Screening & Referral
HCV Screening for all adults 18 years of age and older.
SUMMARY POINTS
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The CDC recommends universal HCV screening at least once in a lifetime for all adults 18 years of age and older and HCV screening for all pregnant persons during each pregnancy; these recommendations do not apply to regions that have an HCV prevalence of less than 0.1%.
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The CDC recommends one-time HCV testing regardless of age or setting prevalence in persons with recognized risk for acquiring HCV.
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The CDC recommends periodic retesting for HCV in persons with ongoing risk for acquiring HCV.
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The USPSTF recommends routine screening for all adults in the United States 18-79 years of age, including pregnant women. Persons outside the 18-79 age range should have HCV testing if they have risk factors for acquiring HCV infection.
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The USPSTF recommends periodic screening for HCV in persons who have continued risk for acquiring HCV infection.
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The AASLD/IDSA recommends one-time, routine, opt-out HCV testing for all individuals aged 18 years and older, one-time testing for persons younger than age 18 who have increased risk for acquiring HCV, and routine perinatal testing for pregnant persons during each pregnancy.
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The AASLD/IDSA recommends periodic testing for persons who have risk activity for acquiring HCV, including the recommendation to perform annual HCV testing for men with HIV who have condomless sex with other men, men who have sex with men who are taking HIV preexposure prophylaxis, and persons who inject drugs.
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Multiple factors have led to the recommendation to provide universal HCV screening in the United States; these factors include increases in HCV cases among young adults, availability of highly effective treatment for HCV, decreases in the cost of HCV therapy, and potential public health transmission benefits associated with more treatment.
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The CDC recommends HCV testing of all perinatally exposed infants with a nucleic acid test (NAT) for detection of HCV RNA at age 2-6 months.
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The CDC recommends using a NAT for HCV RNA for testing of perinatally exposed infants and children aged 7–17 months who have not been previously tested. Perinatally exposed children aged 18 months of age and older who have not been tested previously for HCV, should have testing with an hepatitis C virus antibody (anti-HCV) test, followed by a reflex NAT for HCV RNA (when anti-HCV is reactive).​
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