Authors' objectives: Many patients with chronic hepatitis C virus (HCV) infection are unaware of their status. Screening could identify patients at earlier stages of disease, when interventions might be effective in improving clinical outcomes or reducing transmission risk. The purpose of this report is to systematically review the evidence on screening for HCV infection in asymptomatic adults without known liver enzyme abnormalities, including pregnant women. This review focuses on research gaps identified in the 2004 United States Preventive Services Task Force (USPSTF) review and new studies published since that review, and it reviews evidence on prenatal HCV screening not included in the 2004 USPSTF review. This report examines both direct evidence on the effects of screening for HCV infection compared to no screening on clinical outcomes, as well as the indirect chain of evidence (diagnosis, workup, and treatment) needed to understand effects of screening on clinical outcomes. Treatments evaluated included immunizations, counseling, and interventions to potentially reduce risk of mother-to-child transmission. To complement this review of screening for HCV, the Agency for Healthcare Research and Quality (AHRQ) commissioned a separate review on effectiveness of antiviral treatments.

Authors' recommendations: Although screening tests can accurately identify adults with chronic HCV infection, targeted screening strategies based on the presence of risk factors miss some patients with HCV infection. As a result, more research is needed to understand the effects of different screening strategies on clinical outcomes. Evidence on effects of knowledge of HCV status and counseling and immunizations on clinical and intermediate outcomes in patients diagnosed with HCV infection remains sparse and more research is needed to understand effective interventions for preventing vertical transmission. A complete assessment of benefits and harms of screening requires consideration of the effectiveness of antiviral regimens, which are the subject of a complementary review.

Project Status: Completed

Year Published: 2012

URL for published report: http://effectivehealthcare.ahrq.gov/ehc/products/285/1283/CER69_HepatitisCScreening_FinalReport_20121015.pdf

URL for additional information: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1283

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)