Screening for Hepatitis C

Abstract

of the Clinical Problem Hepatitis C virus affects an estimated 180 million people worldwide,making it themost common chronic blood-borne pathogen.1 Less than half of infected individuals clear their infection without treatment, and 15% to 40% of patients with HCV progress to cirrhosisorhepatocellular cancer.HepatitisCvirus infection is themost commonindication for liver transplantationand is thecauseof8000 to 13 000 deaths in the United States each year.2 SinceHCV testingofbloodproductswas implemented in 1992, the2most important risk factors forHCVacquisitionarepastor current injection drug use and birth between 1945 and 1965.3 DetectionofHCV infectionhasprovendifficultbecausebehavioral riskhistories are often incomplete, most newly infected individuals have no ormild nonspecific symptoms, and up to 50%of those infected have persistently normal serum transaminase values. Not surprisingly, 45% to85%of all personswith chronicHCV infection are unaware that they are infected.3When patients are identified and receive proper HCV treatment, they can reduce their risk of hepatocellular cancer by 70% and all-cause mortality by 50%.3