People Born 1945-1965 (Baby Boomers)

CDC Recommendation: Adults Born from 1945-1965 (Baby Boomers) get Tested for Hepatitis C

In addition to testing adults of all ages at risk for hepatitis C virus infection, CDC recommends:

• All adults born during 1945–1965 receive one-time testing for the hepatitis C virus (HCV).
• Testing should begin with anti-HCV. If the anti-HCV test is positive, or reactive, then a nucleic acid test (NAT) should follow.
• All persons identified with current HCV infection should receive a brief alcohol screening and intervention as clinically indicated, followed by referral to appropriate care and treatment services.

Key Facts about People Born 1945-1965 (Baby Boomers) and Hepatitis C

• Of the estimated 3.2 million people chronically infected with hepatitis C in the U.S., approximately 75% were born during 1945-1965.
• National prevalence data show that people born during these years are five times more likely than other adults to be infected with HCV.
• Hepatitis C is a leading cause of liver cancer and the leading cause of liver transplants; people born during 1945-1965 account for 73% of all hepatitis C- associated mortality.

Rationale for Recommendation

• There is a high prevalence of hepatitis C in people born during 1945–1965, with 75% of people with hepatitis C born during these years.
• There is increasing HCV-associated morbidity and mortality, as annual HCV-associated mortality in the US increased more than 50% from 1999 to 2007. People born 1945-1965 with hepatitis C face increasing hepatitis C-associated morbidity and mortality.
• A high proportion of people with hepatitis C do not know that they are infected (estimates range from 45%-85%).
• Testing based solely on elevated ALT levels is estimated to miss 50% of chronic infections.
• For those who are chronically infected, clinical preventive services including regular medical monitoring, hepatitis A and B vaccination, and behavior changes like alcohol reduction/cessation and achieving and maintaining a healthy BMI can improve health outcomes for people with hepatitis C.
• New therapies, including interferon-free regimens, can halt disease progression cure most infected with hepatitis C. These treatment options increase the effectiveness and reduce the duration of therapy for many patients.
• One-time testing of those born 1945-1965 is estimated to identify 800,000 infections and, with linkage to care and treatment, avert more than 120,000 HCV-related deaths.  This strategy is estimated to save $1.5-$7.1 billion in liver disease-related costs.

Guidelines and Recommendations

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965 (MMWR 2012;61(RR04);1-18).

U.S. Preventive Services Task Force (USPSTF) – Screening for Hepatitis C Virus Infection
USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection and offering one-time screening for HCV infection to adults born during 1945-1965. Grade: B Recommendation.

Patient Resources

• CDC’s Know More Hepatitis campaign, targeting people born 1945-1965 to get tested for hepatitis C