Dr. 汤姆·米勒: 你是婴儿潮一代，你应该接受丙型肝炎筛查. 这是下一个范围电台的内容. 这是博士. 汤姆米勒.
男人: Medical news and research from the University of Utah physicians and specialists you can use for a happier and healthier life. 您正在收听的是范围.
Dr. 汤姆·米勒: Hi. 我和Dr. 今天是胡安·加莱戈斯, 他是消化内科的一员, 肝病专家, and he is going to talk to us today about the recommendation for screening in Baby Boomers for the virus hepatitis C. 早上,胡安.
Dr. 胡安盖乐葛斯: 早上好，汤姆. 谢谢你的邀请.
Dr. 汤姆·米勒: 人们应该接受丙型肝炎筛查吗? 如果是这样，为什么呢?
Dr. 胡安盖乐葛斯: The Centers for Disease Control in the United States came up with a broad recommendation in 2013, 或者去年, 这是指1945年到1965年间出生的人, 这是, 婴儿潮时期出生的人, 一生中至少接受一次丙型肝炎病毒筛查. The reason behind 这是 that we know that the hepatitis C virus is a significant health problem in the United States. It is estimated that there's about 5 million people infected in the United States with hepatitis C.
Dr. 汤姆·米勒: 他们大多是婴儿潮一代?
Dr. 胡安盖乐葛斯: Most of them are Baby Boomers, and, unfortunately, most of them don't even know about the infection.
Dr. 汤姆·米勒: 这是为什么？?
Dr. 胡安盖乐葛斯: 事实上，这种感染不会引起任何特定的症状, and it takes many years after acquiring the infection before there's any 肝 disease issues.
Dr. 汤姆·米勒: So this is a little bit unlike hepatitis A where when you develop hepatitis A, 你得了黄疸病, 黄色的皮肤, 感觉糟透了. Many times, I guess you're saying, when you have hepatitis C, you're infected, and you don't know it.
Dr. 胡安盖乐葛斯: 这是真的. You don't really know at the time of infection that you acquired this infection, and it's only when you start developing symptoms of 肝 disease that you come to your 医生tor, and then we uncover that fact that you've had hepatitis C probably for many years or decades.
Dr. 汤姆·米勒: 不像甲型肝炎，你会病得很重, 然后清除病毒，你就没事了, hepatitis C is just kind of silently working away on the 肝 to destroy it. 是这样吗？?
Dr. 胡安盖乐葛斯: 是正确的. Most patients that get infected with hepatitis C will go onto develop chronic infection of their 肝, 这就是大发娱乐称之为慢性肝炎的原因. And, ultimately, a percentage of them will go onto develop 肝 cirrhosis and even 肝 cancer. Hepatitis C is currently the main cause of 肝 cirrhosis and the need for 肝 transplants in the United States, 在美国，它也是肝癌的主要原因.
在过去的10到15年, the number of cases of 肝 cancer has increased significantly in the country, 同样值得注意的是，在过去的5年左右, the number of deaths attributed to hepatitis C and cirrhosis have overcome the number of deaths attributed to HIV or AIDS.
Dr. 汤姆·米勒: 这是件大事. 人是如何感染这种病毒的?
Dr. 胡安盖乐葛斯: Generally, the infection is transmitted through blood or contaminated blood. So, 一般, people that have had blood transfusions or organ transplants prior to the 1990's, and that's when we started testing for this virus and screening for it, 或者有静脉注射毒品史的人. Even once, many, many years ago, that can be the sole source of infection.
Dr. 汤姆·米勒: 其他感染原因呢? 性交，多个性伴，甚至刷牙?
Dr. 胡安盖乐葛斯: 例如, high-risk sexual behaviors have been attributed as a cause of infection or sharing other contaminated things in your homes like toothbrush or razor blades. But 这是 much less common than blood transfusions or intravenous drug use.
Dr. 汤姆·米勒: 但疾控中心的底线是接受筛查. 如果这是疾控中心的建议, 筛选是如何进行的, 去哪里做检查呢?
Dr. 胡安盖乐葛斯: The screening should be for everybody born between 1945 and 1965 regardless of any of the risk factors that we discussed because we know that a lot of patients with hepatitis C don't have any of these risk factors. 尽管如此，他们还是被感染了.
The way to be screened is basically to ask your 医生tor if you could be screened, and it's a simple blood test where we check for antibodies or chemicals that your body makes to defend yourself. If they're positive, that means that in the past, you've been exposed to the hepatitis C virus.
Now, that doesn't necessarily mean that, that person has hepatitis C at this time. But we do another confirmatory test to see if there's any hepatitis C virus in the blood at this time.
Dr. 汤姆·米勒: I've had patients who I mentioned that they should be screened for hepatitis C in accordance with the CDC guidelines and they've said, “看, 医生, 我过着干净的生活. 我没有任何危险因素. 我真的不需要接受测试.“你怎么看？?
Dr. 胡安盖乐葛斯: 75 percent of all patients infected with hepatitis C in the United States were born in the Baby Boomer era, and many of them did not have any of the typical risk factors that we associate. 所以我告诉我的病人或者我会对你的病人说的是, “你知道, regardless of the fact that you've lived a very clean life and very good for that, but you should be tested because we might find out that you do have hepatitis C regardless of the absence of any risk factors in the past."
Dr. 汤姆·米勒: And if you have hepatitis C, there is now effective treatment for that?
Dr. 胡安盖乐葛斯: 是的，这是最重要的部分. It's that we can now change the natural course of the hepatitis C virus infection with very effective therapies.
Dr. 汤姆·米勒: 防止肝功能衰竭和肝脏移植的需要.
Dr. 胡安盖乐葛斯: 是的.
Dr. 汤姆·米勒: 听起来是个好主意. 非常感谢.
