Hepatitis C Testing
The Canadian Liver Foundation recommends that all adults born between 1945 and 1975 undergo a test for hepatitis C. In Canada, chronic hepatitis C is most prevalent within this age group but risk-based testing has not been effective in identifying all infected adults. As the hepatitis C virus can be transmitted via any blood-to-blood contact and many adults are unaware of their own risk factors, widespread testing has a much higher probability of identifying those who contracted hepatitis C and have been living with it for many years.
More than 300,000 people in Canada are living with chronic hepatitis C but less than half are aware of it. Since chronic hepatitis C causes no symptoms until it has destroyed much of the liver, those who are infected often are not diagnosed until the disease has reached an advanced stage. Left undiagnosed and untreated, chronic hepatitis C can lead to cirrhosis, liver cancer or liver failure. Currently hepatitis C is the leading indication for liver transplant in Canada
Until now, the hepatitis C antibody test was recommended for individuals with recognized risk factors including injection drug use (even a single episode), blood transfusions or use of blood products prior to 1990 or participation in medical procedures or immunization in countries where hepatitis C is common. Risk-based testing has not been widespread and patients continue to be diagnosed by ‘accident’. Unfortunately when risk-based testing has been adopted, risk factor recognition by patients or doctors is poor and as a result the diagnosis is only made when symptoms of advanced liver injury begin to appear.
In August 2012, the U.S. Centers for Disease Control issued its recommendation that all adults born between 1945 and 1965 should have a one-time hepatitis C test. Based on the prevalence data in Canada and taking into account immigration from countries where hepatitis C is endemic, the CLF believes it would be prudent to expand the age bracket for testing to all adults born between 1945 and 1975. The hepatitis C antibody test is inexpensive and is covered by all provincial health care plans. Since early identification and intervention are critical to the effective treatment of hepatitis C, widespread screening of the adult population is warranted.
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