An estimated 3.5 million people in the United States are infected with Chronic Hepatitis C Virus (HCV). Many of these people do not know they are infected and are not receiving care or treatment. The CDC estimates that while Baby Boomers (born 1945-1965) comprise only 27% of the US population, they account for approximately three fourths of all HCV infections. Therefore, they are at greatest risk for hepatocellular carcinoma and other HCV-related liver disease. HCV is now the leading cause of liver transplantation and liver cancer in the US.
The CDC, USPSTF, and AASLD recommend the one-time screening of all Baby Boomers regardless of liver enzyme levels, symptoms, or risk factors. Other at-risk patients who should be screened are: persons who have ever injected illegal drugs, HIV-infected patients, recipients of tattoos from unlicensed or unregulated environments, persons on long-term hemodialysis, persons with persistently abnormal alanine aminotransferase levels, persons who received a blood transfusion or organ transplant before 1992, healthcare workers after accidental needle sticks, and children born to a HCV positive mother.
Once you identify an at-risk patient, screen with an HCV Antibody test. If the result is negative, no further testing is needed. If the result is positive, diagnosis must be confirmed with an HCV RNA test. If RNA is detected, Chronic HCV Infection is confirmed and the patient can be referred to Birmingham Gastroenterology Associates for treatment evaluation.
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