The U.S. Preventive Services Task Force said this week that clinicians should screen all adults for the hepatitis C infection, updating its 2013 recommendation, according to information posted on its website.
The earlier recommendation called for screening people at high risk for infection or one-time testing of adults born between 1945 and 1965. The new recommendation expands screening to all adults ages 18 to 79.
The task force issued its final recommendation after posting a draft version for public comment on its website from August 27 to September 23, 2019.
The task force said it updated its recommendation for these reasons:
· Treatment continues to evolve, and the duration of direct-acting antiviral regimens has been getting shorter with higher rates of sustained virologic response and less serious harm than earlier treatment regimens.
· Since 2013, the prevalence of HCV infection in adults ages 20 to 39 who inject drugs has increased.
· HCV infection rates for adults born between 1945 and 1965 remain relatively high.
Citing studies, the task force estimated that 4.1 million people have tested positive for the anti-HCV antibody, and 2.4 million have current infections.
The task force recommends screening with anti-HCV antibody testing followed by polymerase chain reaction testing for HCV RNA to identify chronic HCV infection.
The task force also noted that current screening rates vary, depending on the type of institution and patient population. For example, screening and treatment rates are high at health systems serving insured populations, some academic medical centers and the Veterans Health Administration. However, rates are much lower at safety-net primary-care practices and community health centers.
