U.S. Preventive Services Task Force Issues New Recommendation Statement on Screening for Hepatitis C in Adolescents and Adults

Note: This new USPSTF recommendation that clinicians screen all adults aged 18 to 79 years for hepatitis C is an important advance in our national efforts to eliminate hepatitis C. The new recommendation will expand access to hepatitis C screening, reduce the significant proportion of people unaware that they are living with the virus, and enable more individuals to seek curative treatment sooner.  This will help prevent long-term complications of chronic HCV such as cirrhosis, liver failure, liver cancer, and death. The recommendation that those with continued risk of hepatitis C be screened periodically is still in effect. With the new recommendation, Medicaid expansion states and most private health insurance must cover hepatitis C screening without cost-sharing (such as a copay or coinsurance) beginning in the plan year that starts after March 2, 2021 (one year from the date the recommendation was issued).

Clinicians should screen all adults for hepatitis C infection

On March 2, 2020, the U.S. Preventive Services Task Force (Task Force) published a final recommendation statement on screening for hepatitis C virus infection in adolescents and adults. The Task Force recommends screening all adults ages 18 to 79 for hepatitis C. This is a B recommendation.

Hepatitis C is a viral infection of the liver and is associated with more deaths than the top 60 other reportable infectious diseases combined. It is primarily spread when blood from an infected person enters the body of someone who is not infected. Newer treatments for hepatitis C have fewer harms than previous options and are highly effective.

“Hepatitis C affects millions of people across the country,” says Task Force member Michael J. Barry, M.D. “We recommend screening all adults regardless of their risk because new evidence shows that more people can benefit from this service than ever before.”

Many people who have hepatitis C do not know they have it. Certain factors such as injection drug use can increase a person’s risk for hepatitis C. Clinicians may want to consider screening their adolescent and older adult patients who are at high risk.

“People with hepatitis C do not always feel sick and may not know they have it,” says Task Force chair Douglas K. Owens, M.D., M.S. “Screening is key to finding this infection early, when it’s easier to treat and cure, helping reduce illnesses and deaths.”

The Task Force’s final recommendation statement and corresponding evidence summary have been published online in the Journal of the American Medical Association, as well as on the Task Force website at http://www.uspreventiveservicestaskforce.org. A draft version of the recommendation statement and evidence review were available for public comment from August 27, 2019, to September 23, 2019.

The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.

Dr. Barry is director of the Informed Medical Decisions Program in the Health Decision Sciences Center at Massachusetts General Hospital. He is also a professor of medicine at Harvard Medical School and a physician at Massachusetts General Hospital.

Dr. Owens is a general internist and investigator at the Center for Innovation to Implementation at the Veterans Affairs Palo Alto Health Care System. He is the Henry J. Kaiser, Jr., professor at Stanford University, where he is also a professor of medicine.

View the JAMA Patient Page: Screening for Hepatitis C Virus Infection

View the Clinical Summary, a one-page document that provides guidance to primary care clinicians for using recommendations in practice.

Read the Recommendation Statement published in JAMA.