Hepatitis C virus (HCV) testing has been recommended since 1998 in those at highest risk for the disease, including injection drug users; people who have undergone hemodialysis; those who have received transfusions, organ transplants, or clotting factors (before 1987); and health care personnel who've been exposed to HCV-positive blood from circumstances such as needle sticks. Now the Centers for Disease Control and Prevention (CDC) has added a new group to that list: every U.S. adult born between 1945 and 1965.
Several factors led the agency to include this population. A CDC work group analyzed studies that had employed data from the U.S. National Health and Nutrition Examination Survey from 1988 to 1994 and again from 1999 through 2008. In the most recent study, the prevalence of HCV antibodies in those born between 1945 and 1965 was 3.25%-five times higher among these baby boomers than among those born in other years. In addition, this birth cohort accounted for 76% of the total anti-HCV antibody prevalence in the United States. The death rate from HCV infection in 2007 also increased substantially from 1999 through 2007: HCV-related deaths among infected 45-to-64-year-olds reached 73% in 2007.
Citing these data, as well as the limitations of risk-based testing and advances in HCV treatment, the following final recommendations were made:
* Adults born between 1945 and 1965 should receive one-time testing for HCV without prior ascertainment of HCV risk.
* All people determined to have HCV infection should 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.
These guidelines are intended to augment, rather than replace, the 1998 testing guidelines, and the CDC intends to review and update them every five years, as new information becomes available. The full report can be accessed online at http://1.usa.gov/NCkNms.-Gail M. Pfeifer, MA, RN, news director