Hepatitis C: The value of
universal screening

Hepatitis C remains a silent epidemic in the United States (US), where an estimated 2.4 million people are living with chronic hepatitis C.1 Although previous clinical guidelines focused on Baby Boomers as a high-risk group, the latest data show dramatic increases in hepatitis C virus (HCV) infection among younger people.

Fortunately, guidelines issued in 2020 recommending universal screening in all adults can empower clinicians to screen more patients, detect more infections, begin treatment sooner, and clear more patients of the virus, improving outcomes while preventing spread of infection.


Guidelines recommend HCV screening for4,5:

  • All adults aged 18 years and older
  • All pregnant women during each pregnancy
  • People with recognized conditions or exposures
  • People with ongoing risk factors, including persons who inject drugs (PWID) (routine periodic testing)
  • Any person who requests hepatitis C testing

The severity of the HCV epidemic

According to the Centers for Disease Control and Prevention2,3:

  • New hepatitis C cases are 4 times as high as they were 10 years ago
  • In 2018, the percent of newly reported chronic infections was equal among Baby Boomers (born 1945–1965) and Millennials (born 1981–1996), both around 36%, while Generation X (born 1966–1980) made up 23%
  • The annual rate of reported acute hepatitis C tripled from 2009 to 2018
  • Rates of acute hepatitis C among people of reproductive age are increasing
  • Most new HCV infections are occurring in PWID

Younger adults 20–39 years old have the highest rates of new HCV cases.2,3


Reflex testing for viral load assessment

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, the patient’s viral load is automatically assessed if hepatitis C antibody is reactive. Performing both qualitative and quantitative testing from a single sample enables earlier diagnosis and baseline assessment so care may begin sooner.

For a complete list of tests for monitoring HCV treatment, download Monitoring Guidance for initial treatment of HCV infection.

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

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

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.

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. Hofmeister MG, Rosenthal EM, Barker LK, et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013–2016. Hepatology. 2019;69:1020–31.  2. Centers for Disease Control and Prevention. Vital signs: dramatic increases in hepatitis C. Accessed May 7, 2020.  3. Ryerson AB, Schillie S, Barker LK, Kupronis BA, Wester C. Vital signs: newly reported acute and chronic hepatitis c cases—United States, 2009–2018. MMWR Morb Mortal Wkly Rep. 2020;69:399–404.  4. Centers for Disease Control and Prevention. CDC recommendations for hepatitis C screening among adults—United States, 2020. April 10, 2020. Accessed May 6, 2020.  5. US Preventive Services Task Force. Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(10):970-975.  6. Centers for Disease Control and Prevention. Hepatitis C information for health professionals. Accessed April 24, 2017.  7. Hepatitis C Online. HCV epidemiology in the United States. Accessed April 24, 2017.  8. American Association for the Study of Liver Diseases, Infectious Diseases Society of America. HCV testing and linkage to care. Accessed May 7, 2020.