Screening tests can accurately identify patients with chronic hepatitis C virus (HCV) infection, most of whom do not know they have it. Screening can identify patients at earlier stages of disease, before serious liver damage develops, and lead to treatment for improved clinical outcomes.
Who Needs to be Screened for HCV?
Recommendations for screening certain populations for HCV have been put forth by the United States Preventive Services Task Force (USPSTF), CDC, Infectious Diseases Society of America (IDSA), and American Association for the Study of Liver Diseases (AASLD). The organizations’ recommendations are essentially identical and are summarized below. The patient populations are at high risk for HCV but, unless screened, may not be aware of their status.
The frequency of HCV testing/screening is based on various demographics and risk factors. The USPSTF/CDC/IDSA/AASLD recommend screening for the following:
• Adults who were born between 1945 and 1965 should undergo 1-time HCV testing without prior ascertainment of risk. The “baby boomer” population has been found to have high rates of HCV; the reason is not completely understood. It may be related to the high rate of blood transfusions given in the 1950s and 1960s. Blood used for transfusions in that era was not screened for HCV.
• Other persons with certain risk behaviors
► Injection drug users (current or prior users, even those who may have injected only once). About one-third of injection drug users aged 18 to 30 years are infected with HCV, according to the CDC.
► Intranasal illicit drug users.
• Other persons with certain exposures
► Recipients of clotting factor concentrates produced before 1987. Screening of clotting factor concentrates for HCV became a requirement in 1987.
► Persons who were notified that they were recipients of blood transfusion from a donor who later tested positive for HCV.
► Recipients of blood or blood components or organ transplants before July 1992. Specific blood tests have been used since 1992 to screen for all donated blood and organs.