Screening for Hepatitis C

Test tube stock image from CDC

The following information is summarized from the article “Hepatitis C Information for Professionals” from the Center for Disease Control and Prevention 2015.

In the US there are approximately 3.2 million people with chronic Hepatitis C (HCV) infections, with a large number of patients unaware of their infected status. 60-70% of patients infected with Hepatitis C are asymptomatic or have mild illness at time of infection. It can take approximately 1-3 weeks after exposure before HCV RNA can be detected and 8-9 weeks before Hepatitis C antibody (HCV Ab) can be detected by clinical laboratory testing. 97% of patients infected with Hepatitis C will be HCV Ab+ within 6 months of exposure. Of those acutely infected with Hepatitis C, 70-85% will develop chronic HCV infections. With several new treatments for chronic Hepatitis C infections now available, there is a renewed emphasis on screening. According to CDC recommendations, Screening for Hepatitis C should start with a serum test for HCV Ab. Patients that test positive for HCV Ab should be subsequently tested for HCV RNA to differentiate between those exposed to Hepatitis C and those that are currently infected. Screening recommendations for specific populations are listed below.

Screening is Recommended

  • Adults born between 1945-1965 regardless of risk factors

  • Current IV drug users

  • Patients with history of IV drug use

  • Patients with certain medical conditions: Hemodialysis, elevated ALT of unknown origin, HIV

  • Recipients of blood transfusions or organ transplantation prior to July 1992

  • Recipients of clotting factors prior to 1987

  • Recognized Exposures: Needle sticks from HCV+ patient, Infants with HCV+ mothers. These patients with potential exposures within last 6 months, testing for HCV RNA or follow-up testing for HCV Ab >6 months after potential exposure is recommended.

Need for Screening uncertain

  • Tissue transplants (cornea, skin grafts, sperm/ova)

  • Non IV, drug users

  • Tattoos or body piercings

  • History of multiple sex partners or STDS

  • Steady sex partners of HCV+ individuals

Routine Screening Not Recommended

  • Healthcare workers without potential exposure history

  • Pregnant women

  • Non sexual household contacts of HCV+ individuals

  • General Population

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