April 10, 2013
Researchers investigated whether baby boomers would be willing to be tested for viral hepatitis during routine colonoscopies. The researchers offered hepatitis tests to 500 individuals ages 50 to 65 years during appointments for outpatient colonoscopy between October 2010 and January 2011. Of the 376 persons who accepted the offer, 346 gave blood samples and reported risk factors and vaccination history as well as their potential exposure to hepatitis. Researchers offered vaccination to participants who did not have immunity to hepatitis A (HAV) or B viruses (HBV) and scheduled follow-up meetings for those who tested positive for hepatitis C (HCV) antibodies or HBV antigen.
Of the 346 participants, 93 percent did not have immunity to HAV, HBV, or both; 240 patients tested negative for HAV; and 283 tested negative for HBV antibodies. Researchers found one or more risk factors for chronic hepatitis in 36 percent of participants; 8 percent had multiple risk factors. The most common risk factors were getting a tattoo before the year 2000 (8 percent), high-risk sexual behavior and/or having STDs (8 percent), and ever having injected or snorted drugs (7 percent). Researchers found HCV antibodies in four individuals; one person had detectable virus. All four participants who tested positive for HCV complied with testing and follow-up, and the individual with detectable virus received vaccination against HAV and HBV, improved his diet, stopped drinking alcohol, and agreed to noninterferon-based treatment.
Researchers contend that using an existing healthcare screening system is a highly desirable way of complying with CDC's recommendation for one-time hepatitis screening of baby boomers in the United States. They conclude that incorporating viral hepatitis screening with colorectal cancer screening has the potential to be an easily instituted mass-screening mechanism.
The full report, "Birth Cohort Screening for Chronic Hepatitis During Colonoscopy Appointments," was published online in the American Journal of Gastroenterology, (2013; doi: 10.1038/ajg.2013.50).