Hepatitis C screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Not everyone should be screened for HCV. Persons living in regions highly prevalent with HCV and who have engaged in high risk should be screened. Screening by serological testing, confirmed by HCV RNA or NAT is required. Additionally, screening for other bloodborne infections, such as HBV and HIV, is required once diagnosis is made.

Screening

Screening for HCV is performed by HCV serological testing. In cases who test positive, a confirmation for chronic HCV status is required by nucleic acid amplification (NAT) or HCV RNA. Screening for other infections, such as HBV and HIV, is also indicated when patients are found to be HCV-positive. In some endemic areas and high risk populations, screening for tuberculosis (TB) is also warranted.

Generally, the World Health Organization (WHO) Guidelines for the Screening, Care, and Treatment of Persons with Hepatitis C Infection published on April 2014 recommends HCV screening for all persons living in regions of high HCV prevalence with positive history for risk exposure and behavior.

Screening includes:

• Persons who received medical or dental interventions in health-care settings where infection control practices are substandard
• Persons who received blood transfusions prior to the time when serological testing of blood donors for HCV was initiated
• Persons who received blood transfusions in countries where serological testing of blood donations for HCV is not routinely performed
• Persons who inject drugs (PWID)
• Persons who have had tattoos, body piercings, or scarification procedures done where infection control practices are substandard
• Persons with HIV infection
• Persons who have used intranasal drugs
• Prisoners and previously incarcerated persons

References