All adults in the United States should be screened for hepatitis C by healthcare providers as part of routine medical care, updated guidelines from the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recommend. The testing is recommended as a one-time, opt-out routine test.
In addition, the new guidelines recommend repeat testing for people with behaviours, exposures or conditions associated with an increased risk of hepatitis C, and annual testing for people who inject drugs and for men who have condomless sex with men.
The new US guidelines also follow guidance issued in France earlier this year, recommending a simplified treatment protocol for people with hepatitis C who do not have cirrhosis. The new recommendation is designed to encourage primary care physicians to initiate treatment in previously untreated non-complicated patients.
People with cirrhosis, chronic kidney disease, HIV or hepatitis B co-infection and pregnant women should be treated by a liver specialist, as should people with a previous history of hepatitis C treatment.
The guidelines recommend two regimens, either glecaprevir/pibrentasvir (Maviret) or sofosbuvir/velpatasvir (Epclusa), as suitable for all people.
For people with compensated cirrhosis (Child-Pugh A, FIB-4 score > 3.25) and no complicating factors (such as HIV, pregnancy, chronic kidney disease or a previous history of hepatitis C treatment), an eight-week course of treatment with glecaprevir/pibrentasvir (Maviret) can be initiated by any physician. No genotyping is needed before starting treatment with glecaprevir/pibrentasvir.
For people who have recently acquired hepatitis C – acute infection – the guidelines have been updated to recommend immediate treatment. Previous guidance counselled physicians to wait and see whether patients cleared the virus spontaneously. The new guidance recommends immediate treatment to avoid further hepatitis C transmission.
Connect with infohep on Facebook: Keep up to date with all the latest news and developments.
Follow infohep on Twitter for links to news stories and updates from infohep.org. Follow us at www.twitter.com/infohep.
Follow all the infohep news by subscribing to our RSS feeds.