Skip to main content

Advertisement

SpringerLink
Log in

Impact of Birth Cohort Screening for Hepatitis C

  • Liver (B Bacon, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Hepatitis C (HCV) is a leading cause of liver-related complications, and the burden of liver disease is expected to increase. Given the over-representation of HCV-related liver disease in persons born between 1945 and 1965, and the failure of risk-based screening to identify many infected persons, birth cohort screening has been advocated and endorsed by both the Centers for Disease Control and United States Preventive Services Task Force, regardless of the presence of risk factors. Birth cohort testing is more cost-effective than risk-based screening especially when those with more advanced disease are given priority for treatment. Several barriers exist at the patient and provider level that need to be overcome to fully realize the potential benefit of birth cohort screening in reducing HCV-related morbidity and mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Smith BD, Morgan RL, Beckett GA, Falck-Ytter Y, Holtzman D, Teo CG, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rep. 2012;61:1–32. CDC guideline for birth cohort screening.

    PubMed  Google Scholar 

  2. Chou R, Cottrell EB, Wasson N, Rahman B, Guise JM. Screening for hepatitis C virus infection in adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;158:101–8. USPSTF guideline for birth cohort screening with subsequent change from grade C to grade B recommendation.

    Article  PubMed  Google Scholar 

  3. Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013;57:1333–42.

    Article  PubMed  Google Scholar 

  4. Anonymous. Hepatitis C-global prevalence (update). Wkly Epidemiol Rec 2000;75:18–19.

  5. Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao F, Moyer LA, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341:556–62.

    Article  CAS  PubMed  Google Scholar 

  6. Armstrong GL, Alter MJ, McQuillan GM, Margolis HS. The past incidence of hepatitis C virus infection: implications for the future burden of chronic liver disease in the United States. Hepatology. 2000;31:777–82.

    Article  CAS  PubMed  Google Scholar 

  7. Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–14.

    Article  PubMed  Google Scholar 

  8. Holmberg SD, Spradling PR, Moorman AC, Denniston MM. Hepatitis C in the United States. N Engl J Med. 2013;368:1859–61.

    Article  CAS  PubMed  Google Scholar 

  9. Denniston MM, Klevens RM, McQuillan GM, Jiles RB. Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001-2008. Hepatology. 2012;55:1652–61.

    Article  PubMed  Google Scholar 

  10. Briggs ME, Baker C, Hall R, Gaziano JM, Gagnon D, Bzowej N, et al. Prevalence and risk factors for hepatitis C virus infection at an urban Veterans Administration medical center. Hepatology. 2001;34:1200–5.

    Article  CAS  PubMed  Google Scholar 

  11. Chung MY, Jun DW, Sung SA. Diagnostic value of cystatin C for predicting acute kidney injury in patients with liver cirrhosis. Korean J Hepatol. 2010;16:301–7.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011;378:571–83.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Bornschlegel K, Holtzman D, Monina Klevens R, Ward JW. Vital signs: evaluation of hepatitis C virus infection testing and reporting - Eight U.S. Sites, 2005-2011. Morb Mortal Wkly Rep. 2013;62:357–61.

    Google Scholar 

  14. Kanwal F, Hoang T, Kramer JR, Asch SM, Goetz MB, Zeringue A, et al. Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection. Gastroenterology. 2011;140:1182–8 e1181. Highlights change in epidemiology of HCV and its complications.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Biggins SW, Bambha KM, Terrault NA, Inadomi J, Shiboski S, Dodge JL, et al. Projected future increase in aging hepatitis C virus-infected liver transplant candidates: a potential effect of hepatocellular carcinoma. Liver Transpl. 2012;18:1471–8.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Asrani SK, Larson JJ, Yawn B, Therneau TM, Kim WR. Underestimation of liver-related mortality in the United States. Gastroenterology. 2013;145(2):375–82.

    Google Scholar 

  17. Ly KN, Xing J, Klevens RM, Jiles RB, Ward JW, Holmberg SD. The increasing burden of mortality from viral hepatitis in the United States between 1999 and 2007. Ann Intern Med. 2012;156:271–8.

