Testing Recommendations for Hepatitis C Virus Infection

CDC’s Testing Recommendations for hepatitis C virus infection are outlined below. Testing should be initiated with anti-HCV. For those with reactive test results, the anti-HCV test should be followed with an HCV RNA.

Persons for Whom HCV Testing Is Recommended

• Adults born from 1945 through 1965 should be tested once (without prior ascertainment of HCV risk factors)
• HCV testing is recommended for those who:
  • Currently injecting drugs
  • Ever injected drugs, including those who injected once or a few times many years ago
  • Have certain medical conditions, including persons:
    • who received clotting factor concentrates produced before 1987
    • who were ever on long-term hemodialysis
    • with persistently abnormal alanine aminotransferase levels (ALT)
    • who have HIV infection
  • Were prior recipients of transfusions or organ transplants, including persons who:
    • were notified that they received blood from a donor who later tested positive for HCV infection
    • received a transfusion of blood, blood components, or an organ transplant before July 1992
• HCV- testing based on a recognized exposure is recommended for:
  • Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood
  • Children born to HCV-positive women

Note: For persons who might have been exposed to HCV within the past 6 months, testing for HCV RNA or follow-up testing for HCV antibody is recommended.

Persons for Whom Routine HCV Testing Is of Uncertain Need

• Recipients of transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, sperm)
• Intranasal cocaine and other non-injecting illegal drug users
• Persons with a history of tattooing or body piercing
• Persons with a history of multiple sex partners or sexually transmitted diseases
• Long-term steady sex partners of HCV-positive persons

Persons for Whom Routine HCV Testing Is Not Recommended 

(unless they have risk factors for infection):

• Health-care, emergency medical, and public safety workers
• Pregnant women
• Household (nonsexual) contacts of HCV-positive persons
• General population

Sources

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965  (MMWR 2012;61(RR04);1-18).

Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease [PDF - 54 pages] (MMWR 1998;47(RR-19)).

Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [PDF - 216 pages] (MMWR 2009; 58(RR04)).

USPSTF Recommendations

U.S. Preventive Services Task Force - Screening for Hepatitis C Virus Infection
USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection and offering one-time screening for HCV infection to adults born between 1945-1965. Grade: B Recommendation.

Resources

• Overview of Testing Recommendations for Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965
• Testing for HCV infection: An update of guidance for clinicians and laboratorians. [PDF - 4 pages]
  MMWR 2013; Vol. 62 Early Release
• Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infection [PDF- 1 page]
• Interpretation of Results of Tests for Hepatitis C Virus (HCV) Infection and Further Actions [PDF- 1 page]