New US guidelines urge a hepatitis C check for most adults

Most American adults need to be checked for hepatitis C, say guidelines released Monday that urge millions more people to get screened for the liver-damaging virus that can fester for decades it's spotted.

The call for expanded screening for Americans ages 18 to 79 is the first since 2013 when U.S. health authorities urged all baby boomers to get a one-time hepatitis C test because that age group appeared at particularly high risk.

The U.S. Preventive Services Task Force said Monday that hepatitis C is on the rise because of the opioid crisis, prompting the recommendation to expand testing.

Finding infection early is critical now that drugs are available that cure most people after two to three months of treatment. And the price of those costly medications has dropped sharply in recent years.

Authorities estimate that only about half of people with hepatitis C know they're infected. The task force concluded that more widespread screening would be cost-saving, giving its recommendation a rating that requires insurance companies to cover testing without patient co-pays.

About 2.4 million people in the U.S. are living with hepatitis C, and there were an estimated 44,700 new infections in 2017 alone, the task force reported in the Journal of the American Medical Association.

That's largely due to the opioid epidemic: The most rapid increase in infections over the past decade has been in young adults, 20- to 39-year-olds who inject drugs, the task force found. Sharing needles is the main way that hepatitis C spreads in the U.S.

"It is time to revisit the effective but now outdated baby boomer screening recommendations, and the updated recommendations ... are welcome," Drs. Camilla Graham of Harvard Medical School and Stacey Trooskin of the University of Pennsylvania wrote in an accompanying editorial.

They weren't involved in the guidelines, but cautioned that in addition to virus testing, greater access to hepatitis C treatment and addiction treatment are needed.

While there's limited information on hepatitis C infections in teens, the task force said doctors may consider screening those known to be at risk because of past or current drug use.