Improved Hepatitis C Screening Still Needed for Baby Boomers

Since baby boomers are 5 times more likely to have been exposed to hepatitis C virus (HCV), the US Centers for Disease Control and Prevention (CDC) and the US Preventive Service Task Force recommend adults in this age bracket get tested.

Blood tests are available to help detect the virus and prevent illness from taking over the body, but performing them on baby boomers during routine medical appointments are few and far between. This is because the appointments are packed with other preventative measures and tests, as well as current problems the patient is dealing with that require the physician’s immediate attention.

To address this issue, researchers at the University of Michigan Health System found that electronic medical record alerts is an easy way to help primary care physicians ensure that HCV screening is part of baby boomers routine checkups. The automated alert is programmed to appear if a patient is in the at-risk age bracket.

The alert will remind physicians to issue an HCV test, and to provide the patient with educational materials on the disease.

The electronic medical record alert strategy was implemented into primacy care clinics throughout the U-M health system in fall 2015. This approach was found to contribute to the significant rise (eightfold) in screenings in the first 6 months alone.

“A large part of the success was figuring out how to take the logistical work away, which involves more than looking at a patient’s date of birth,” said Monica Konerman, MD, MSc, a hepatologist at the University of Michigan.

It remains unclear why HCV rates are higher in baby boomers, however, the CDC believes most individuals became infected during the 1970s and 80s, a time when the rates were highest and before screenings of blood and organs became available in 1992.

Furthermore, HCV can lay dormant for decades, making patients unaware that they could have the disease and never seeking out testing. Researchers believe that a universal one-time HCV screening based on age can help address the issues patients may have with talking about prior drug use.

Since the alert was adopted, the screenings have increased equally among insurance plans and UMHS clinic sites, genders, and races.

Since the approval of interferon-free oral combination therapy, hepatitis C has cure rates in 95% of patients and if the virus is treated soon enough it can prevent liver failure and damage from occurring.

“The availability of direct-acting antiviral agents has been a game-changer,” Konerman said. “Previously, many providers thought screening had low utility: (that) the treatment was terrible and didn’t work well. Today, short courses of all oral treatments are highly effective and can prevent progressive liver disease.”