The Canadian Task Force on Preventive Health Care recommends against screening for chronic hepatitis C virus (HCV) in adults at low risk in a guideline published in CMAJ (Canadian Medical Association Journal).
"Given the lack of direct evidence that mass screening is beneficial and that patients identified by screening will either never develop symptoms of hepatitis C, or will remain well for decades after infection, we have recommended 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 work group.
This is the first hepatitis C screening guideline from the task force. The task force looked for the highest-quality scientific evidence available about the effectiveness (benefits and harms) of screening to develop its recommendation. The recommendation is based on the following:
• the low prevalence of hepatitis C in Canada among the general adult population not at elevated risk for chronic infection;
• the lack of direct evidence on the benefits and harms of screening;
• many individuals with chronic hepatitis C identified by screening would not have timely access to anti-viral treatment;
• the potential for harms caused by screening could include labeling, stigma, and difficulties with insurance;
• the low risk of household and sexual transmission of HCV among individuals not at elevated risk, as well as the low risk of transmission through blood products given routine screening of blood and organs; and
• the anticipated increase in harm resulting from diagnosing and treating individuals who screen positive, but would have never developed HCV-related disease during their lifetime.
This recommendation is for people who are not at increased risk of hepatitis C. It does not apply to pregnant women or people at increased risk, including:
• people with current or past history of injection drug use;
• people who have been in jail;
• people who were born, travelled or lived in hepatitis C endemic countries;
• people who have received health care where there is a lack of universal precautions to protect against viral transmission;
• recipients of blood transfusions, blood products or an organ transplant before 1992 in Canada;
• hemodialysis patients;
• people who have had needle stick injuries;
• people who have engaged in other behaviors associated with hepatitis C exposure such as high-risk sexual behavior, homelessness, intranasal and inhalation drug use, tattooing, body piercing or sharing sharp instruments or personal hygiene materials with someone who is hepatitis C-positive; and
• anyone with clinical clues suspicious for hepatitis C infection.
"The HCV prevalence in most adults in the general Canadian population is low and direct evidence examining the benefits and harms of screening for HCV is not available," write the authors. "Not screening for HCV [in the general population] will help focus our limited health care resources to test (and treat) individuals at elevated risk for HCV and to provide other medical interventions that are of proven to be of benefit."
Source: Canadian Medical Association Journal
Endoscopes and Lumened Instruments: New Studies Highlight Persistent Contamination Risks
May 7th 2025Two new studies reveal troubling contamination in both new endoscopes and cleaned lumened surgical instruments, challenging the reliability of current reprocessing practices and manufacturer guidelines.
Happy Hand Hygiene Day! Rethinking Glove Use for Safer, Cleaner, and More Ethical Health Care
May 5th 2025Despite their protective role, gloves are often misused in health care settings—undermining hand hygiene, risking patient safety, and worsening environmental impact. Alexandra Peters, PhD, points out that this misuse deserves urgent attention, especially today, World Hand Hygiene Day.