Hepatitis C: Screening
and diagnosis

Who is at risk?

Up to an estimated 2.7–3.9 million people in the United States are infected with the Hepatitis C virus (HCV).1 However, because symptoms may take decades to develop, at least 50% of cases are not diagnosed.2 The CDC calls Hepatitis C “an unrecognized health crisis in the United States.”3

Important facts on Hepatitis C:

  • Baby boomers—people born from 1945 to 1965—are 5x as likely as others to be infected with Hepatitis C.4 In fact, more than 75% of adults infected with Hepatitis C are baby boomers.3
 

Guidelines recommend screening for HCV in anyone whoa:

  • Was born between 1945 and 1965 (baby boomers)5
  • Was or is currently an injection drug user5,6
  • Received transfusions or organ transplants prior to July 19925,6
  • Has additional risk factors or medical conditions5,6,b
 
 
  • Most people may have become infected in the 1970s and 1980s when rates of Hepatitis C were high and before widespread blood supply screenings were introduced.4
  • The majority of those infected are asymptomatic and remain undiagnosed for many years; 60%–70% of these individuals develop chronic liver disease.1
  • Health officials estimate that one-time testing of all baby boomers will prevent more than 120,000 HCV-related deaths.3

1 in 30 baby boomers has HCV and is not aware.3

Reflex testing and HCV genotyping

Once HCV infection has been confirmed, it is important to know the patient’s viral genotype as this information is helpful in assessing the prognosis of Hepatitis C, and is critical in determining the most effective treatment regimen.

At least six distinct HCV genotypes (1–6) and more than 50 subtypes have been identified.1,7

Quest Diagnostics is the leader in providing Hepatitis C antibody screening with reflex testing. With our Hepatitis C screening assay, Hepatitis C Antibody with Reflex to HCV RNA, PCR with Reflex to Genotype, LiPA®, the patient’s viral load is automatically assessed if Hepatitis C antibody is reactive. If Hepatitis C viral RNA, quantitative, real-time PCR is >= 300 IU/mL, then the patient’s genotype is automatically assessed. This test makes it easy to diagnose, and determine treatment course for your Hepatitis C patients.

Before starting patients on antiviral therapy, the AASLD/IDSA guidelines recommend the following tests8:

  • HCV genotype and subtype
  • Quantitative HCV RNA (HCV viral load)

Quest Diagnostics shares your mission to improve healthcare

At Quest Diagnostics, we are committed to offering the support and information you need to successfully treat HCV. Our extensive diagnostic and prognostic screening options and seamless results reporting are designed to help you with Managing Hep C at every stage.

The importance of screening for HCV

Dr. Pearlman discusses:

  • Population recommended for HCV screening by the CDC and USPSTF
  • High prevalence and impact of HCV among baby boomers
  • Algorithm for testing for HCV
  • Interpreting results of HCV testing
 

Consult with our HCV and HIV specialists

With the introduction of new treatments, collaborating with specialists is critical to ensure the best treatment outcomes for your patients. Here at Quest, we have experts available to consult with you at every stage.

“If we find the patients and treat them appropriately, we could essentially eradicate Hepatitis C.”—Dr. Bruce R. Bacon

Read more about Dr. Bruce R. Bacon’s perspective here.

AASLD=American Association for the Study of Liver Diseases; CDC=Centers for Disease Control and Prevention; IDSA=Infectious Diseases Society of America; USPSTF=U.S. Preventive Services Task Force.

aAccording to the CDC and USPSTF.
bAdditional risk factors include: HIV-positive individuals, chronic hemodialysis patients, individuals with known exposure to HCV (ie, being born to an HCV-infected mother, needlestick injuries in healthcare settings with HCV-positive blood), incarceration, intranasal drug use, unregulated tattoos, and other percutaneous exposures.

References: 1. Centers for Disease Control and Prevention. Hepatitis C Information for Health Professionals. https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm#section1. Accessed April 24, 2017. 2. Holmberg SD, Spradling PR, Moorman AC, Denniston MM. Hepatitis C in the United States. N Engl J Med. 2013;368(20):1859–1861. 3. Centers for Disease Control and Prevention. Expanded hepatitis C testing recommendations. https://www.cdc.gov/media/dpk/diseases-and-conditions/hepc-2012/hepc-2012.html. Accessed April 24, 2017. 4. Centers for Disease Control and Prevention. Hepatitis C: Why people born from 1945-1965 should get tested. https://www.cdc.gov/knowmorehepatitis/media/pdfs/factsheet-boomers.pdf. Accessed April 24, 2017. 5. U.S. Preventive Services Task Force. Final recommendation statement. Hepatitis C: Screening. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/hepatitis-c-screening. Accessed April 24, 2017. 6. Centers for Disease Control and Prevention. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR Recomm Rep. 1998;47(RR-19):1–39. 7. Hepatitis C Online. HCV Epidemiology in the United States. http://www.hepatitisc.uw.edu/pdf/screening-diagnosis/epidemiology-us/core-concept/all. Accessed April 24, 2017. 8. American Association for the Study of Liver Diseases, Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org/sites/default/files/HCV-Guidance_April_2017_a.pdf. Accessed April 24, 2017.