BOX 5-5

Summary of CDC At-Risk Populations for Hepatitis C Virus Infection

  • Persons who have ever injected illegal drugs, including those who injected only once many years ago

  • Recipients of clotting-factor concentrates made before 1987

  • Recipients of blood transfusions or solid-organ transplants before July 1992

  • Patients who have ever received long-term hemodialysis treatment

  • Persons who have known exposures to HCV, such as

    • Health-care workers after needlesticks involving HCV-positive blood

    • Recipients of blood or organs from donors who later tested HCV-positive

  • All persons who have HIV infection

  • Patients who have signs or symptoms of liver disease (for example, abnormal liver-enzyme tests)

  • Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before the age of 18 months)

Abbreviation: HCV, hepatitis C virus.

SOURCE: CDC, 2001.

naires to assess a person’s potential exposure to HCV infection. It has been found to correlate with infection status and is an effective mechanism for identifying candidates for testing (Armstrong et al., 2006; McGinn et al., 2008; Zuniga et al., 2006). Armstrong et al. (2006) reported that 85% of HCV-infected people could be identified on the basis of three risk factors: injection-drug use, blood transfusion before 1992, and abnormal serum alanine aminotransferase levels. Additional studies have also found that questioning patients about exposures to known risk factors for hepatitis C is predictive of HCV infection in US veterans (Zuniga et al., 2006). People who are current or past users of illicit drugs may not fit the stereotype of an IDU, so all patients should be questioned about any past episode of illicit-drug injection. It has also been suggested that people who have tattoos and body piercings should be tested for HCV (Carey, 2003). Researchers who were evaluating hepatitis C incidence along the Texas–Mexico border found tattooing to be an independent risk factor for infection in their majority-Hispanic population (Hand and Vasquez, 2005). However, it is



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