HCV Screening Now Recommended for All Adults

By Joe Elia

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

All adults from ages 18 to 79 should be screened for hepatitis C virus (HCV) infection at least once, according to a draft recommendation from the U.S. Preventive Services Task Force. The B-grade recommendation denotes "high certainty that the net benefit is moderate."

Clinicians can consider screening high-risk patients who are younger than 18 — including those who are pregnant — or older than 79.

HCV infections more than tripled between 2010 and 2016, with an estimated prevalence of about 1%. The highest risk occurs among young, white people who inject drugs.

In its 2013 statement the Task Force recommended screening only adults at high risk as well as the "baby boomer" population born between 1945 and 1965.

Clinicians should test for anti-HCV antibody. Positive results may be confirmed with testing for HCV RNA. Therapy consists of oral direct-acting antivirals (except during pregnancy, for which there is a lack of safety data).