Testing Recommendations for Hepatitis C Virus Infection
CDC Recommendations for Hepatitis C Screening Among Adults in the United States
- Universal hepatitis C screening:
- Hepatitis C screening at least once in a lifetime for all adults aged 18 years and older, except in settings where the prevalence of HCV infection (HCV RNA‑positivity) is less than 0.1%*
- Hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection (HCV RNA‑positivity) is less than 0.1%*
- One‑time hepatitis C testing regardless of age or setting prevalence among people with recognized conditions or exposures:
- People with HIV
- People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago
- People with selected medical conditions, including:
- people who ever received maintenance hemodialysis
- people with persistently abnormal ALT levels
- Prior recipients of transfusions or organ transplants, including:
- people who received clotting factor concentrates produced before 1987
- people who received a transfusion of blood or blood components before July 1992
- people who received an organ transplant before July 1992
- people who were notified that they received blood from a donor who later tested positive for HCV infection
- Health care, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood pdf icon[PDF – 177 KB]
- Children born to mothers with HCV infection
- Routine periodic testing for people with ongoing risk factors, while risk factors persist:
- People who currently inject drugs and share needles, syringes, or other drug preparation equipment
- People with selected medical conditions, including:
- people who ever received maintenance hemodialysis
- Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons may be reluctant to disclose stigmatizing risks
MMWR 2020 (RR 69)
Testing Sequence
Hepatitis C testing should be initiated with a Food and Drug Administration (FDA)‑approved anti‑HCV test. People testing anti‑HCV positive/reactive should have follow-up testing with an FDA‑approved nucleic acid test (NAT) for detection of HCV RNA. See complete Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infection.
USPSTF Recommendations
U.S. Preventive Services Task Force – Screening for Hepatitis C Virus Infectionexternal icon
The USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years. Grade: B Recommendation.
Resources
- Newly Reported Hepatitis C Infections and Recommendations for Universal Hepatitis C Screening pdf icon[PDF – 39 pages]
Slide set from April 9, 2020 webinar - Summary of CDC Recommendations for Hepatitis C Screening Among Adults pdf icon[PDF – 690 KB]
- Dramatic increases in hepatitis C: CDC now recommends hepatitis C testing for all adults – Vital Signs fact sheet for consumers, partners and providers
- Testing for HCV infection: An update of guidance for clinicians and laboratorians. pdf icon[PDF – 4 pages]
MMWR 2013; Vol. 62 Early Release - Recommended Testing Sequence for Identifying Current Hepatitis C Virus (HCV) Infection pdf icon[PDF- 1 page]
- Interpretation of Results of Tests for Hepatitis C Virus (HCV) Infection and Further Actions pdf icon[PDF- 1 page]