By Ronald Valdiserri, MD, MPH, Professor, Department of Epidemiology, Rollins School of Public Health, Emory University, Former Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services
The U.S. Preventive Services Task Force has expanded its screening guidelines for Hepatitis C and now recommends that most adults get tested for the virus. Here is a quick look at what this means.
What do the USPSTF recommendations mean?
- Hepatitis C virus (HCV) has contributed to more US patient deaths than the next 60 reportable infectious diseases combined.
- The guidelines were last updated in 2013 and called for screening high-risk individuals and individuals born between 1945 and 1965.
- The new guidelines, published in JAMA, call for clinicians to screen all adults between the ages of 18 and 79 at least once regardless of their level of risk for contracting the virus.
- The task force gave the recommendation a B rating, which means Hepatitis C testing will qualify as a preventive health service under the Affordable Care Act. That will allow insured patients to get screened without a deductible or co-pay.
Why the change?
- Historically, Baby Boomers (people born between 1945 and 1969) have had a higher prevalence of Hepatitis C than other age groups. Between 2013 and 2016, Hepatitis C prevalence in Baby Boomers was three times higher than the prevalence among those born after 1969.
- Since 2013, a larger proportion of younger Americans have become infected with HCV, largely as a consequence of injection drug use associated with America’s opioid use epidemic.
- HepVu maps show that in certain states, such as Kentucky, New Mexico, West Virginia, and Oklahoma, the Hepatitis C prevalence rate among people born after 1969 was twice as high as the national average for that age group. Kentucky, West Virginia, and Oklahoma also have some of the highest opioid prescription rates in the country.
- The continued improvements in Hepatitis C treatment have resulted in greater benefits to infected patients to receive effective treatment before developing complications.
- The CDC announced last year that it plans to expand its current recommendations for Hepatitis C screening and collected public comments on the proposed changes at the end of 2019. The agency is considering broadening its recommendations to call for universal Hepatitis C screening for all adults 18 and older at least once in their lifetime and all pregnant women during each pregnancy. The final recommendation is expected in the coming months.
- This is also a call to action for physicians to begin offering routine Hepatitis C screenings to their patients. Current estimates show that half of all people living with Hepatitis C don’t know they have it.