Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Recommendations for Hep C Virus testing of persons born during 1945–1965

This month's Annals of Internal Medicine reports on recommendations from the Centers for Disease Control and prevention Hepatitis C virus testing of persons born during 1945–1965.

News image

The Centers for Disease Control and Prevention developed these evidence-based recommendations to increase the proportion of hepatitis C virus (HCV)–infected persons who know their status and are linked to appropriate care and treatment.

They recommend that adults born during 1945–1965 receive 1-time testing for HCV without prior ascertainment of HCV risk.

The team report that all persons identified with HCV infection receive a brief alcohol screening and intervention as clinically indicated, followed by referral to appropriate care and treatment services for HCV infection and related conditions as indicated.

The Centers for Disease Control and Prevention (CDC) estimates that 3.4 to 4.9 million persons have ever been infected with hepatitis C virus (HCV) in the United States.

All of these persons develop HCV antibodies, and approximately 75% develop a chronic infection.

This results in an estimated 2.7 to 3.9 million persons living with HCV infection in the United States.

Incidence of HCV increased markedly during the 1970s and 1980s, reaching an average of 230,000 new infections each year throughout the 1980s.

Incidence declined rapidly in the 1990s because of effective screening of blood donors starting in 1992, and reduced numbers of new infections among persons who inject drugs.

The CDC reports that the incidence declined until 2006 and has since remained stable, with an estimated 17,000 new infections in 2010.

Those who were infected in the remote past have been living with HCV infection for 20 to 40 years and are at increased risk for HCV-related morbidity and mortality.

Hepatitis C virus infection is the leading indication for liver transplantation, and accounts for more than 50% of incident hepatocellular carcinoma.

The team reports that the fastest-growing cause of cancer-related death in the United States.

The team noted that annual HCV-associated mortality in the United States increased over 50% from 1999 to 2007.

Data from death certificates show that HCV-associated deaths are now more frequent than deaths caused by HIV.

Modeling studies forecast substantial increases in morbidity and mortality among HCV-infected persons as they enter into their third, fourth, and fifth decades of living with infection.

The CDC estimates that without diagnosis and treatment 1.76 million persons with HCV infection will develop cirrhosis during their lifetimes, over 400,000 will develop HCC, and over 1 million will die from HCV-associated disease.

In 1998, the CDC issued recommendations for identifying HCV-infected persons.

Testing for HCV was recommended for persons most likely to be infected, including those who had ever injected drugs, received clotting factor concentrates produced before 1987, ever received long-term hemodialysis, had laboratory evidence of liver disease, or received transfusions of blood or blood components or organ transplants before 1992.

Screening also was recommended for persons who had a recognized blood exposure.

In 1999, HCV testing was recommended for persons infected with HIV.

The success of risk-based testing strategies has been limited.

Depending on the level of risk in the population and site-specific testing practices, an estimated 45% to 85% of U.S. adults are chronically infected with HCV yet unaware of their condition.

Testing for HCV seromarkers is suboptimal even among high-risk populations for whom routine testing is recommended.

The CDC notes that a sizeable percentage of these persons remain unaware of their infection status.

Dr Smith and colleagues conclude, "Because of the limited effectiveness of the current HCV testing recommendations alone in identifying undiagnosed infections, the CDC considered a birth year–based HCV testing strategy to increase the proportion of infected persons who know their HCV infection status."

"1-time HCV testing of persons born during 1945–1965."

"These persons account for 76.5% of all prevalence of those with HCV antibodies."

"Because alcohol accelerates progression of liver disease in HCV-infected persons, the CDC also addressed brief alcohol screening for those with HCV infection."

Ann Intern Med 2012; 157(11): 817-822
07 December 2012

Go to top of page Email this page Email this page to a colleague

 18 September 2014

Advanced search
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Management of complex colon polyps
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease
 03 September 2014 
Predictors of response in Crohn's disease
 03 September 2014 
Diagnosis of atrophic gastritis
 03 September 2014 
Safety of reinitiation of infliximab therapy
 02 September 2014 
SSRIs and depression in Hep C
 02 September 2014 
Bariatric surgery for obesity
 02 September 2014 
Eosinophilic esophagitis in adults
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease
 22 August 2014 
Outlier identification in colorectal surgery
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us