In a mere 30 years since it was identified, hepatitis C (HCV) is now a curable disease when treated with short-duration, well-tolerated finite therapy. Despite these advances, however, HCV continues to be a public health threat that requires better identification and linkage to care. Here are five issues about HCV that clinicians should know.
1. HCV is now a bimodal disease.
Until recently, baby boomers made up the biggest group of people infected with HCV, defined by the Centers for Disease Control and Prevention as those born between 1945 and 1965. But now there is a new peak in those aged 20-35 years, driven largely by the opioid epidemic and injection drug use.[1] This new cohort defies preconceptions of HCV, in that patients are more rural, nearly equally divided between women and men, and less likely to be predominantly from minority populations. This bimodal distribution has significant implications for screening guidelines and could lead to a recommendation for universal screening.[2] Until then, it is vital that we ask our patients about risk factors.
With these demographics, HCV is also affecting women of reproductive age. The rates of HCV diagnosed during pregnancy have increased more than 100% in some locations.[3]Legislation mandating HCV testing in all pregnant women was approved in Kentucky.
