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Hepatitis C Risk Factors? There May Be More Than You Realize

NoMoreHepThere are some facts about hepatitis C that I know so well, I could probably recite them in a coma.  For instance, I know the hepatitis C risk factors backwards and forwards. Or so I thought. Yesterday, two risk factors popped up that had probably been there for years, but I hadn’t seen them before. And both may be fairly common.

Before I tell you what they, I’ll review the testing recommendations, since my smug-little self obviously needs it.  Let’s begin with the CDC recommendations:

Persons for Whom HCV Testing Is Recommended

  • Adults born from 1945 through 1965 should be tested once
  • Anyone with a current or past history of injecting drugs (including those who injected once or a few times many years ago)
  • People with certain medical conditions, including those who:
    • received clotting factor concentrates produced before 1987
    • were ever on long-term hemodialysis
    • have persistently abnormal alanine aminotransferase levels (ALT)
    • have HIV infection
  • Prior recipients of transfusions or organ transplants, including persons who:
    • were notified that they received blood from a donor who later tested positive for HCV infection
    • received a transfusion of blood, blood components, or an organ transplant before July 1992

HCV- testing based on a recognized exposure is recommended for:

  • Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood
  • Children born to HCV-positive women

Persons for Whom Routine HCV Testing Is of Uncertain Need

  • Recipients of transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, sperm)
  • Intranasal cocaine and other non-injecting illegal drug users
  • Persons with a history of tattooing or body piercing
  • Persons with a history of multiple sex partners or sexually transmitted diseases
  • Long-term steady sex partners of HCV-positive persons

Persons for Whom Routine HCV Testing Is Not Recommended (unless there are risk factors for infection):

  • Health-care, emergency medical, and public safety workers
  • Pregnant women
  • Household (nonsexual) contacts of HCV-positive persons
  • General population

The AASLD/IDSA recommendations are the same as the CDC’s. The new information that caught my eye came from the United States Prevention Services Task Force (USPSTF). In addition to all the above, they include:

  • Incarceration
  • Having surgery before the implementation of universal precautions

Universal precautions were introduced in 1985-1988 and improved over time. The USPSTF doesn’t specifically state that anyone who had surgery before a certain year should be tested, but if you aren’t a baby boomer, you have normal liver enzymes (ALT) and have any of the symptoms of hep C, talk to your doctor about being tested.

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