Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease

Persons for whom routine hepatitis C virus (HCV) testing is of uncertain need

For persons at potential (or unknown) risk for HCV infection, the need for, or effectiveness of, routine testing has not been determined.

Recipients of Transplanted Tissue

On the basis of currently available data, risk for HCV transmission from transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, or sperm) appears to be rare.

Intranasal Cocaine and Other Noninjecting Illegal Drug Users

Currently, the strength of the association between intranasal cocaine use and HCV infection does not support routine testing based solely on this risk factor.

Persons with a History of Tattooing or Body Piercing

Because no data exist in the United States documenting that persons with a history of such exposures as tattooing and body piercing are at increased risk for HCV infection, routine testing is not recommended based on these exposures alone. In settings having a high proportion of HCV-infected persons and where tattooing and body piercing might be performed in an unregulated manner (e.g., correctional institutions), these types of exposures might be a risk factor for HCV infection. Data are needed to determine the risk for HCV infection among persons who have been exposed under these conditions.

Persons with a History of Multiple Sex Partners or STDs

Although persons with a history of multiple sex partners or treatment for STDs and who deny injecting-drug use appear to have an increased risk for HCV infection, insufficient data exist to recommend routine testing based on these histories alone. Health-care professionals who provide services to persons with STDs should use that opportunity to take complete risk histories from their patients to ascertain the need for HCV testing, provide risk-reduction counseling, offer hepatitis B vaccination, and, if appropriate, hepatitis A vaccination.

Long-Term Steady Sex Partners of HCV-Positive Persons

HCV-positive persons with long-term steady partners do not need to change their sexual practices. Persons with HCV infection should discuss with their partner the need for counseling and testing. If the partner chooses to be tested and tests negative, the couple should be informed of available data regarding risk for HCV transmission by sexual activity to assist them in making decisions about precautions (see section regarding counseling messages for HCV-positive persons). If the partner tests positive, appropriate counseling and evaluation for the presence or development of liver disease should be provided.