Hepatitis C Screening and Evaluation Clinical Decision Support Tool

strong Strong recommendation based on strong evidence. weak Evidence not sufficient; recommendation to include is based on expert opinion.

Screen at least once per lifetime
Screen at least once annually

Adults born between 1945–1965 who have never been evaluated for HCV.

Detail

Patients with previous high risk factors, including any blood transfusions prior to 1992 or history of intravenous drug use.

Detail

Patients with current injection drug use

Detail

Conduct hepatitis C antibody testing.

Detail

Conduct quantitative HCV RNA testing.

Detail

Patients with previous high risk factors, including any blood transfusions prior to 1992 or history of intravenous drug use.

Detail

Testing, vaccinations, and screening for confirmed HCV viremia.

ORDER INITIAL LABORATORY TESTS
HAV & HBV VACCINATION
ALCOHOL SCREENING/
COUNSELING

Comprehensive metabolic panel

Detail

HCV genotype

Detail

Administer HAV vaccination

Detail

Conduct alcohol screening and intervention as clinically indicated.

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INR

Detail

CBC/diff/
platelets

Detail

HIV Antibody

Detail

HBV surface antigen

Detail

HBV vaccinations if the patient does not have documented immunity

Detail

Determine treatment plan

Make decisions regarding liver disease severity, treatment
and other evaluations as appropriate.

Refer to care and treatment services for HCV infection, liver disease and other related conditions.

The Hepatitis C Screening and Evaluation: Clinical Decision Tool was originally published in Gastroenterology. The citation should state “Allen JI. The Hepatitis C Screening and Evaluation: Clinical Decision Tool. Gastroenterology 2013; 145(5):1144-45.
A print-friendly version of this tool is also available for download as a PDF. To learn more about the “Hepatitis C Screening and Evaluation: Clinical Decision Tool,” visit the official Hepatitis C Screening and Evaluation Clinical Decision Tool Guideline.

2013 © American Gastroenterological Association

strong Decision Point # 1: Adults born between 1945- 65 who have never been evaluated for HCV


i. CDC. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR. 2012;61(RR- 4):1-32.

ii. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159:349-357.

×

strong Decision Point # 2: Those at high risk, including any blood transfusions prior to 1992, or history of intravenous drug use.


ii. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159:349-357.

×

strong Decision Point # 3: Testing for current intravenous drug users.


ii. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159:349-357.

×

strong Decision Point #4: Hepatitis C antibody testing.


ii. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159:349-357.

×

strong Decision Point #5: Quantitative HCV RNA testing


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

iv. European Association for the Study of the Liver. EASL clinical practice guidelines: Management of hepatitis c virus infection. J Hepatol. 2011;55:245-264.

v. CDC. Recommendations for prevention and control of hepatitis c virus (HCV) infection and HCV-related chronic disease. MMWR. 1998;47(RR-19):1-39.

×

strong Decision Point #6: Counseling and retesting and other testing as appropriate.


v. CDC. Recommendations for prevention and control of hepatitis c virus (HCV) infection and HCV-related chronic disease. MMWR. 1998;47(RR-19):1-39.

×

strong Decision Point #7: Initial test for HCV: comprehensive metabolic panel.


ii. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159:349-357.

×

strong Decision Point #8: Initial test for HCV: HCV genotype.


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

iv. European Association for the Study of the Liver. EASL clinical practice guidelines: Management of hepatitis c virus infection. J Hepatol. 2011;55:245-264.

×

strong Decision Point #9: Initial test for HCV: international normalized ratio.


vi. Federal Bureau of Prisons. Evaluation and treatment of hepatitis C guideline, Federal Bureau of Prisons, March 2012, Washington DC.

×

strong Decision Point #10: Initial test for HCV: complete blood count and differential.


vi. Federal Bureau of Prisons. Evaluation and treatment of hepatitis C guideline, Federal Bureau of Prisons, March 2012, Washington DC.

×

strong Decision Point #11: Initial test for HCV: HIV antibody.


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

×

strong Decision Point #12: Initial test for HCV: HBV. surface antigen.


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

×

strong Decision Point #13: Administer HAV vaccination if no documented immunity.


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

×

strong Decision Point #14: Administer HBV vaccination if no documented immunity.


iii. G hany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology. 2009;49:1335-1374.

×

strong Decision Point #15: Conduct brief alcohol screening and intervention as clinically indicated.


i. CDC. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR. 2012;61(RR- 4):1-32.

×