In the United States alone, 2.3 million adults are infected with the hepatitis C virus2

HCV is largely asymptomatic2

Most people with chronic HCV infection have nonspecific symptoms,
such as chronic fatigue and depression2

Around 40% of people may not know they're infected.

New HCV infections are rapidly increasing among4,5:

Patients from ages 20 to 39

Caucasian females and males

Those living in rural areas

Injection drug users

Injection drug use accounts for approximately



Who should be tested for HCV?

AASLD & IDSA Guideline recommendations for hepatitis C testing6:


One-time, routine, opt-out HCV testing is recommended for all individuals aged 18 years and older.

One-time HCV testing should be performed for all persons less than 18 years old with behaviors, exposures, or conditions or circumstances associated with an increased risk of HCV infection (see below).

Periodic repeat HCV testing should be offered to all persons with behaviors, exposures, or conditions or circumstances associated with an increased risk of HCV exposure (see below).

Annual HCV testing is recommended for all persons who inject drugs and for HIV-infected men who have unprotected sex with men.

Risk behaviors6:

Injection drug use (current or ever, including those who injected only once)

Intranasal illicit drug use

Men who have sex with men

Risk exposures6:

Persons on long-term hemodialysis (ever)

Healthcare, emergency medical, and public safety workers after needlestick, sharps, or mucosal exposure to HCV-infected blood

Persons with percutaneous/parenteral exposures in an unregulated setting

Children born to HCV-infected women

Prior recipients of a transfusion or organ transplant, including persons who:

  • Were notified that they received blood from a donor who later tested positive for HCV
  • Received clotting factor concentrates produced before 1987
  • Received a transfusion of blood or blood components, or underwent an organ transplant, before July 1992

Persons who were ever incarcerated

Risk conditions and circumstances6:

HIV infection

Unexplained chronic liver disease, including elevated alanine aminotransferase (ALT) levels

Sexually active persons about to start pre-exposure prophylaxis (PrEP) for HIV

Solid organ donors (living and deceased) and solid organ transplant recipients

Refer to AASLD/IDSA guidelines for further details.

CDC recommendations for HCV testing7

Recommended testing sequence for identifying current HCV infection

CDC recommendations for HCV testing chart

*For persons who might have been exposed to HCV within the past 6 months, testing for HCV RNA or follow-up testing for HCV antibody is recommended. For persons who are immunocompromised, testing for HCV RNA can be considered.

To differentiate past, resolved HCV infection from biologic false positivity for HCV antibody, testing with another HCV antibody assay can be considered. Repeat HCV RNA testing if the person tested is suspected to have had HCV exposure within the past 6 months or has clinical evidence of HCV disease, or if there is concern regarding the handling or storage of the test specimen.