HCV Screening, Testing, and Diagnosis in Adults: Who to Test Recs

Routine Testing

• Clinicians should perform HCV screening at least once for all patients ≥18 years old who are not known to have HCV infection. (A2)
• Clinicians should repeat HCV screening in all patients who are planning to get pregnant (A2) or are currently pregnant (B3), and screening should be repeated with each pregnancy. (B3)
  • See the NYSDOH AI guideline Treatment of Chronic HCV Infection in Adults > HCV Testing and Management in Pregnant Adults and the NYSDOH Dear Colleague Letter (11/1/2021): HCV Testing in Pregnant Persons.
• Clinicians should perform repeat HCV testing based on individual exposure to the following risk factors, at least once if risk exposure is episodic and annually if ongoing:
  • Injection (A1) or intranasal (A2) drug use
  • Hemodialysis (A1)
  • HIV infection diagnosis (A1)
  • Sex partner(s) with HCV infection (A2)
  • Tattoo, piercing, or acupuncture obtained in a nonsterile setting (A2)
  • Incarceration (A2)
  • Unexplained liver disease or abnormal transaminase levels (A1)
• Clinicians should recommend repeat HCV testing at least annually to MSM and others who are not known to have HCV infection and:
  • Engage in receptive anal sex and other behaviors that may tear mucous membranes (A2)
  • Have multiple sex partners (A2)
  • Are taking PrEP to prevent HIV acquisition (A3)
  • Are transgender women (B3)
  • Engage in sex while using recreational mind-altering substances, particularly methamphetamine (A2)
  • Have been diagnosed with another STI within the previous 12 months (A2)

 

Potential Exposure to HCV in an Occupational Setting: See the NYSDOH AI guideline PEP to Prevent HIV Infection > Management of Potential Exposure to Hepatitis C Virus.