Beyond Baby Boomers: Hepatitis C Now Heavily Impacting Multiple Generations

Cross-posted from NCHHSTP Newsroom

Data emphasize importance of new CDC hepatitis C screening recommendations for all adults

New data show that chronic hepatitis C infection affects every generation—underscoring new CDC recommendations that every adult should be tested at least once in their lifetime for this curable infection. Previously, hepatitis C was primarily a concern for the baby boomer generation, as well as people with risk factors, such as injection drug use.

The study published in CDC’s Morbidity and Mortality Weekly Report reveals how all adults are being impacted by hepatitis C. The report shows that the number of millennials (people born 1981–1996) diagnosed with chronic hepatitis C infection in 2018 was equal to the number of baby boomers (people born 1945–1965) diagnosed that year. The data show that members of Generation X (people born 1966–1980) are heavily impacted by the infection as well. High rates of hepatitis C among people of reproductive age are also putting our very youngest at risk of infection, as hepatitis C can be transmitted from mother to infant during pregnancy or childbirth.

In 2018:

• Millennials (most adults in their 20s and 30s) made up 36.5% of newly reported chronic hepatitis C infections.
• Baby boomers (most adults in their mid-50s to early 70s) made up 36.3% of newly reported chronic hepatitis C infections.
• Generation X (adults in their late 30s to early 50s) made up 23.1% of newly reported chronic hepatitis C infections.

Get tested. Get cured.

The data are being released along with CDC’s new hepatitis C screening recommendations calling for:

• One-time screening for all adults 18 years and older
• Screening of all pregnant women during every pregnancy
• Testing for all persons with risk factors, with testing continued for those with ongoing risk.

“The hepatitis C epidemic has changed, and so should the nation’s testing guidelines,” said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “CDC wants all of us to get tested, and get cured.”

Hepatitis C is a curable disease. Left untreated, it can cause severe liver damage, liver cancer, or death. Hepatitis C is usually spread when blood from a person infected with the virus enters the body of someone who is not infected, often during injection drug use. It can also come from an infected mother to her infant during pregnancy or childbirth. Although less common, hepatitis C can also be spread by having sex with someone who has the virus.

There were about 2.4 million people living with hepatitis C from 2013 through 2016, despite the availability of accurate diagnostic tests and medical treatment that cures it. In 2018, more than 15,000 death certificates listed hepatitis C as an underlying or contributing cause of death in the U.S.

Some people with acute hepatitis C (also referred to here as “new hepatitis C infections”) do recover from (or clear) the infection without treatment. However, more than half of people with acute hepatitis C infection will develop chronic hepatitis C, which can only be cured if diagnosed and treated.

Hepatitis C in the U.S.

New hepatitis C infections continue to increase:

• The rate of new hepatitis C infections reported to CDC in 2018 was four times as high as it was in 2009.
• CDC estimates there were about 50,300 new hepatitis C infections in 2018.

Dramatic increases in hepatitis C infections coincide with the opioid crisis:

• 2018 marked a decade of increases in new hepatitis C infections among people in their 20s and 30s, with injection drug use as the primary route of transmission.

Awareness of hepatitis C infection still lags:

• Only 61% of people with hepatitis C between 2015 and 2018 were aware of their infection.

“The opioid crisis shifted the course of the hepatitis C epidemic in less than a decade,” said Dr. Mermin. “There are nearly 1 million Americans with hepatitis C who don’t know they have it. This is a curable disease—no one should have to look back knowing something as simple as a blood test could have changed their life or the life of their loved one.”

Treatment for hepatitis C can cure the disease, eliminating a serious and potentially deadly health threat to those with the infection, and preventing transmission to others. That’s why increased testing, prevention services and treatment are so vital to the health of both those living with hepatitis C and those at risk for the infection. These services can be provided in a range of settings, including:

• Comprehensive syringe services programs
• Substance use disorder programs such as medication-assisted treatment programs
• Other healthcare settings such as primary care clinics and emergency departments

“Every case of liver failure and each death from this disease is a preventable tragedy,” said Carolyn Wester, MD, MPH, director of CDC’s Division of Viral Hepatitis. “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.”