One-time HCV screening for all adults ≥18 years (March 2020, Modified April 2020)

One-time HCV screening for all adults ≥18 years

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C형 간염바이러스에 대해 선택적인 검사를 하는 것보다 18세 이상의 모든 성인에서 한 번의 감시 검사를 제안합니다. 이전에는 특정 위험인자가 있거나 특정 decade에 태어난 환자에서만 권고되었습니다. 새로운 CDC 권고는 모든 성인에서 1회의 감시 검사를 하는 것이고 위험 인자가 있는 경우에는 반복적 감시 검사를 제안합니다.

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● We suggest one-time screening for hepatitis C virus infection in all adults aged ≥18 years rather than selective screening (Grade 2C).

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In April 2020, the US Centers for Disease Control and Prevention (CDC) recommended that all adults ≥18 years be screened at least once for chronic hepatitis C virus (HCV) infection. The CDC recommendations differ from the US Preventive Services Task Force (USPSTF) recommendations issued in March 2020, which included an upper age limit of 79 years for universal screening. Previously, screening was recommended only for patients who had certain risk factors or were born during certain decades, but this approach results in many missed diagnoses. The improved efficacy, tolerability, and accessibility of antiviral treatment for HCV also support a broader screening strategy. We agree with the new CDC recommendation for broad one-time screening in all adults, and we continue to suggest repeat screening in individuals with ongoing risk factors (algorithm).

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Screening and diagnosis of chronic hepatitis C infection in adults aged ≥18 years

We suggest at least one-time screening for chronic HCV infection in all adults ≥18 years. Patients with ongoing risk for exposure warrant repeat screening.

HCV: hepatitis C virus; MSM: men who have sex with men; RNA: ribonucleic acid.

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* These include new onset jaundice and markedly elevated transaminases.

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¶ For patients on hemodialysis or with a severely immunocompromising condition (eg, advanced HIV, organ transplantation), HCV RNA can be checked at the same time as HCV antibody testing because of concern for a false-negative antibody. In such cases, a positive HCV RNA confirms the diagnosis of HCV infection, whereas a negative HCV RNA rejects it.

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REF. UpToDate 2020.06.08