Oct. 21, 2004 — ACPM recommends that individuals at high risk for chronic
hepatitis C infection be screened for hepatitis C by an FDA-approved screening
test, followed by a confirmatory test where the low signal cutoff (S/C) ratio
indicates a less than 95 percent chance of infection.
Risk factors
include injection drug use (IDU), sexual exposure to individuals with IDU, and a
history of receiving blood or blood products before 1992. The College does not
find sufficient evidence to recommend for or against universal
screening.
Hepatitis C is an under-diagnosed blood-borne illness,
resulting in chronic cirrhosis in up to 25 percent of those infected. While the
overall prevalence in the U.S. is low (1.7 percent), high risk populations may
have up to 80 percent prevalence. Current screening practices are inadequately
identifying infected individuals, causing ongoing spread of the virus and
resulting in under-treatment.
ACPM's recommendations were adopted on
Sept. 30 by ACPM's Board of Regents. The practice policy statement has been
submitted to the American Journal of Preventive Medicine for
publication.
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