A long sleeping epidemic is waking like a bear among baby boomers in the United States and causing the Centers of Disease Control to urge all people born 1945 through 1965 be tested for hepatitis C.
According to CDC reports, an estimated 3.5 million people in the U.S. — 75 percent ranging from 47 to 67 — have the virus. But most do not know it.
About 15,000 Americans, most of them baby boomers, die every year from hepatitis C-related liver disease such as liver cancer and cirrhosis.
It is the fastest rising cause of liver cancer and the leading reason for liver transplants in the United States.
Canned quote from CDC to be replaced Monday:
“Because hepatitis C has few noticeable symptoms, many of those who are infected have no idea that the virus has been slowly damaging their livers. Testing is the only way to identify the millions of Americans who have the virus, and is the first step in stopping this epidemic in its tracks,” said Bryuce Smith, lead health scientist of the CDC’s Division of Viral Hepatitis.
A nationwide recommendation for all baby boomers to get a one-time hepatitis C test was made by the federal agency last month. Officials believe more than 800,000 new cases will be identified and nearly 120,000 deaths will be prevented.
Dr. Eugene R. Schiff, director of the Schiff Center for Liver Disease at the University of Miami School of Medicine and vice president of the Chronic Liver Disease Foundation, said the majority of baby boomers infected were teenagers and young adults during the ’60s and ’70s.
“These were mainstream Americans who may have experimented with drugs, engaged in free love, were injured in the military … They had no idea they were picking up an insidious, notoriously chronic virus,” Schiff said.
Decades can pass before the virus shows any obvious signs. It is only detected by a blood test specific for the infection. The virus is transmitted when the contaminated blood of an infected person is introduced in the broken skin of another person.
Transmission modes include person to person during medical care, shared intravenous needles primarily between needle drug users, rough or anal sex, and from mother to newborn at childbirth.
Until July 1992, when hepatitis C was identified and strict blood screenings were put into place, the virus was primarily spread through blood transfusions or organ transplants. Rarely is it transmitted by sharing toothbrushes or shaving razors but the possibility exists.
Hepatitis C is not contracted through eating utensils, coughing, sneezing, kisses, hugs, breast feeding, food or drinks.
Schiff, co-editor of Schiff’s Diseases of the Liver and author of more than 200 articles, books and chapters in books about liver disease and related topics, said one-time testing for the infection should be on the medical “to do list” of every baby boomer.
“Right now, the CDC wants the group with the most risk to be tested. But it’s the group that most won’t admit that they have any risk factor,” Schiff said. “They are afraid to put the past out there.”
Some baby boomers might not even remember their carefree, youthful behaviors from decades past. Schiff said that’s why the CDC and physicians are supporting “test and treat” care with very few questions asked.
Dr. Fernando Castro, a staff physician and liver disease specialist at Cleveland Clinic Florida in Weston, said he remembers that when he began treating patients with hepatitis C 20 years ago, the cure rate was only about 5 percent. Now it is 75 percent curable.
Not all people with the virus require treatment, Castro said. In 25 percent of cases, the patient’s natural antibodies clear the virus within the first six months of infection.
“But once it goes chronic, about 30 percent get cirrhosis. It’s a slowly progressive disease and that’s why we have to target and identify the patients before they get sick and harder to treat,” Castro said.
Septimio “Tim” Sardina, 57, of Miami, who found out he was infected in 1992 after donating blood, said he has no qualms about telling how he may have contracted the virus.
“If it can happen to me, it can happen to anyone,” Sardina said.
A Cuban immigrant at age 6, Sardina grew up in tough Miami streets where “shot ladies” used to administer vitamin doses by needle to neighborhood kids. He was in the Army during his late teens and early 20s when a stateside injury required a blood transfusion. Later, he “played around and tried some things” before marrying and settling down as a letter carrier for the U. S. Postal Service.
For decades, Sardina seemed more fit than most men. He was an amateur boxer and sparring partner for professional fighters. He ran several miles three times a week and worked out in the boxing gym every day.
“I was going along with my life. Healthy and strong. Then boom — I get a letter that the same blood I was donating for years and years was no good,” Sardina said.
Sardina became Schiff’s patient after he was tested. Then he found out he had cirrhosis, which slowly damages the liver until it is scarred and hardened like cobblestone.
He participated in two treatment studies that were unsuccessful for him but is now just four weeks away from completing a rigorous FDA-approved 48 week treatment program and being able to claim he is cured.
Schiff said the 75 percent cure rate is possible using combinations of three types of drugs: interferon to bring the immune system into attack mode; ribavirin to stop the virus from spreading inside the body; and a protease inhibitor to block viral RNA from breaking into enzymes that produce more virus.
Schiff said three leading pharmaceutical companies are now in the final third phases of clinical trials for new drugs that will cure the virus 100 percent. Those medicines will likely be available to the public within the next two years, he said, but will be very expensive.
Castro said the cost of the cure — right now about $70,000 a year in medication alone —goes beyond money. Sometimes patients are not candidates simply because their bodies will not tolerate the destructive power of the triple combo.
“Treatment is very complex with significant side effects. Fatigue, depression, anemia, skin rash … it’s a tough sell in some cases and in my 20 years’ experience, sometimes it just doesn’t work,” Castro said.
Schiff said the newer drugs, however, are less toxic and more curative.
“At 100 percent effective, they are 100 percent cost-effective,” Schiff said.
Sardina counts his blessings to have known Schiff and be able to afford the medications.
For his current treatment course, Sardina first had to pay $450 monthly for meds. Later, he talked a pharmaceutical company into providing one of the drugs at a $150 discount. Recently, he’s been going for treatment at the Bruce W. Carter Department of Veterans Affairs Medical Center, part of the Miami VA Center, where payment is not an issue.
“People should do what they have to do. Get in front of the virus. Get tested and get started on your cure,” Sardina said.