US panel recommends expanding hepatitis C screenings

The U.S. Preventive Services Task Force on Tuesday proposed recommending clinicians screen all adults between the ages of 18 and 79 for the hepatitis C virus regardless of their risk level of contracting the disease.

The expert panel’s draft recommendation is a departure from its 2013 screening guidelines that called for screening adults at high risk for hepatitis C, and to test individuals born between 1945 and 1965 at least once.

The change is a direct result of the steady rise in hepatitis C infections seen over the past decade as a result of the ongoing opioid epidemic. The number of hepatitis C cases reported in the U.S. nearly tripled between 2010 and 2015, according to the Centers for Disease Control and Prevention. All in all, an estimated 41,200 acute hepatitis C cases occurred in 2016.

“Today, more people are infected with hepatitis C than there were a decade ago, but there are now better treatments available,” task force chair Dr. Douglas Owens said in a statement. “The evidence now shows more people can benefit from screening.”

USPSTF also suggested clinicians consider screening patients who are younger than 18 and older than 79 if they are at high risk for infection, as well as pregnant women. All of those groups have seen more hepatitis C cases over the past decade.

Hepatitis C is the most common chronic bloodborne disease in the U.S. and is associated with more annual deaths than any other infection. More than 18,000 people died from hepatitis C infections in 2016, which the CDC acknowledged is likely an underestimate.

Mounting evidence shows a link between increased injection drug use and rising Hepatitis C infections in recent years.

A Health Affairs analysis published in February states that had higher than average OxyContin misuse before Purdue Pharma reformulated the drug in 2010 to make it harder to abuse had a 222% increase in Hepatitis C infections rates after the change because many people switched to heroin.

“It is concerning that we are seeing a significant increase in hepatitis C, and many people don’t know they have it,” task force vice chair Dr. Alex Krist said in a statement. “The good news is that we have newer treatments that are more effective and safer, and screening adults for hepatitis C can detect the infection earlier, before they have complications from the virus.”

The public can comment on the draft recommendation until Sept. 23.

USPSTF gave the recommendation a “B” rating, which means if finalized, hepatitis C testing would qualify for first-dollar coverage under the Affordable Care Act the requires insurers to provide coverage for preventive health services without cost-sharing.

https://www.modernhealthcare.com/safety-quality/uspstf-recommends-expanding-hepatitis-c-screenings