Cochrane for Clinicians
Putting Evidence into Practice
Screening for Hepatitis C Virus Infection in Adolescents and Adults
Am Fam Physician. 2020 Sep 15;102(6):367-368.
Author disclosure: No relevant financial affiliations.
Case Study
M.S. is a 20-year-old man who presents for a preemployment physical examination. He states that he is single, has two or three drinks per month on social occasions, does not smoke, is sexually active, and does not use illicit drugs.
Case Study Questions
1. According to the U.S. Preventive Services Task Force (USPSTF), which one of the following statements indicates why screening for hepatitis C virus (HCV) infection should be discussed and offered to M.S.?
A. HCV infection is primarily acquired via sexual transmission.
B. The patient's moderate intake of alcohol puts him at increased risk of HCV infection.
C. All adults 18 to 79 years of age should be screened.
D. Adult men are at increased risk of HCV infection.
2. According to the USPSTF, which one of the following statements about screening for HCV infection is correct?
A. If the test result is negative and risk factors remain unchanged, the patient should be rescreened in five years.
B. There is adequate evidence on the timing of repeat testing in people who continue to be at risk of new HCV infection.
C. There is adequate evidence to recommend onetime testing in all adults and periodic testing in people at continued risk of new HCV infection.
D. There is inadequate evidence that HCV testing accurately detects HCV infection.
3. According to the USPSTF, which of the following statements about potential harms associated with screening and treatment for HCV infection are correct?
A. Anxiety, patient labeling, and feelings of stigmatization are potential harms of screening.
B. The most common adverse effects of direct-acting antiviral regimens are fatigue, headache, nausea, and diarrhea.
C. Direct-acting antiviral regimens are associated with fewer harms than older interferon-containing therapies.
D. Direct-acting antiviral therapy commonly causes serious adverse effects that require additional medication.
Answers
1. The correct answer is C. The USPSTF recommends screening for HCV infection in asymptomatic adults 18 to 79
References
1. Owens DK, Davidson KW, Krist AH, et al. Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(10):970–975.
2. Chou R, Dana T, Fu R, et al. Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020;323(10):976–991.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening#fullrecommendationstart.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
Copyright © 2020 by the American Academy of Family Physicians.
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