Screening for hepatitis C virus infection: a review of the evidence for the U.S. Preventive Services Task Force

[Guest guest]

Ann Intern Med. 2004 Mar 16;140(6):465-79. Related Articles, Links

Screening for hepatitis C virus infection: a review of the evidence for the

U.S. Preventive Services Task Force.

Chou R, EC, Helfand M; U.S. Preventive Services Task Force.

Oregon Health & Science University and the Veterans Affairs Medical Center,

Portland, Oregon 97239, USA.

BACKGROUND: Hepatitis C virus (HCV) is the most common bloodborne pathogen

in the United States and is an important cause of patient morbidity and

mortality, but it is unclear whether screening to identify asymptomatic

infected persons is appropriate. PURPOSE: To synthesize the evidence on

risks and benefits of screening for HCV infection. DATA SOURCES: MEDLINE

(through February 2003), Cochrane Clinical Trials Registry (2002, Issue 2),

reference lists, and experts. STUDY SELECTION: Controlled studies of

screening and antiviral therapy and observational studies on other

interventions, risk factors, accuracy of antibody testing, work-up, harms of

biopsy, and long-term outcomes. DATA EXTRACTION: Using preset criteria, the

authors assessed the quality of included studies and abstracted information

about settings, patients, interventions, and outcomes. DATA SYNTHESIS: There

are no published trials of screening for HCV infection. Approximately 2% of

U.S. adults have HCV antibodies, with the majority having chronic infection.

Risk factor assessment could identify adults at substantially higher risk.

Antiviral treatment can result in a sustained virologic response rate of 54%

to 56%, but no trials have been done specifically in asymptomatic patients

likely to be identified by screening. Data are insufficient to determine

whether treatment improves long-term outcomes. There are no data to estimate

the benefit from counseling or immunizations. Although risks of biopsy and

treatment appear minimal or self-limited, data on other adverse effects of

screening, such as labeling or anxiety, are sparse. CONCLUSIONS: Antiviral

treatment can successfully eradicate HCV, but data on long-term outcomes in

populations likely to be identified by screening are lacking. Although the

yield from targeted screening, particularly in intravenous drug users, would

be substantially higher than in the general population, data are inadequate

to accurately weigh the overall benefits and risks of screening in otherwise

healthy asymptomatic adults.

PMID: 15023713 [PubMed - in process]

[Guest guest]

Ann Intern Med. 2004 Mar 16;140(6):465-79. Related Articles, Links

Screening for hepatitis C virus infection: a review of the evidence for the

U.S. Preventive Services Task Force.

Chou R, EC, Helfand M; U.S. Preventive Services Task Force.

Oregon Health & Science University and the Veterans Affairs Medical Center,

Portland, Oregon 97239, USA.

BACKGROUND: Hepatitis C virus (HCV) is the most common bloodborne pathogen

in the United States and is an important cause of patient morbidity and

mortality, but it is unclear whether screening to identify asymptomatic

infected persons is appropriate. PURPOSE: To synthesize the evidence on

risks and benefits of screening for HCV infection. DATA SOURCES: MEDLINE

(through February 2003), Cochrane Clinical Trials Registry (2002, Issue 2),

reference lists, and experts. STUDY SELECTION: Controlled studies of

screening and antiviral therapy and observational studies on other

interventions, risk factors, accuracy of antibody testing, work-up, harms of

biopsy, and long-term outcomes. DATA EXTRACTION: Using preset criteria, the

authors assessed the quality of included studies and abstracted information

about settings, patients, interventions, and outcomes. DATA SYNTHESIS: There

are no published trials of screening for HCV infection. Approximately 2% of

U.S. adults have HCV antibodies, with the majority having chronic infection.

Risk factor assessment could identify adults at substantially higher risk.

Antiviral treatment can result in a sustained virologic response rate of 54%

to 56%, but no trials have been done specifically in asymptomatic patients

likely to be identified by screening. Data are insufficient to determine

whether treatment improves long-term outcomes. There are no data to estimate

the benefit from counseling or immunizations. Although risks of biopsy and

treatment appear minimal or self-limited, data on other adverse effects of

screening, such as labeling or anxiety, are sparse. CONCLUSIONS: Antiviral

treatment can successfully eradicate HCV, but data on long-term outcomes in

populations likely to be identified by screening are lacking. Although the

yield from targeted screening, particularly in intravenous drug users, would

be substantially higher than in the general population, data are inadequate

to accurately weigh the overall benefits and risks of screening in otherwise

healthy asymptomatic adults.

