Universal Hepatitis C Screening Among Adults and Treatment for Hepatitis C Virus Infection

What to know

Read about how universal Hepatitis C virus screening in all adults in the United States can save hundreds of thousands of lives and saves money.

A doctor advises a patient about prescription medications.

What Is hepatitis C virus?

Hepatitis C virus (HCV) can cause a serious and sometimes fatal infection of the liver. The virus is spread primarily when blood from an infected person enters the body of someone who is not infected. For some persons, HCV causes no symptoms or only a mild illness which goes away over a few weeks. For the majority of infected persons, untreated HCV can cause serious, chronic illness.

In the United States, approximately 2.4 million persons live with chronic HCV infection.1 About 44% of these persons do not know their HCV status.2 Without screening and diagnosis, these persons cannot take the first step toward receiving lifesaving treatment.

Without treatment, persons with chronic HCV infection can die prematurely. In 2018, approximately 16,000 persons died in the United States because of chronic HCV-infection-related causes.3 In 2020, CDC recommended HCV screening at least once in a lifetime for all adults:

  • aged 18 years or older
  • pregnant people during each pregnancy

Screening is not recommended in settings where there is less than 0.1% HCV infection.4 However, hepatitis C testing regardless of age or setting continues to be recommended for persons with recognized conditions or exposures.4

Benefits of hepatitis C screening and treatment among all adults

Universal screening among all adults leads to improved patient outcomes and lower costs. A cost effectiveness simulation found that screening all adults led to:

  • 280,000 people cured
  • 4,400 fewer cases of hepatocelluar carcinoma
  • Incremental cost-effectiveness ratio of $28,000 per quality adjusted life years (compared to screening only adults born between 1945-1965)5

Cost savings for society and payers

Treatment for HCV infection can be cost saving for society and payers. A systematic review found that the median price at which hepatitis C treatment becomes cost-saving is $70,900 (in USD 2014), with an interquartile range of $43,300-$103,700. The costs of HCV treatment regimens are within or below that range. 6

Additionally, insurance companies negotiate the lowest prices they are willing to pay for medications. Under some commercial plans, the average price continued to decrease by 2018.7

With millions of persons in the U.S. undiagnosed with chronic HCV, routine screening and treatment programs for adults are urgently needed to save lives and money.12

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Content Source:
National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention
  1. Hofmeister MG, Rosenthal EM, Barker LK, et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013–2016. Hepatology 2019;69:1020–31.
  2. Kim HS, Yang JD, El-Serag HB, Kanwal F. Awareness of chronic viral hepatitis in the United States: an update from the National Health and Nutrition Examination Survey. J Viral Hepat 2019;26:596–602.
  3. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance – United States, 2018. Published July 2020. Accessed November 3, 2020.
  4. Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020. MMWR Recomm Rep 2020;69(No. RR-2):1–17. DOI:
  5. Barocas JA, Tasillo A, Eftekhari Yazdi G, et al. Population-level outcomes and cost-effectiveness of expanding the recommendation for age-based hepatitis C testing in the United States. Clin Infect Dis 2018;67:549–56.
  6. Chhatwal J, He T, Hur C, Lopez-Olivo MA. Direct-acting antiviral agents for patients with hepatitis C virus genotype 1 infection are cost-saving. Clin Gastroenterol Hepatol 2017;15:827–37.
  7. Express Scripts. 2018 drug trend report. Accessed November 25, 2020.