Guideline recommends against screening for HCV in adults who are not at elevated risk
OTTAWA, ON, APRIL 24, 2017 – To help provide clarity for Canadian physicians and policy makers the Canadian Task Force on Preventive Health Care (CTFPHC) has released its first Hepatitis C (HCV) screening guideline for the general adult population.
“Given the lack of evidence that population-wide screening is beneficial and that most patients identified by screening will either never develop symptoms of HCV, or will remain healthy for decades after infection, the CTFPHC recommends against screening for HCV in adults who are not at elevated risk,” said Dr. Roland Grad, member of the Task Force and chair of the guideline working group.
These recommendations were published today in the Canadian Medical Association Journal (CMAJ).
The CTFPHC recommends against screening for HCV in adults who are not at elevated risk.
The reasons include:
- The low prevalence of HCV in Canada among the general adult population not at elevated risk for HCV
- The lack of direct evidence on the benefits and harms of screening
- The vast majority of individuals with HCV identified by screening would not have access to anti-viral treatment
- The potential for harms caused by screening could include labeling, stigma, difficulties with insurance) but no benefits from treatment
This recommendation applies only to adults who are not at elevated risk for HCV. It does not apply to pregnant women or adults who are at elevated risk for hepatitis C, such as:
- Individuals with current or past history of injection drug use
- Individuals who have been incarcerated
- Individuals who were born, travelled or resided in HCV endemic countries
- Individuals who have received health care where there is a lack of universal precautions
- Recipients of blood transfusions, blood products or organ transplant before 1992 in Canada
- Hemodialysis patients
- Individuals who have had needle stick injuries
- Individuals who have engaged in other risks sometimes associated with HCV exposure such as high-risk sexual behaviours, homelessness, intranasal and inhalation drug use, tattooing, body piercing or sharing sharp instruments or personal hygiene materials with someone who is HCV positive.
- Anyone with clinical clues suspicious for HCV infection (and above risk factors)
“The CTFPHC estimated the cost of screening and treatment associated with the new HCV treatments at $1.5 billion and notes the wide global price discrepancy of these treatments,” said Dr. Marcello Tonelli member of the Task Force and guideline working group. “We encourage pharmaceutical companies to make these treatments available in Canada to patients with diagnosed HCV infection at the substantially lower prices that are charged in other jurisdictions.”
The guideline, developed by the CTFPHC, an independent body of specialists with expertise in primary care and prevention, examined the best and most current scientific evidence related to screening tests to formulate the following key screening recommendations.
For the complete report and details on the CTFPHC’s findings and recommendations and accompanying clinician FAQ tool, please visit: www.canadiantaskforce.ca
About the Canadian Task Force on Preventive Health Care
The Canadian Task Force on Preventive Health Care (CTFPHC) has been established to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of CTFPHC is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence.