Dr. Gish: We need to think about who to screen for hepatitis C in two distinct groups. The first group is the risk group, where you're going to take a risk history for blood exposure [and] intimate exposure. That risk factor list is available through the CDC [Centers for Disease Control and Prevention] MMWR [Morbidity and Mortality Weekly Report] [and] a lot of different national and international guidelines. But of course some patients don't remember or don't want to admit to their risk events. So another strategy recently is what's called the birth cohort screening, and that has to do with people born between 1945 and 1965.1 This birth cohort represents close to 70% of the individuals infected with hepatitis C today. And look how simple this is. You look at their date of birth and you order a hepatitis C antibody test.
This all came about through a collaboration of the CDC and the U.S. Public Health Service's Preventive Task Force, backed up by lots of data saying, one, hepatitis C is curable; two, with treatment and cure, we decrease mortality due to cancer, cirrhosis, [and] we decrease transplant.2 These are very important points.
Testing is inexpensive. The risks in terms of adverse events from testing are very low. False positive rates for testing, especially with confirmatory testing with PCR, are extremely low. So a whole package has now been put together. Take a risk history, look at the date of birth, order hepatitis C antibody tests. If positive, do confirmatory testing, and link those people to care.
Narrator: One-time testing should be done for those persons born between 1945 and 1965 regardless of risks.