DIAGNOSE AND START THE JOURNEY TO HELP CURE CHRONIC HCV1
>4 million
people living in United States with HCV, only 5% treated2,3,a
aBased on NHANES+ model estimates of current HCV infections from 2017-2020 and AASLD treatment numbers from 2020.2,3
1 in 2 people
who inject drugs in the United States have HCV4,b
b45% of people 17-35 years of age.4
Within the first 3 years of initial infection
Each person with HCV who injects drugs is likely to infect ~20 people5,c
cBased on the 2021 NIH National Institute on Drug Abuse Heroin Research Project.5
GUIDELINES RECOMMEND UNIVERSAL TESTING AND TREATMENT FOR HEPATITIS C, INCLUDING IN PEOPLE WHO INJECT DRUGS6-8
|
Test All Adult Patients At Least Once |
Test All At-Risk Patients |
Begin Treating All Diagnosed Patients |
|
|---|---|---|---|
| AASLD/IDSA |
|
|
|
| CDC |
|
|
 f
|
| USPSTF |
|
|
h
|
d Unless they have limited life expectancy that cannot be remediated by HCV treatment, liver transplantation, or another directed therapy.6
e Except in settings where the prevalence of HCV infection (HCV RNA-positivity) is <0.1%.7
f Patients need further evaluation before treatment.7
g Recommendations for screening of adults (18-79 years).8
h Adults with a positive result are usually followed up with a diagnostic evaluation8
SIMPLIFIED ALGORITHM TO DIAGNOSE HCV IN ADULTS6 Based on AASLD/IDSA
START
Run an HCV antibody test with reflex to an HCV RNA test
NEGATIVE RESULT = STOP
No additional action is required if the HCV antibody test result is negative/non-reactive
POSITIVE RESULT = GO
A positive result on an antibody test with reflex will automatically trigger an HCV-RNA PCR test
HCV-RNA PCR TEST
NEGATIVE RESULT = STOP
No additional action is required if the RNA test is negative
POSITIVE RESULT = GO
If HCV RNA is detected, a positive HCV infection has been confirmed
BEGIN NEXT STEPS TO INITIATE TREATMENT
Repeat HCV-RNA testing if HCV exposure within the last 6 months is suspected, if there is clinical evidence of HCV disease, or if there is concern regarding the handling/storage of the test specimen. For persons who are immunocompromised, testing for HCV RNA can be considered. A prior HCV infection may result in a positive HCV antibody test. While not indicative of a current infection, patients can still become reinfected with HCV.6
| Useful HCV Screening Codes9-14 | |
|---|---|
| HCV antibody with reflex to HCV RNA |
CPT: 86803 Labcorp: 144050 Quest Diagnostic: 8472 |
| HCV RNA, quantitative, real-time PCR (viral load) |
CPT: 87522 Labcorp: 550070 Quest Diagnostic: 35645 |
| ICD-10 Screening | |
| Encounter for screening for other viral diseases | Z11.59 |
| ICD-10 Diagnosis | |
| Chronic viral hepatitis C | B18.2 |