screening for hepatitis C
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Indications
CDC & USPSTF recommend screening all adults 18-79 for HCV at least once[13]
Canadian Task Force on Preventive Health Care (CTFPHC) recommends against screening for hepatitis C virus (HCV) in adults who are not at elevated risk
risk factors for hepatitis C virus
- history of intravenous drug abuse
- history of receiving blood products prior to 1992
- patients notified that they received blood from a donor identified as having HCV in the 'Look Back' program mandated by federal law
- history of organ transplantation prior to 1992
- patients on chronic hemodialysis
- patients with > 1 unexplained elevated ALT
- health care workers after an occupational exposure to HCV infected blood
- children born to HCV+ mothers (check HCV antibody at 1 year)
- consider screening
- intranasal illicit drug use
- patients with multiple sexual partners
- patients with HCV-infected sexual partners
- serology may be negative despite chronic HCV infection
- ref[2] seems to propose routine screening
- when blood is being drawn in an emergency department for acute-care reasons, an extra tube should probably be sent for HIV screening & HCV screening, unless the patient is already known to be positive[9]
Laboratory
- HCV Ab in serum/plasma/blood (HCV antibody screening)
- 2nd generation tests available in 1993
- insensitive for detection of acute HCV infection
- antibody does not confer immunity
- confirmatory testing of positives with HCV RNA indicated (see hepatitis C infection)[12]
Notes
More general terms
Additional terms
References
- ↑ Journal Watch 24(8):66, 2004 US Preventive Services Task Force, Ann Intern Med, 140:462, 2004 http://www.ahrq.gov/clinic/3rduspstf/hepcscr.htm
Chou R et al, Screening for hepatitis C virus infection: A review of the evidence for the US Preventive Services Task Force, Ann Intern Med, 140:465, 2004 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15023713 <Internet> http://www.ahrq.gov/clinic/3rduspstf/hepcrev.htm - ↑ 2.0 2.1 Coffin PO et al. Cost-effectiveness and population outcomes of general population screening for hepatitis C. Clin Infect Dis 2012 May 1; 54:1259 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22412061
- ↑ 3.0 3.1 CDC Announces First Ever National Hepatitis Testing Day and Proposes that All Baby Boomers Be Tested Once for Hepatitis C CDC Press Release, May 18, 2012 http://www.cdc.gov/nchhstp/newsroom/HepTestingRecsPressRelease2012.html
Centers for Disease Control and Prevention Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945-1965 MMWR 61(4) August 17, 2012 http://www.cdc.gov/mmwr/pdf/rr/rr6104.pdf (corresponding NGC guideline withdrawn Jan 2018) - ↑ Chou R et al Screening for Hepatitis C Virus Infection in Adults: A Systematic Review to Update the 2004 U.S. Preventive Services Task Force Recommendation Ann Intern Med. 27 November 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23183613 <Internet> http://annals.org/article.aspx?articleid=1458679
Cottrell EB et al Reducing Risk for Mother-to-Infant Transmission of Hepatitis C Virus: A Systematic Review for the U.S. Preventive Services Task Force Ann Intern Med. 27 November 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23437438 <Internet> http://annals.org/article.aspx?articleid=1402436 - ↑ 5.0 5.1 Moyer VA et al Screening for Hepatitis C Virus Infection in Adults: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. June 25, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23798026 <Internet> http://annals.org/article.aspx?articleid=1700383
Ngo-Metzger Q Expanded Hepatitis C Virus Screening Recommendations Promote Opportunities for Care and Cure. Ann Intern Med. June 25, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23797155 <Internet> http://annals.org/article.aspx?articleid=1700384 - ↑ 6.0 6.1 Stockman LJ et al Rapid Hepatitis C Testing Among Persons at Increased Risk for Infection - Wisconsin, 2012-2013. MMWR. April 11, 2014 / 63(14);309-311 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6314a3.htm
- ↑ 7.0 7.1 Smith BD et al. Hepatitis C virus antibody positivity and predictors among previously undiagnosed adult primary care outpatients: Cross-sectional analysis of a multisite retrospective cohort. Clin Infect Dis 2015 Apr 15; 60:1145 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25595745 <Internet> http://cid.oxfordjournals.org/content/60/8/1145
- ↑ Centers for Disease Control and Prevention (CDC) Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR Morb Mortal Wkly Rep. 2013 May 10;62(18):362-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23657112
- ↑ 9.0 9.1 Lyons MS et al. Prevalence of diagnosed and undiagnosed hepatitis C in a Midwestern urban emergency department. Clin Infect Dis 2016 Feb 21 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26908799 <Internet> http://cid.oxfordjournals.org/content/early/2016/02/21/cid.ciw073
- ↑ 10.0 10.1 Ahmedin J, Fedewa SA Recent Hepatitis C Virus Testing Patterns Among Baby Boomers. Am J Preventive Med http://www.ajpmonline.org/article/S0749-3797(17)30092-2/fulltext
- ↑ Flanigan CA, Leung SJ, Rowe KA, et al. Evaluation of the Impact of Mandating Health Care Providers to Offer Hepatitis C Virus Screening to All Persons Born During 1945-1965 - New York 2014. MMWR Morb Mortal Wkly Rep 2017;66:1023 https://www.cdc.gov/mmwr/volumes/66/wr/mm6638a3.htm
- ↑ 12.0 12.1 Shah H, Bilodeau M, Burak KW et al The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver. CMAJ June 04, 2018 190 (22) E677-E687 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29866893 <Internet> http://www.cmaj.ca/content/190/22/E677
Crismale JF, Ahmad J. Expanding treatment for hepatitis C in Canada. CMAJ June 04, 2018 190 (22) E667-E668 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29866891 <Internet> http://www.cmaj.ca/content/190/22/E667 - ↑ 13.0 13.1 U.S. Preventive Services Task Force (USPSTF) Screening for Hepatitis C Virus Infection in Adolescents and Adults. US Preventive Services Task Force Recommendation Statement. JAMA. Published online March 2, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32119076 https://jamanetwork.com/journals/jama/fullarticle/2762186
Chou R, Dana T, Fu R et al Screening for Hepatitis C Virus Infection in Adolescents and Adults. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. Published online March 2, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32119034 https://jamanetwork.com/journals/jama/fullarticle/2762185
Graham CS, Trooskin S Universal Screening for Hepatitis C Virus InfectionA Step Toward Elimination. JAMA. Published online March 2, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32119041 https://jamanetwork.com/journals/jama/fullarticle/2762183
Rosenberg ES, Barocas JA. USPSTF's s Hepatitis C Screening Recommendation - A Necessary Step to Tackling an Evolving Epidemic. JAMA Netw Open. 2020;3(3):e200538. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32119098 Free Article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2762048
Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC Recommendations for Hepatitis C Screening Among Adults - United States, 2020. MMWR Recomm Rep 2020;69(No. RR-2):1-17 https://www.cdc.gov/mmwr/volumes/69/rr/rr6902a1.htm