The rate of acute, or newly acquired, hepatitis C tripled between 2009 and 2018, according to a recent report from the Centers for Disease Control and Prevention (CDC). What’s more, the liver disease now affects every generation, with new cases of chronic hep C among millennials—largely associated with the opioid crisis—equaling those among baby boomers.
An estimated 2.4 million people are living with chronic hepatitis C virus (HCV) infection, and around 40% of them do not know they carry the virus. Although some people with newly acquired HCV will clear the virus spontaneously without treatment, more than half develop chronic infection lasting more than six months.
As described in the April 10 Morbidity and Mortality Weekly Report, 3,621 cases of acute HCV were reported to the CDC in 2018, representing an estimated 50,300 total new cases after underreporting is taken into account. The rate of new infections increased by about 300% among people ages 20 to 29 and by about 400% among those ages 30 to 39.
In addition, the CDC received reports of 137,713 new cases of chronic hepatitis C during the same year. Nearly two thirds (63.1%) were in men. Millennials (people born between 1981 and 1996) accounted for 36.5% of these cases, compared with 36.3% among baby boomers (those born between 1945 and 1965) and 23.1% among generation X (those born between 1966 and 1980).
These findings support the CDC’s new recommendation that all adults age 18 and older—not just baby boomers—should be screened for HCV at least once unless the local prevalence of the virus is very low. Rising hep C rates among people of childbearing age has led to a growing risk of mother-to-child transmission of HCV, and the CDC now advises women to get tested during each pregnancy. People of any age should be tested if they are at higher risk for hep C, and those who currently share needles or other drug injection equipment should receive regular HCV testing as long as they remain at risk.
Many people with hepatitis C have no symptoms or only minor symptoms, like fatigue, during its early stages. But over years or decades, chronic hep C can lead to serious liver complications, including cirrhosis, liver cancer and liver failure that requires a transplant. HCV is now easily curable with direct-acting antivirals, so it’s important for people living with the virus to learn their status so they can get timely care and treatment.
Along with more hep C testing and treatment, the CDC recommends expanded prevention services, including syringe access programs and medication-assisted treatment (for example, using methadone or buprenorphine) for people with substance use disorder. These services can be provided in a range of settings, such as primary care clinics and emergency departments.
“Every case of liver failure and each death from this disease is a preventable tragedy,” Carolyn Wester, MD, MPH, director of the CDC’s Division of Viral Hepatitis, said in a press release. “Our hope is that universal screening and increased access to treatment will significantly improve the health of millions of Americans who already have hepatitis C and also help to stop the epidemic of hepatitis C infections among all generations.”