1）：65-73。