    Article  PubMed  Google Scholar 

  18. Davis GL, Alter MJ, El-Serag H, Poynard T, Jennings LW. Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterology. 2010;138:513–21, 521 e511-516. Markov modeling highlighting anticipated burden of liver disease.

    Article  PubMed  Google Scholar 

  19. Chou R, Hartung D, Rahman B, Wasson N, Cottrell EB, Fu R. Comparative effectiveness of antiviral treatment for hepatitis C virus infection in adults: a systematic review. Ann Intern Med. 2013;158:114–23.

    Article  PubMed  Google Scholar 

  20. Backus LI, Boothroyd DB, Phillips BR, Belperio P, Halloran J, Mole LA. A sustained virologic response reduces risk of all-cause mortality in patients with hepatitis C. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2011;9:509–16. e501.

    Google Scholar 

  21. van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA. 2012;308:2584–93.

    Article  PubMed  Google Scholar 

  22. van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, et al. The number needed to treat to prevent mortality and cirrhosis-related complications among patients with cirrhosis and HCV genotype 1 infection. J Viral Hepat. 2013. doi:10.1111/jvh.12185

  23. Morgan RL, Baack B, Smith BD, Yartel A, Pitasi M, Falck-Ytter Y. Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma: a meta-analysis of observational studies. Ann Intern Med. 2013;158:329–37.

    Article  PubMed  Google Scholar 

  24. Rein DB, Smith BD, Wittenborn JS, Lesesne SB, Wagner LD, Roblin DW, et al. The cost-effectiveness of birth-cohort screening for hepatitis C antibody in U.S. primary care settings. Ann Intern Med. 2012;156:263–70.

    Article  PubMed  Google Scholar 

  25. McEwan P, Ward T, Yuan Y, Kim R, L'Italien G. The impact of timing and prioritization on the cost-effectiveness of birth cohort testing and treatment for hepatitis C virus in the United States. Hepatology. 2013;58:54–64.

    Article  PubMed  Google Scholar 

  26. McGarry LJ, Pawar VS, Panchmatia HR, Rubin JL, Davis GL, Younossi ZM, et al. Economic model of a birth cohort screening program for hepatitis C virus. Hepatology. 2012;55:1344–55.

    Article  PubMed  Google Scholar 

  27. Younossi ZM, Stepanova M, Afendy M, Lam BP, Mishra A. Knowledge about infection is the only predictor of treatment in patients with chronic hepatitis C. J Viral Hepat. 2013;20:550–5.

    Article  CAS  PubMed  Google Scholar 

  28. Sears DM, Cohen DC, Ackerman K, Ma JE, Song J. Birth cohort screening for chronic hepatitis during colonoscopy appointments. Am J Gastroenterol. 2013;108:981–9.

    Article  PubMed  Google Scholar 

  29. Inadomi JM, Vijan S, Janz NK, Fagerlin A, Thomas JP, Lin YV, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012;172:575–82.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Galbraith JW, Franco R, Rodgers JB. Screening in emergency department identifies a large cohort of unrecognized chronic hepatitis C virus infection among baby boomers. Hepatology. 2013;58:LB6.

    Google Scholar 

  31. Rockey DC, Bissell DM. Noninvasive measures of liver fibrosis. Hepatology. 2006;43:S113–20.

    Article  CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Davis reports personal fees from Gilead and personal fees from BMS outside the submitted work.

Dr. Asrani has nothing to disclose.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information

Author notes

  1. Gary L. Davis

    Present address: MedLogician Consulting, 201 S Ocean Grande Dr., Ste 304, Ponte Vedra Beach, FL, 32082, USA

Authors and Affiliations

  1. Baylor University Medical Center, 3410 Worth St., Suite 860, Dallas, TX, 75246, USA

    Sumeet K. Asrani & Gary L. Davis

Authors
  1. Sumeet K. Asrani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gary L. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sumeet K. Asrani.

Additional information

This article is part of the Topical Collection on Liver

Rights and permissions

Reprints and permissions

About this article

Cite this article

Asrani, S.K., Davis, G.L. Impact of Birth Cohort Screening for Hepatitis C. Curr Gastroenterol Rep 16, 381 (2014). https://doi.org/10.1007/s11894-014-0381-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-014-0381-5

Keywords

Search

Navigation