Hep C–big problem

I see a lot of Hep C–Since I am a Jail Doc.

Hep C can cause Hepatic Cancer and Failure, so it is not a benign thing in many persons infected.
Hepatitis A is a ubiquitous virus, very high rates in 3rd world for example. Self limited acute disease, mostly benign limited viral liver infection that comes and goes, rarely causes acute yellow atrophy. Hep B is a bad boy, transmitted by intimate and blood contact can go on to cause cirrhosis, failure and liver cancer. Treatment available, vaccine available, routine for kids now, advised for adults with risk, required for medical workers.
Hepatitis C is a big player, more common world wide and in America than B. Most common reason for liver transplants.
It is infectious by blood products/needles, maybe intimate contact.
Treatment for Hep B and C is available. Expensive. Hepatic Cancer can develop from B and C.
Prevalence of Chronic Hepatitis C Virus Infection in the United States
Ann. Intern. Med 2014 Mar 03;160(5)293-300, MM Denniston, RB Jiles, J Drobeniuc, M Klevens, JW Ward, GM McQuillan, SD Holmberg
Research · March 05, 2014
TAKE-HOME MESSAGE
This study evaluating data from 2003 to 2010 from NHANES estimated the incidence of hepatitis C virus (HCV) antibodies among Americans to be 1.3% (3.6 million persons), with 1.0% (2.7 million) having chronic infection. This suggests a decrease from that reported in earlier analyses evaluating similar data from 1988 to 1994 and 1999 to 2002, in which anti-HCV prevalence was 1.8% and 1.6%, respectively. Risk factors and exposures associated with chronic infection were illicit drug use and blood transfusion before 1992 as well as age 40 to 59 years, male gender, non-Hispanic black race, and lower socioeconomic status.
The findings suggest a decrease in HCV infection, which the authors attribute to an increase in mortality, largely among baby-boomers, related to HCV-associated conditions. Thus, there is an urgency to implement the US Centers for Disease Control and Prevention recommendations for one-time HCV screening.
Commentary by
Tricia C Elliott MD, FAAFP
As primary care physicians, we are often the first contact for patients and we have the opportunity to screen and detect chronic HCV infection. Identifying patients early and appropriately treating them before the development of liver complications can help reduce morbidity and mortality. Based on this study and other recommendations, who is at risk for HCV infection and who should be considered for testing?
All adults born during 1945 through 1965
Past or current injection drug use
Received blood transfusion or organ transplant before 1992
Long-term hemodialysis
Hemophilia patients receiving clotting factors produced before 1987
History of incarceration
Born to HCV-infected mother
HIV disease
Although it is not considered screening, physicians may also consider testing for HCV in patients with persistently elevated transaminases on liver function tests.
Testing is recommended with qualitative anti-HCV (antibody testing) with positive or indeterminate results being followed by quantitative HCV RNA testing.
Reference:
Centers for Disease Control and Prevention. Viral Hepatitis Surveillance – United States, 2010. Atlanta, GA: Centers for Disease Control and prevention; 2012. www.cdc.gov/hepatitis/statistics/2010Surveillance