Testing Recommendations for Hepatitis C Virus Infection

CDC Recommendations for Hepatitis C Screening Among Adults in the United States

  • Universal hepatitis C screening:
    • Hepatitis C screening at least once in a lifetime for all adults aged 18 years and older, except in settings where the prevalence of HCV infection (HCV RNA‑positivity) is less than 0.1%*
    • Hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection (HCV RNA‑positivity) is less than 0.1%*
  • One‑time hepatitis C testing regardless of age or setting prevalence among people with recognized conditions or exposures:
    • People with HIV
    • People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago
    • People with selected medical conditions, including:
      • people who ever received maintenance hemodialysis
      • people with persistently abnormal ALT levels
    • Prior recipients of transfusions or organ transplants, including:
      • people who received clotting factor concentrates produced before 1987
      • people who received a transfusion of blood or blood components before July 1992
      • people who received an organ transplant before July 1992
      • people who were notified that they received blood from a donor who later tested positive for HCV infection
    • Healthcare, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood
    • Children born to mothers with HCV infection
  • Routine periodic testing for people with ongoing risk factors, while risk factors persist:
    • People who currently inject drugs and share needles, syringes, or other drug preparation equipment
    • People with selected medical conditions, including:
      • people who ever received maintenance hemodialysis
  • Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons may be reluctant to disclose stigmatizing risks
*Determining prevalence: In the absence of existing data for hepatitis C prevalence, healthcare providers should initiate universal hepatitis C screening until they establish that the prevalence of HCV RNA positivity in their population is less than 0.1%, at which point universal screening is no longer explicitly recommended but may occur at the provider’s discretion.

Testing Sequence

Hepatitis C testing should be initiated with a Food and Drug Administration (FDA)‑approved anti‑HCV test. People testing anti‑HCV positive/reactive should have follow-up testing with an FDA‑approved nucleic acid test (NAT) for detection of HCV RNA. See complete Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infectionpdf icon.

USPSTF Recommendations

U.S. Preventive Services Task Force – Screening for Hepatitis C Virus Infectionexternal icon
The USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years. Grade: B Recommendation.

Resources

Hepatitis C Campaign