People who should be offered a HCV antibody test

• RCGP guidance suggests the following people should be offered a HCV antibody test. The guidance also notes that it is good practice to offer HIV, HAV and HBV testing along with HCV after appropriate counselling
  • anyone who has ever injected drugs
    • it is very important that ex-injecting drug users are offered an HCV test as there is a high probability that many will have been infected for several or many years. Never assume a person has not used drugs in their past without asking, particularly if they present with a range of vague symptoms
  • current injecting drug users
  • people who have or are currently snorting or smoking drugs such as cocaine, particularly if they have shared pipes or straws
  • recipients of blood (before 1991) or blood products (before 1986 in UK) and/or organ transplants (before1992)
  • people from countries where hepatitis C is endemic (e.g. Bangladesh, Egypt, India, Japan and Pakistan)
  • people who may have had unsterile medical or dental procedures abroad
  • people involved in high risk sexual practices with a person who is HCV positive (Regular sexual partners are at low risk and can be tested if requested)
  • people who are positive for hepatitis B and/or HIV
  • people who may have had ear piercing, body piercing, tattooing or acupuncture with unsterile equipment. Particularly tattooing before the mid 80s or tattooing abroad as pre HIV awareness many tattoo parlours had inadequate sterilising facilities
  • children born to mothers with HCV who are HCV RNA positive
  • there is some remote risk of social transmission through sharing of contaminated items such as razors or toothbrushes
  • consider any patient with abnormal liver function tests (LFT), especially elevated alanine aminotransferase (ALT
  • healthcare workers who have been accidentally exposed or needlestick injury. Risk of transmission by routes other than those listed above is remote
  • the following people should be tested for HCV (as well as HIV, HAV and HBV)
    • anyone going to donate blood or tissue
    • healthcare workers who perform invasive techniques, such as surgeons
    • people on dialysis.

Reference:

1. RCGP (2007).Guidance for the prevention, testing, treatment and management of hepatitis C in primary care.