When is hepatitis C virus (HCV) infection screening indicated?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Screen patients for HCV infection if any of the following applies:

  • History of illegal injected drug use

  • Transfusion with clotting factor concentrates before 1987

  • Transfusion with blood or blood components or receipt of organ transplants before July 1992

  • Use of HCV-contaminated blood from a donor

  • Long-term hemodialysis or persistently abnormal serum alanine aminotransferase (ALT) levels

  • Needle sticks, accidents with sharps, or mucosal exposures to HCV-positive blood

Considering HCV testing in patients with HIV infection may be prudent, especially in those who acquired HIV through intravenous drug use. HCV is more easily transmitted than HIV, and the 2 viruses are often co-infections.

Approximately 25% of patients with acute HCV infection have jaundice, whereas less than one third have hepatomegaly. Some patients with chronic infection have findings consistent with chronic liver disease; these include hepatomegaly, ascites, splenomegaly, and spider nevi.

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