Updated Hepatitis C Guidelines Seek to Accelerate Testing Rates

Clinicians who screen patients for HCV have a new resource to help them, just in time for National Hepatitis C Testing Day on May 19.

The Guide to Hepatitis C Testing summarizes the latest examination recommendations and provides key laboratory, diagnostic and billing codes for practitioners. The pamphlet, produced by the Institute for Hepatitis C at the American Academy of HIV Medicine (AAHIVM) and the American College of Physicians (ACP), also lists providers experienced with HCV to expedite patient referrals.

“We know there is widespread uncertainty out there about whom to test and with what labs, and how to get reimbursed,” Margaret Hoffman-Terry MD (pictured), who chairs the AAHIVM board of directors, said. “We hope this new resource will give clinicians the information they need to ramp up testing.”

People born in the "Baby Boomer" generation, from 1945-1965 should be screened for the liver-attacking hepatitis C virus at least once in their lives, according to the guide.

Other candidates include injection drug users, people with human immunodeficiency virus (HIV), children born to HCV-positive mothers, and healthcare workers with exposure to HCV-positive blood.

Patients with persistently abnormal alanine aminotransferase (ALT) levels should be tested, along with those treated with clotting factor concentrates produced before 1987. People who received blood transfusions or organ transplants before July 1992, or who underwent long-term hemodialysis, should be screened as well, according to the guide.

Testing should start with an assay for serum antibody to HCV (anti-HCV). For those with reactive results, the anti-HCV test should be followed by a confirmatory nucleic acid test for HCV (HCV RNA). This allows definitive testing to be completed with one blood draw, the guide notes.

Some 2.7 million to 3.9 million people in the US are infected with the virus, which can lead to persistent liver disease, cancer and death. Many individuals with HCV are undiagnosed, according to the US Centers for Disease Control (CDC).

The launch of Guide to Hepatitis C Testing closely follows the reporting of preliminary CDC data that show new HCV infections have nearly tripled over 5 years to a 15-year high.

“It is imperative that clinicians are testing indicated patient cohorts, and this guide will help them to do that,” Hoffman-Terry said.

The CDC established May as Hepatitis Awareness Month. The centers chose the 19^th as the national day of testing to remind health care providers and the public who should be screened for viral hepatitis.

The complimentary guide is available on the AAHIVM website.