Canadian Group Offers New Guidelines on Hepatitis C Screening, Management

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

The Canadian Association for the Study of the Liver recommends one-time screening for hepatitis C virus (HCV) for all adults born between 1945 and 1975.

Writing in the Canadian Medical Association Journal, the authors say that 63% of Canadian HCV cases occur in this age group.

Guidelines from the U.S. Preventive Services Task Force currently recommend screening for those born between 1945 and 1965.

The Canadian guidelines also recommend the following:

• Anti-HCV antibody tests should be used for the initial screening. If positive, confirmation is required with HCV RNA polymerase chain reaction tests.

• Screening should also be performed in those at high risk for infection, including injection drug users.

• All patients with HCV should be considered for antiviral treatment.

• Baseline resistance testing is recommended in certain circumstances (e.g., before starting elbasvir/grazoprevir in patients with HCV genotype 1a).

Dr. Atif Zaman of NEJM Journal Watch Gastroenterology comments: "These Canadian guidelines are consistent with guideline recommendations by European and U.S. liver societies. Since there is now lower cost therapy with efficacy rates nearing 100% for all hepatitis C populations, the goal should be to cure all patients who are infected in order to prevent transmission and completely eradicate this public health disease. Therefore, birth cohort screening is an important step towards this goal."