SCREENING AND DIAGNOSIS 

In Canada, the Public Health Agency of Canada advocates for a risk-based screening approach for hepatitis C. Individuals who have or had engaged in activities which increase the likelihood of coming into contact with contaminated blood or blood products should be screened including:

  • IDU or sharing contaminated drug equipment, even once. 
  • Receipt of health care or personal services, where there is a lack of infection prevention and control practices
  • Receipt of a blood transfusion, blood products or organ transplant before 1992 in Canada
  • Birth or residence in a region where hepatitis C is more common (prevalence >3%), including Central, East and South Asia; Australasia and Oceania; Eastern Europe; Sub-Saharan Africa; and North Africa/Middle East
  • Other Risks:
    • Sharing personal care items with someone who is HCV-positive
    • Participating in risky sexual activity
    • Being born to a mother who is HCV-positive


In more recent years, there has been increased advocacy in North America for one-time screening of the "baby boomer" population (individuals born between 1945 and 1965) regardless of their risk factors. Individuals in this age group are estimated to have the highest prevalence of the disease in the USA, accounting for 75% of all HCV infections. This group is also the most likely to have more advanced disease and therefore be at higher risk for significant complications as a result of long term HCV infection. In 2012, the Centers for Disease Control (CDC) issued a recommendation to screen all those born between 1945 and 1965 one-time for hepatitis C. Following this, the Canadian Liver Foundation issued a similar position statement for the Canadian population but expanded the birth cohort to also include those born up to 1975 citing national prevalence data and patterns of immigration for HCV-endemic countries. 



For Healthcare Providers: What do I do with a newly identified HCV positive patient?

If you think you should be tested for hepatitis C you can contact the RECAP Clinic for a free appointment to be tested. We use rapid on-site testing (OraQuik) and with just a finger prick we can give you your results in as little as 20 minutes. Contact us at 657-5699!


If you are positive, we'll make sure all of the education and follow up care you need is there for you right in our clinic. 

Once your patient has been confirmed as both HCV-antibody and HCV-PCR positive, how do you proceed?  Here is a straightforward guide to referring your patient and what tests they will need in advance to being seen by a specialist for their HCV:


Serology

  • HCV viral load & genotype
  • HIV screen
  • HBsAg 
  • HBsAb
  • HAV IgG
  • RPR (rapid plasma reagin)


Haematology/Chemistry

  • CBC
  • ALT
  • Bilirubin
  • Albumin
  • PT/INR
  • Creatinine


 Diagnostic Imaging

  • Routine abdominal ultrasound


Referral

  • Once the above testing has been arranged, patients can easily be referred to one of the primary HCV specialists in New Brunswick using this form.  Please ensure that all requested information is completed and supporting documentation included along with any other information you feel is pertinent for the HCV specialist to be aware of. 
The path of hepatitis C testing and interpretation of results 

In Canada, the Public Health Agency of Canada advocates for a risk-based screening approach for hepatitis C. Individuals who have or had engaged in activities which increase the likelihood of coming into contact with contaminated blood or blood products should be screened including:

  • Intravenous drug use or sharing contaminated drug equipment (like spoons, crack pipes, straws, wash), even once. 
  • Receipt of health care or personal services, where there is a lack of infection prevention and control practices
  • Receipt of a blood transfusion, blood products or organ transplant before 1992 in Canada
  • Birth or residence in a region where hepatitis C is more common (prevalence >3%), including Central, East and South Asia; Australasia and Oceania; Eastern Europe; Sub-Saharan Africa; and North Africa/Middle East
  • Other Risks:
    • Sharing personal care items with someone who is HCV-positive
    • Participating in risky sexual activity
    • Being born to a mother who is HCV-positive


In more recent years, there has been increased advocacy in North America for one-time screening of the "baby boomer" population (individuals born between 1945 and 1965) regardless of their risk factors. Individuals in this age group are estimated to have the highest prevalence of the disease in the USA, accounting for 75% of all HCV infections. This group is also the most likely to have more advanced disease and therefore be at higher risk for significant complications as a result of long term HCV infection. In 2012, the Centers for Disease Control (CDC) issued a recommendation to screen all those born between 1945 and 1965 one-time for hepatitis C. Following this, the Canadian Liver Foundation issued a similar position statement for the Canadian population but expanded the birth cohort to also include those born up to 1975 citing national prevalence data and patterns of immigration for HCV-endemic countries. 

Screening and Diagnosis

Hepatitis C: Who should be tested?