Hepatitis C is the most common bloodborne infection in the United States. In 2016, there were an estimated 2.4 million people living with hepatitis C in the United States. The hepatitis C virus (HCV) is usually spread when blood from a person infected with the virus enters the body of someone who is not infected. Today, most people become infected with HCV by sharing needles or other equipment used to prepare or inject drugs. Other factors associated with transmission include receiving a transfusion or organ transplant before 1992, receiving long-term hemodialysis, or receiving clotting factor concentrates produced before 1987.
In April 2020, the Centers for Disease Control and Prevention (CDC) released a Morbidity and Mortality Weekly Report announcing expanded testing recommendations for hepatitis C infection. As of April 2020, CDC now recommends HCV testing:
- At least once in a lifetime for all adults aged ≥ 18 years, except in settings where the prevalence of HCV infection is <0.1%, and
- For all pregnant persons during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%
In addition to CDC’s new HCV testing recommendations, the following CDC HCV testing recommendations continue to remain in effect:
- One-time HCV testing regardless of age or setting prevalence among people with recognized conditions or exposures
- Routine periodic HCV testing for people with ongoing risk factors, while risk factors persist
Furthermore, the CDC states that any person requesting HCV testing should receive it, regardless of disclosure of risk factors, as individuals may be reluctant to disclose risk factors due to stigma.
Patients with confirmed HCV infection should be linked to care and evaluated for presence of chronic liver disease, including assessment of liver function tests, evaluation for severity of liver disease, and recommended HCV treatment, and determination of need for hepatitis A and hepatitis B vaccination. New direct-acting antiviral therapies are can achieve sustained virologic response (SVR), which is defined as the absence of detectable virus 12 weeks after completion of treatment and is indicative of a cure of HCV infection.
For questions related to CDC's hepatitis C testing recommendations, please contact the Michigan Department of Health and Human Services' Viral Hepatitis Unit at MDHHS-Hepatitis@Michigan.gov.