7/26/2023 0 Comments M.e.a.t. checklist hcc![]() 8, 15, 17 Point-of-care testing allows for expanded screening. 21 Anti-HCV antibody testing (third-generation enzyme-linked immunosorbent assay with 99% sensitivity and specificity) is the screening test of choice with follow-up reflex HCV RNA polymerase chain reaction testing for positive results to confirm the active disease. ![]() Preventive Services Task Force recommends screening all asymptomatic adults (including people who are pregnant) 18 to 79 years of age and people younger or older who are at high risk of infection. 17 One-time screening is recommended for patients younger than 18 years with risk factors. 20 People at risk, or those who request testing, should be screened periodically for as long as the at-risk behavior persists. 17 The American College of Obstetricians and Gynecologists recommends screening all pregnant individuals during each pregnancy. The Centers for Disease Control and Prevention recommends universal HCV screening at least once for all adults 18 years and older and during each pregnancy 19 ( Table 2). Placebo-controlled trials show a > 95%sustained viral response at 12 weeks posttreatment sustained virologic response is associated with improved patient-oriented outcomes in long-term cohort studiesĪll people should receive education about preventing HCV transmission and reducing the progression of hepatic disease. 8, 15, 17, 18Įxpert opinion and consensus guideline from the Advisory Committee on Immunization Practices and Centers for Disease Control and PreventionĪdults with HCV infection who meet criteria for treatment with a simplified regimen should be treated with eight weeks of glecaprevir/pibrentasvir (Mavyret) or 12 weeks of sofosbuvir/velpatasvir (Epclusa), regardless of the HCV genotype. A pneumococcal polysaccharide vaccine is indicated for adults 19 to 64 years of age with chronic hepatic disease and cirrhosis. Hepatitis A and hepatitis B vaccinations should be administered to people with HCV. Preventive Services Task Force, and American College of Obstetricians and GynecologistsĪnti-HCV antibody testing with follow-up reflex HCV RNA polymerase chain reaction testing is recommended for initial testing. 17, 20, 21Ĭenters for Disease Control and Prevention, U.S. Screen for HCV infection in adults 18 to 79 years of age, during each pregnancy, and for patients with at-risk behavior for as long as the behavior persists. In the absence of cirrhosis, no liver-related follow-up is recommended. In patients with compensated cirrhosis, posttreatment surveillance for hepatocellular carcinoma and esophageal varices should include abdominal ultrasonography (with or without alpha fetoprotein) every six months and upper endoscopy every two to three years. A sustained virologic response is associated with lower all-cause mortality and improves hepatic and extrahepatic manifestations, cognitive function, physical health, work productivity, and quality of life. ![]() Undetectable HCV RNA 12 weeks after completing therapy is considered a virologic cure (i.e., sustained virologic response). For treatment-naive adults without cirrhosis or with compensated cirrhosis, a simplified treatment regimen consisting of eight weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir results in greater than 95% cure rates. One-time screening is recommended for patients younger than 18 years with risk factors. Any person with ongoing risk factors should be screened periodically as long as the at-risk behavior persists. Universal screening with an anti-HCV antibody test with follow-up reflex HCV RNA polymerase chain reaction testing for positive results to confirm active disease is recommended at least once for all adults 18 years and older and during each pregnancy. People at the greatest risk of HCV infection are those between 18 and 39 years of age and those who use injection drugs. Screening recommendations and treatment guidelines for hepatitis C virus (HCV) infection have been updated.
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