Testing Recommendations for Hepatitis C Virus Infection

CDC’s Testing Recommendations for hepatitis C virus infection are outlined below. Testing should be initiated with anti-HCV. For those with reactive test results, the anti-HCV test should be followed with an HCV RNA.

Persons for Whom HCV Testing Is Recommended

  • Adults born from 1945 through 1965 should be tested once (without prior ascertainment of HCV risk factors)
  • HCV testing is recommended for those who:
    • Currently injecting drugs
    • Ever injected drugs, including those who injected once or a few times many years ago
    • Have certain medical conditions, including persons:
      • who received clotting factor concentrates produced before 1987
      • who were ever on long-term hemodialysis
      • with persistently abnormal alanine aminotransferase levels (ALT)
      • who have HIV infection
    • Were prior recipients of transfusions or organ transplants, including persons who:
      • were notified that they received blood from a donor who later tested positive for HCV infection
      • received a transfusion of blood, blood components, or an organ transplant before July 1992
  • HCV- testing based on a recognized exposure is recommended for:
    • Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood
    • Children born to HCV-positive women

Note: For persons who might have been exposed to HCV within the past 6 months, testing for HCV RNA or follow-up testing for HCV antibody is recommended.

Persons for Whom Routine HCV Testing Is of Uncertain Need

  • Recipients of transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, sperm)
  • Intranasal cocaine and other non-injecting illegal drug users
  • Persons with a history of tattooing or body piercing
  • Persons with a history of multiple sex partners or sexually transmitted diseases
  • Long-term steady sex partners of HCV-positive persons

Persons for Whom Routine HCV Testing Is Not Recommended

(unless they have risk factors for infection):

  • Health-care, emergency medical, and public safety workers
  • Pregnant women
  • Household (nonsexual) contacts of HCV-positive persons
  • General population

Sources

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965  (MMWR 2012;61(RR04);1-18).

Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease[PDF – 54 pages] (MMWR 1998;47(RR-19)).

Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents[PDF – 216 pages] (MMWR 2009; 58(RR04)).

USPSTF Recommendations

U.S. Preventive Services Task Force – Screening for Hepatitis C Virus Infection
USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection and offering one-time screening for HCV infection to adults born between 1945-1965. Grade: B Recommendation.

Resources

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PHAB Accredited

How Healthy Are We?

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