Screen All Adults for Hepatitis C Infection

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Screening in adults 18-79 replaces more limited 2013 recommendation.

All adults — not just Baby Boomers and other considered at high risk — should be screened for hepatitis C virus (HCV) infection, said the U.S. Preventive Services Task Force (USPSTF).

Citing better treatments with direct-acting antiviral (DAA) therapy and increasing prevalence of HCV infection among younger adults, the Task Force concluded with “moderate certainty” that there was a substantial net benefit in screening adults ages 18-79 for HCV infection (‘B’ recommendation).

This is an update from its 2013 recommendation, in which the USPSTF recommended screening those at high risk for HCV, as well as a one-time screening for adults born between 1945 and 1965. Support for an update calling for universal screening has been building in the hepatology and public health communities, so the USPSTF’s shift did not come as a surprise.

This draft recommendation statement was published on the USPSTF website.

“Today, more people are infected with hepatitis C than there were a decade ago, but there are now better treatments available,” USPSTF chair Douglas K. Owens, MD, said in a statement. “The evidence now shows more people can benefit from screening.”

The authors noted that since 2013, prevalence of HCV infection has increased in younger persons, though the rate of HCV among adults born between 1945 and 1965 — the Baby Boomers — remains “relatively high” and will increase as the population continues to age. In 2012, the CDC recommended screening everyone in that birth cohort.

“It is concerning that we are seeing a significant increase in hepatitis C, and many people don’t know they have it,” USPSTF vice chair Alex H. Krist, MD, said in a statement. “The good news is that we have newer treatments that are more effective and safer, and screening adults for hepatitis C can detect the infection earlier, before they have complications from the virus.”

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