Screening Veterans for Hepatitis C Infection

Hepatitis C is an important public health issue in the veteran community. Since 1998, the Veterans Health Administration has initiated and implemented a comprehensive National Hepatitis C Program to screen veterans for HCV.

The VHA has developed the Hepatitis C Virus (HCV) Testing and Prevention Counseling Guidelines for VA Health Care Practitioners to offer guidelines to providers in a variety of VA settings who

• assist veterans in identifying their HCV status,
• provide education,
• and help facilitate behavior changes that will reduce their risk of acquiring or transmitting HCV.

The following is a list of criteria that the VA uses to screen veterans for HCV infection:

• Patient desires to be tested, or
• One or more of the following risks are identified:
  • Prior or current intravenous drug use
  • Blood transfusion or organ transplantation prior to 1992
  • Hemodialysis
  • Vietnam-era Veteran, defined by dates of service from 1964 through 1975
  • Health care, emergency medical care, emergency medical and public safety workers after a needlestick injury or mucosal exposure to HCV-positive blood
  • Tattoos or body-piercings obtained in non-regulated settings
  • Intranasal drug users who have shared paraphernalia
  • Past sexual exposure to an HCV infected partner or 10 or more lifetime sexual partners
  • Current sexual partners of HCV-infected persons
  • Persons with HIV infection
  • History of hemophilia and received clotting factor concentrates prior to 1987
  • History of unexplained liver disease or abnormal liver function test
  • Persons who have alcoholic hepatitis or a diagnosis (DSM-IV) of alcohol abuse or dependence.
  • Born to a mother with HCV

Clinicians are urged to utilize the Hepatitis C Virus Antibody Screening Flow Chart if there is a presence or history of any of the above criteria. To learn more about diagnostic tests for HCV, please see the provider education section on Laboratory Tests and HCV.