National Center for Health Research, September 23, 2019
National Center for Health Research’s Public Comments on
the USPSTF’s Draft Recommendation Statement for
Hepatitis C Virus Infection in Adolescents and Adults: Screening
Thank you for the opportunity to express our views on the U.S. Preventive Services Task Force (USPSTF) draft recommendation regarding screening for hepatitis C. Virus (HCV) in adolescents and adults. The National Center for Health Research is a nonprofit think tank that conducts, analyzes, and scrutinizes research, policies, and programs on a range of issues related to health and safety. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
In general, we support the USPSTF draft recommendation related to HCV screening in adults ages 18-79; however, we are concerned about the potential for anxiety, stress, and other psychological harms for patients who are diagnosed with HCV but cannot afford to obtain treatment. Research is needed to evaluate that risk, and it should be considered in the USPSTF recommendations. In addition, clinicians should discuss with their patients whether screening is appropriate, particularly when the cost of treatment would be prohibitive.
As discussed in the recommendation and review, the majority of people with acute HCV eventually develop chronic hepatitis, and increased screening may allow earlier detection and intervention. Screening is of particular importance for high risk populations such as individuals who partake in injection drug use and pregnant persons. However, we also agree with the inclusion of the general population, as this may detect infections in people who otherwise would not have been screened.
It is also important to highlight where new research is needed, to better inform future recommendations. In particular, studies are needed to determine the optimal repeat testing intervals for people with high-risk of contracting HCV, which will allow for more standardized and efficient screening.
Thank you for the opportunity to comment on HCV screening.
For questions or more information, please contact Stephanie Fox-Rawlings, PhD at the National Center for Health Research at firstname.lastname@example.org or at (202) 223-4000.