Screening for Hepatitis C Virus Infection

  • Practice Advisory PA
  • April 2020

On April 9, 2020, the Centers for Disease Control and Prevention (CDC) released updated guidance on screening for hepatitis C virus (HCV) infection. The U.S. Preventive Services Task Force (USPSTF) released a new B-grade recommendation statement on HCV screening on March 2, 2020. New guidance from both the CDC and the USPSTF represent a change in routine screening for HCV; both organizations now recommend HCV screening for all adults, including pregnant and nonpregnant individuals.

The American College of Obstetricians and Gynecologists (ACOG) is actively reviewing the new guidance from the CDC and USPSTF. Updated guidance from ACOG will be posted on ACOG’s website and published in Obstetrics & Gynecology when available. ACOG is also reviewing its current guidance on the screening and management of hepatitis for pregnant individuals in ACOG Practice Bulletin No. 86, Viral Hepatitis in Pregnancy (2007).

New Guidance on Routine Hepatitis C Virus Infection Screening from the CDC and USPSTF*

CDC (2020) USPSTF (2020)

Nonpregnant individuals

  • Hepatitis C virus (HCV) screening at least once in a lifetime for all adults aged 18 years and older, except in settings where the prevalence of HCV infection is less than 0.1%.
  • Regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist.
  • Screen for HCV infection in adults aged 18 to 79 years (B-grade recommendation). Most adults need to be screened only once.
  • The USPSTF also suggests that clinicians consider screening persons younger than 18 years and older than 79 years who are at high risk for infection (eg, those with past or current drug use).

Pregnant individuals

Hepatitis C virus screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is less than 0.1%.**

  • Pregnant adults should be screened.
  • Because of the increasing prevalence of HCV in women aged 15–44 years and in infants born to HCV-infected mothers, clinicians may want to consider screening pregnant persons younger than age 18 years.

* Guidance on recommended screening interval is lacking.
** The CDC does not provide definitive guidance on the ideal time to screen during pregnancy. For more information on when pregnant individuals could be screened, see the CDC guidance.

Please contact with any questions.

A Practice Advisory is issued when information on an emergent clinical issue (e.g. clinical study, scientific report, draft regulation) is released that requires an immediate or rapid response, particularly if it is anticipated that it will generate a multitude of inquiries. A Practice Advisory is a brief, focused statement issued within 24-48 hours of the release of this evolving information and constitutes ACOG clinical guidance. A Practice Advisory is issued only on-line for Fellows but may also be used by patients and the media. Practice Advisories are reviewed periodically for reaffirmation, revision, withdrawal or incorporation into other ACOG guidelines.

This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on or by calling the ACOG Resource Center.

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The American College of Obstetricians and Gynecologists (ACOG), is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care.