PMID: 15023713 [PubMed - in process]

[Guest guest]

Ann Intern Med. 2004 Mar 16;140(6):465-79. Related Articles, Links

Screening for hepatitis C virus infection: a review of the evidence for the

U.S. Preventive Services Task Force.

Chou R, EC, Helfand M; U.S. Preventive Services Task Force.

Oregon Health & Science University and the Veterans Affairs Medical Center,

Portland, Oregon 97239, USA.

BACKGROUND: Hepatitis C virus (HCV) is the most common bloodborne pathogen

in the United States and is an important cause of patient morbidity and

mortality, but it is unclear whether screening to identify asymptomatic

infected persons is appropriate. PURPOSE: To synthesize the evidence on

risks and benefits of screening for HCV infection. DATA SOURCES: MEDLINE

(through February 2003), Cochrane Clinical Trials Registry (2002, Issue 2),

reference lists, and experts. STUDY SELECTION: Controlled studies of

screening and antiviral therapy and observational studies on other

interventions, risk factors, accuracy of antibody testing, work-up, harms of

biopsy, and long-term outcomes. DATA EXTRACTION: Using preset criteria, the

authors assessed the quality of included studies and abstracted information

about settings, patients, interventions, and outcomes. DATA SYNTHESIS: There

are no published trials of screening for HCV infection. Approximately 2% of

U.S. adults have HCV antibodies, with the majority having chronic infection.

Risk factor assessment could identify adults at substantially higher risk.

Antiviral treatment can result in a sustained virologic response rate of 54%

to 56%, but no trials have been done specifically in asymptomatic patients

likely to be identified by screening. Data are insufficient to determine

whether treatment improves long-term outcomes. There are no data to estimate

the benefit from counseling or immunizations. Although risks of biopsy and

treatment appear minimal or self-limited, data on other adverse effects of

screening, such as labeling or anxiety, are sparse. CONCLUSIONS: Antiviral

treatment can successfully eradicate HCV, but data on long-term outcomes in

populations likely to be identified by screening are lacking. Although the

yield from targeted screening, particularly in intravenous drug users, would

be substantially higher than in the general population, data are inadequate

to accurately weigh the overall benefits and risks of screening in otherwise

healthy asymptomatic adults.

PMID: 15023713 [PubMed - in process]

[Guest guest]

Ann Intern Med. 2004 Mar 16;140(6):465-79. Related Articles, Links

Screening for hepatitis C virus infection: a review of the evidence for the

U.S. Preventive Services Task Force.

Chou R, EC, Helfand M; U.S. Preventive Services Task Force.

Oregon Health & Science University and the Veterans Affairs Medical Center,

Portland, Oregon 97239, USA.

BACKGROUND: Hepatitis C virus (HCV) is the most common bloodborne pathogen

in the United States and is an important cause of patient morbidity and

mortality, but it is unclear whether screening to identify asymptomatic

infected persons is appropriate. PURPOSE: To synthesize the evidence on

risks and benefits of screening for HCV infection. DATA SOURCES: MEDLINE

(through February 2003), Cochrane Clinical Trials Registry (2002, Issue 2),

reference lists, and experts. STUDY SELECTION: Controlled studies of

screening and antiviral therapy and observational studies on other

interventions, risk factors, accuracy of antibody testing, work-up, harms of

biopsy, and long-term outcomes. DATA EXTRACTION: Using preset criteria, the

authors assessed the quality of included studies and abstracted information

about settings, patients, interventions, and outcomes. DATA SYNTHESIS: There

are no published trials of screening for HCV infection. Approximately 2% of

U.S. adults have HCV antibodies, with the majority having chronic infection.

Risk factor assessment could identify adults at substantially higher risk.

Antiviral treatment can result in a sustained virologic response rate of 54%

to 56%, but no trials have been done specifically in asymptomatic patients

likely to be identified by screening. Data are insufficient to determine

whether treatment improves long-term outcomes. There are no data to estimate

the benefit from counseling or immunizations. Although risks of biopsy and

treatment appear minimal or self-limited, data on other adverse effects of

screening, such as labeling or anxiety, are sparse. CONCLUSIONS: Antiviral

treatment can successfully eradicate HCV, but data on long-term outcomes in

populations likely to be identified by screening are lacking. Although the

yield from targeted screening, particularly in intravenous drug users, would

be substantially higher than in the general population, data are inadequate

to accurately weigh the overall benefits and risks of screening in otherwise

healthy asymptomatic adults.

PMID: 15023713 [PubMed - in process]