Screening tests can identify patients with chronic hepatitis C virus (HCV) infection, most of whom don't even know they have it. Screening can identify patients at earlier stages of disease, before serious liver damage develops, and can lead to treatment for improved clinical outcomes.
Recommendations for screening for HCV come from the United States Preventive Services Task Force (USPSTF), CDC, Infectious Diseases Society of America (IDSA), and American Association for the Study of Liver Diseases (AASLD). These organizations' recommendations are essentially identical and are summarized below.
* Adults who were born between 1945 and 1965 should undergo 1-time HCV testing without prior ascertainment of risk. The "baby boomer" population has been found to have high rates of HCV, they reason is not completely understood. Some think It may be related to the high rate of blood transfusions in the 1950's and 1960's. The blood transfusions in that ear were not screened for HCV.
* Injection drug users (current or prior users, even those who may have injected only once.) About one-third of injection drug users aged 18 to 30 years old are infected with HCV, according to the CDC.
*Intranasal illicit drug users.
*Recipients of clotting factor concentrates produced before 1987. Screening of clotting factor concentrates for HCV became a requirement in 1987.
*Persons who were notified that they were recipients of a blood transfusion from a donor who later tested positive for HCV.
*Recipients of blood or blood components or organ transplants before July 1992. Specific blood tests have been used since 1992 to screen for all donated blood and organs.
*Long-term hemodialysis patients. Investigations regarding the increased number of reports of acute HCV infection among hemodialysis patients are ongoing. According to the CDC, "lapses in infection control (such as injection safety, environmental disinfection, and hand hygiene)' were identified as common factors in facilities that reported HCV infection.
*Children born to HCV-infected mothers.
*Persons with a history of incarceration. According to the CDC, 1 in 3 persons incarcerated in jails and prisons tests positive for HCV infection. Most commonly HCV is transmitted among inmates through the sharing of equipment used for piercing, performing tattoos, and injecting drugs.
*Persons getting unregulated tattoo's or other percutaneous or parenteral exposures in an unregulated setting.
*Health care, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood.
*Persons with certain medical conditions...HIV infection or unexplained persistently elevated alanine aminotransferase levels.
*Solid organ donors