In the U.S., almost 3.9 million people are infected with HCV, a virus that can cause inflammation and permanent liver damage and which is most common in individuals born from 1945 through 1965. Around 50 to 75% of people with HCV are unaware that they are infected, which is a major concern since HCV progresses slowly and the risk of serious complications increases with time.
According to new recommendations by The Centers for Disease Control and Prevention (CDC) published early online in Annals of Internal Medicine, all Americans born between 1945 and 1965 should have a one-time screening for the hepatitis C virus (HCV), even if they have no risk factors. In addition, the CDC also recommends that all individuals diagnosed with HCV should receive a brief alcohol screening and intervention and be referred to appropriate care and treatment services for HCV and associated conditions.
The CDC wanted to find testing strategies that raise the percentage of those infected with HCV who know their status and especially whether tests based on the year of birth would identify those who are infected but who are unaware of their infection. To evaluate the frequency of HCV and clinical outcomes, they performed a systematic review of evidence published between 1995 and February 2012, discovering that the percentage of those born between 1945 and 1965 with HCV antibodies was higher compared with that of the general population.
The findings revealed compelling evidence that achieving sustained virologic response (SVR) was linked to a lower mortality risk and liver cancer.
According to the CDC recommendations, individuals that have been diagnosed with HCV have a brief alcohol screening and intervention, since there is evidence that alcohol consumption accelerates the progression of liver disease. The authors of the recommendations performed a systematic review of 22 randomized, controlled trials since 2010, and considered them to determine the impact of a brief alcohol intervention compared with no intervention on reducing the consumption of alcohol.
The findings revealed that those who had a brief alcohol reduction intervention managed to decrease their weekly alcohol intake by an average of 38.42 grams in comparison with those who had received no intervention.
The CDC previously recommended antibody screening only for those whose health or lifestyle indicators, such as having a blood transfusion prior to 1992, a history of injecting rugs or being a chronic hemodialysis patient suggested a potential infection. Because of the restricted time of primary care visits and unease in discussing behavioral risks, low case identification may lead to difficulties of implementing risk-based screening.
Written by Petra Rattue