The U.S. Department of Homeland Security requires certain health tests as part of the immigration process to prevent the entry of individuals with communicable diseases that could pose a public health risk. The required health tests typically include screening for tuberculosis, syphilis, gonorrhea, and other sexually transmitted diseases. DHS also requests vaccination records, when available, or testing for immunity to preventable diseases like measles, mumps, rubella, and hepatitis B.
Hepatitis C (HCV) is not currently a DHS testing requirement. HCV is a viral infection that affects the liver and the leading cause of liver cancer. While hepatitis C is not one of the diseases explicitly required by DHS for immigration purposes, the following are concerns about the potential risks of excluding it from mandatory testing.
- High Prevalence : Hepatitis C is a major public health concern worldwide, with millions of people infected, many of whom are unaware of their condition. An infected person can be positive for decades and be asymptomatic, but can still transmit the virus, putting others at risk.
- Chronic Health Issues: Hepatitis C can lead to severe liver damage, including cirrhosis, liver cancer, and the need for a liver transplant. As a result, identifying the infection early is crucial for ensuring proper treatment and to mitigate Medicare/Medicaid costs for the uninsured.
- Undetected Spread: If a person is not screened for HCV, they may unknowingly carry the virus and spread it to others. The virus can be transmitted through blood-to-blood contact. There are Genotypes historically specific to other regions that we may begin to see in the US, if we allow this to go unchecked.
- Medical Costs and Public Health Impact : With the average cost of treating HCV at $56,000, the uninsured are reliant upon public insurance programs. However, the average cost of a liver transplant is $870,000. Failing to identify hepatitis C at an early stage can lead to higher long-term medical costs, both for the individual and the U.S. healthcare system. It would also increase the burden on public health programs aimed at preventing and managing the disease. The average positive patient in the U.S. is between 25 and 45 years of age. At some point, those positives will age into Medicare.
While we have no opportunity for health testing, for those who enter illegally, those applying for residency should be tested for HCV, without question. Not including hepatitis C in routine screenings might overlook a critical aspect of preventing chronic health conditions and managing public health risks effectively.