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March 24, 2020

Updated guidelines recommend all adults screen for hepatitis C, regardless of risk

By GlobalData Healthcare

The US Preventive Services Task Force (USPSTF) recently released new guidelines, in early March, for the screening of hepatitis C virus infections, last updated in 2013.

The new recommendation expands screening to all adults ages 18 to 79 years, as opposed to previously only screening in high-risk individuals and adults born between 1945 and 1965. The updated recommendations come in response to the opioid crisis paired with the high proportion of undiagnosed asymptomatic cases, both of which have driven a significant increase in new cases over the past several years.

According to estimates from the US Centers for Disease Control and Prevention (CDC), new cases of hepatitis c have increased from approximately 30,000 cases in 2013 to 45,000 cases in 2017 (as shown in Figure 1). The CDC data demonstrate a startling 50% increase in cases over a five-year period. This is primarily fueled by the opioid epidemic and a high prevalence of injection drug use; in 2017, about 90% of hepatitis c cases with an identified risk were attributable to injection drug use alone. With these numbers in mind, it is important to note that the CDC estimates adjust for under-reporting and under-ascertainment, and therefore represent the total incident population of hepatitis c (both diagnosed and undiagnosed cases). The true number of newly diagnosed cases of hepatitis c is far lower due to a high proportion of individuals who present as asymptomatic, and are unaware of their infection status.

According to primary market research conducted by GlobalData, about one-third of total incident hepatitis c cases are actually diagnosed (as shown in the image). With the expanded screening criteria, GlobalData epidemiologists expect that the number of truly diagnosed incident cases will substantially increase over the next five years, with hepatitis c case numbers approaching those estimated by the CDC. Ultimately, the higher screening uptake will serve to more accurately identify the true burden of the disease allow for earlier detection, and improve related health outcomes in the US.

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