Guideline Updated for Hepatitis C Virus in Unique Populations

The hepatitis C virus (HCV) guidelines for unique populations have recently been updated. These guidelines provide new testing and management recommendations for pregnant women, individuals who inject drugs, men who have sex with men (MSM), and individuals who are incarcerated.

Managing HCV in Pregnancy

Approximately 29,000 HCV-infected women gave birth each year from 2011 to 2014.¹The guidelines call for testing all pregnant women for HCV infection, especially at the initiation of prenatal care.¹Women of reproductive age with known HCV infection should receive antiviral therapy before considering pregnancy to reduce the risk of mother-to-child transmission (MTCT), which is about 5-15%. Treatment during pregnancy is not recommended due to the lack of efficacy and safety data.

HCV in Individuals who Inject Drugs

Injection drug use is the most common risk factor for HCV infection in the United States and Europe.¹All individuals who currently inject drugs or have injected drugs in the past should be tested for HCV infection. An HCV-antibody test should be used, and positive results should be confirmed by immediate HCV-RNA testing.

HCV in MSM

Annual HCV testing is recommended for sexually active HIV-infected adolescents, and adult MSM.¹Acute HCV infections have been recently reported in HIV-uninfected MSM who present for pre-exposure prophylaxis (PrEP).¹

HCV in Patients Who Are Incarcerated

The guidelines recommend HCV-antibody testing followed by HCV-RNA testing if antibody-positive.¹Jails and prisons should encourage the continuation of HCV therapy for individuals receiving treatment at the time of incarceration. Individuals diagnosed with HCV while incarcerated should receive DAA therapy and substance use disorder treatment.

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Reference

1. The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C.www.hcvguidelines.org/sites/default/files/full-guidance-pdf/HCVGuidance_May_24_2018a.pdf. Last updated May 24, 2018. Accessed May 25, 2018.