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USPSTF 2020 recommends screening for hepatitis C virus infection in adolescents and adults aged 18 to 79 (B recommendation)
Clinical Question
Should primary care clinicians screen for the hepatitis C virus in asymptomatic adolescents and adults aged 18 years to 79 years?
Bottom line
In this updated 2020 review, the U.S. Preventive Services Task Force (USPSTF) found adequate evidence that hepatitis C virus (HCV) screening accurately detects HCV infection. Although there is no direct evidence on the benefit of screening for HCV infection on patient-oriented outcomes, there is convincing evidence that treatment results in a high proportion (95.5% - 98.9%) of adults who maintain a sustained virologic response (SVR), with a strong association between SVR and improved health outcomes. The task force also recommends screening for HCV in all pregnant women. These recommendations replace the previous 2013 USPSTF recommendation of screening adults born between 1945 and 1965. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Population-based
Synopsis
In this updated review, the task force found no direct evidence of a benefit of screening for HCV infection on patient-oriented outcomes. The task force did find that the current screening regimen accurately detects HCV infection. In addition, current treatment protocols are very effective and safe at achieving an SVR in greater than 95% of patients aged 18 years to 79 years. Finally, the available evidence shows a consistent association between SVR and improved patient-oriented outcomes, including a reduction in all-cause mortality, cirrhosis, and hepatocellular carcinoma. The potential harms of screening include patient anxiety and labeling, but the task force concluded that the overall net benefit is substantial. The Centers for Disease Control and Prevention and the Infectious Disease Society of America recommend at least one screening for HCV infection in all adults 18 years and older.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
How many have been screened ...
How many Canadian adults have already been screened for HCV infection?