The Centers for Disease Control and Prevention (CDC) in 2012 recommended hepatitis C screenings for anyone born from 1945 to 1965. In 2014, the World Health Organization made the same recommendation, but a group of scientists are not convinced that mass screenings for the age group are effective or even necessary.
In a piece published in the journal BMJ, Ronald Koretz, Kenneth Lin, John Ioannidis and Jeanne Lenzer questioned the recommended screening for hepatitis C, concerned that it has no basis for clinical harm or benefit for the affected population. Those born between 1945 and 1965 are targeted because around three-quarters of hepatitis C cases occur within the Baby Boomers' age group.
Koretz and colleagues are concerned that treatments are being over-promoted, practically telling everyone with hepatitis C to undergo treatment. That's taking it too far because millions of those who will test positive for the virus are actually not or will not experience ill effects from the disease.
Aside from unnecessary costs (a standard 12-week course for hepatitis C treatment can range up to $84,000); imposing treatment is not necessarily safe as long-term effects have not been thoroughly explored.
Instead of simply implementing widespread screening programs, the group suggests that randomized trials be carried out to test for how useful the screening programs are and who are the likeliest to benefit from them.
In the last few years, new hepatitis C drugs have been made available, drastically improving effectiveness compared to medications used in the past. However, side effects like anemia and fatigue remain, albeit milder.
Baby Boomers are particularly targeted for screening because their age group runs the risk of having been infected due to unsafe tattoos, contaminated blood transfusions or intravenous drug use during a time when safer practices were not followed yet.
Still, up to a third of those infected with hepatitis C clear the virus without requiring treatment.
The rest of those with hepatitis C will live with chronic infections, with 20 percent of them going on to develop liver disease severe enough to cause scarring, cancer or death. Around 16,000 people die every year in the U.S. due to hepatitis C.
There is pressure on practitioners to adhere to policies by recommending organizations, and there is a limited window that researchers can use to assess if screening is a good idea or not.
"Until then, physicians should not be pressured to enforce birth cohort screening strategies out of enthusiasm for new treatments that have not yet been shown to cause long term clinical improvement," said the group.
