Screening for Hepatitis C

Primary care physicians urged to offer a one-time screen to all baby boomers

State lawmakers could approve legislation mandating that Hepatitis C screening be offered to all individuals born between 1945 and 1965 and others at high risk who receive hospital inpatient services or hospital emergency department care. The legislation would also apply to Baby Boomers and high-risk groups who receive primary care services in an outpatient hospital department or from a primary care provider, unless the practitioner believes that certain conditions are not present.

Both the Illinois State Medical Society and the Chicago Medical Society oppose enforcement of such regulations by the General Assembly because it encroaches on physician autonomy. ISMS also points out that the legislative proposal does not offer immunity for health care professionals from criminal and civil liability and from professional discipline for failure to offer HCV screening. Nor does it put in place any guarantee that patients who test positive for HVC could access treatment. Not all insurers cover the cost of screening and treatment; many screened individuals would turn out not to have HVC.

However, both ISMS and CMS urge primary care physicians to offer a one-time screening to their Baby Boomer patients and high-risk populations, consistent with the updated U.S. Preventive Services Task Force guidelines, which recommend screening for persons at high risk, and a one-time screening for adults born between 1945 and 1965. In reviewing the prevalence data on high-risk groups and the potential for reduced transmission, the USPSTF concluded that screening in high-risk persons (prevalence ≥50%) and the birth cohort (prevalence of 3% to 4%) would have a moderate net benefit.

The Centers for Disease Control estimates that a one-time screening in Illinois alone would find about 40,000 undiagnosed Hepatitis C cases. Currently, an estimated 160,000 Illinoisans suffer from HCV infection, the most common chronic blood borne infection in the United States, and the leading cause of chronic liver disease. Both ISMS and CMS are working to raise awareness with physicians, group practices and health systems about the updated screening guidelines and the availability of newer treatments that most patients can well tolerate and benefit from.