From the Guidelines
All Medicare beneficiaries born between 1945 and 1965 should undergo a one-time screening for Hepatitis C (HCV) infection. According to the US Preventive Services Task Force (USPSTF) recommendation statement 1, screening for HCV infection in adults aged 18 to 79 years has a substantial net benefit. The recommended screening test is an anti-HCV antibody test, followed by confirmatory polymerase chain reaction testing if the initial test is positive 1.
Key Points to Consider
- The USPSTF recommends a one-time screening for most adults, with periodic screening for persons with continued risk for HCV infection, such as those with past or current injection drug use 1.
- Treatment options typically consist of oral direct-acting antiviral regimens for 8 to 12 weeks, which have been shown to result in a sustained virologic response (SVR) in a high proportion of adults 1.
- Early detection and treatment can significantly improve health outcomes, reducing the risk of liver disease, cirrhosis, and hepatocellular carcinoma 1.
- The USPSTF assessment concludes that screening for HCV infection in adults aged 18 to 79 years has a substantial net benefit, with moderate certainty 1.
Implementation of the Recommendation
- Clinicians should communicate that screening is voluntary and undertaken only with the patient's knowledge, and inform patients about HCV infection, its transmission, and the benefits and harms of treatment 1.
- Patients should be provided the opportunity to ask questions and decline screening 1.
From the Research
Hepatitis C Screening Guidelines
The guidelines for Hepatitis C (HCV) screening in Medicare beneficiaries born between 1945 and 1965 are as follows:
- The US Preventive Services Task Force (USPSTF) recommends screening for HCV infection in adults aged 18 to 79 years, including those born between 1945 and 1965 2.
- The Centers for Disease Control and Prevention (CDC) also recommends HCV screening for individuals born between 1945 and 1965, as this cohort has a higher prevalence of HCV infection 3.
- The USPSTF concludes that screening for HCV infection in adults has substantial net benefit, with moderate certainty 2.
Rationale for Screening
The rationale for screening individuals born between 1945 and 1965 for HCV infection includes:
- The high prevalence of HCV infection in this cohort 3.
- The potential for progression of disease if left untreated, and the availability of effective treatments for HCV infection 3, 2.
- The importance of early detection and treatment to reduce the risk of complications from chronic liver disease 2.
Comparison with Other Guidelines
It is worth noting that the USPSTF guidelines for HCV screening are consistent with other recommendations for preventive services in older adults, including those from the CDC and professional societies 4. However, the USPSTF guidelines for HCV screening are specific to adults aged 18 to 79 years, and do not address screening for other conditions, such as HIV infection or type 2 diabetes, which may have different recommendations 5, 6.