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Testing Recommendations for Chronic Hepatitis C Virus Infection

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

Person who should be tested once for hepatitis C virus (HCV) infection without prior ascertainment of HCV risk factors include:
  • Adults born during 1945 through 1965

 

In 1998 CDC published guidelines for testing for Hepatitis C virus (HCV) infection and Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease [PDF - 54 pages] (MMWR 1998;47(RR-19)). A test for HCV antibodies is recommended for routine testing of asymptomatic persons with specific risk factors. For those with reactive test results, the anti-HCV test should be followed with an additional, supplemental or confirmatory test for presence of the virus.

Persons who should be tested routinely for hepatitis C virus (HCV) infection based on their risk for infection include those who:
  • Currently inject 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)
  • 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
Persons who should be tested routinely for HCV-infection based on a recognized exposure:
  • Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood
  • Children born to HCV-positive women
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
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

 

In 2009, Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [PDF - 216 pages] (MMWR 2009; 58(RR04)) were published as Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. 

Persons who should be tested routinely for evidence of chronic HCV infection include:
  • All HIV-infected patients

 

Guidelines and Recommendations

Testing for HCV infection: An update of guidance for clinicians and laboratorians. [PDF - 4 pages]
MMWR 2013; Vol. 62 Early Release

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965 [PDF - 36 pages]
MMWR 2012; Vol. 61 (RR04)

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)

 

Other Hepatitis C-related Guidelines

http://www.cdc.gov/hepatitis/HCV/Management.htm

 

Patient Education Tools

http://www.cdc.gov/hepatitis/C/PatientEduC.htm

 

 
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