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 22 May 2018

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News

Screening for hepatitis C virus infection in adults

Individuals who are not at high risk for hepatitis C infection do not need to be screened for the disease, according to a new recommendation from the US Preventive Services Task Force.

News image

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The US Preventive Services Task Force (USPSTF) has issued recommendations on screening for hepatitis C virus (HCV) infection in asymptomatic individuals.

USPSTF has based their recommendations on evidence presented by Dr Roger Chou and colleagues from Portland, Oregon.

HCV is the most common bloodborne pathogen in the United States. It is an important cause of patient morbidity and mortality.

Dr Chou's team synthesized the evidence on risks and benefits of screening for HCV infection.
There are no data to estimate the benefit from counseling or immunizations.
Annals of Internal Medicine

The team searched for controlled studies of screening and antiviral therapy, as well as observational studies on other interventions. They also evaluated risk factors, accuracy of antibody testing, work-up, harms of biopsy, and long-term outcomes.

The researchers found that there were no published trials of screening for HCV infection.

They determined that approximately 2% of US adults have HCV antibodies. The majority of these people have chronic infection.

The team that risk factor assessment identifies adults at substantially higher risk of infection.

However, while antiviral treatment can result in a sustained virologic response rate of 54% to 56%, no trials have been done in asymptomatic patients likely to be identified by screening.

Furthermore, data are insufficient to determine whether treatment improves long-term outcomes.

Also, there are no data to estimate the benefit from counseling or immunizations.

The researchers also found that while risks of biopsy and treatment appear minimal or self-limited, data on other adverse effects of screening are sparse.

Dr Chou's team concluded, "Antiviral treatment can successfully eradicate HCV, but data on long-term outcomes in populations likely to be identified by screening are lacking".

"Although the yield from targeted screening…would be substantially higher than in the general population, data are inadequate to accurately weigh the overall benefits and risks of screening in otherwise healthy asymptomatic adults".

Ann Intern Med 2004; 140(6): 465-79
17 March 2004

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