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The U.S. Centers for Disease Control and Prevention has recommended hepatitis C screening for all Americans born between 1945 and 1965. 

The new recommendations will be published in Annals of Internal Medicine, the flagship journal of the American College of Physicians.

Is is estimated that nearly 4 million people in the United States are infected with HCV, a virus that can cause inflammation and permanent liver damage. The infection is most prevalent among people born from 1945 through 1965, and approximately 50 to 75 percent of those with HCV are unaware that they are infected. This is a problem because HCV progresses slowly, and the risk of serious complications increases as time passes.

CDC also recommends that all persons identified with HCV should receive a brief alcohol screening and intervention and be referred to appropriate care and treatment services for HCV and related conditions. Alcohol use has been shown to accelerate the progression of liver disease. In a review of several published study, the CDC reports that patients who had a brief alcohol reduction intervention reduced their weekly alcohol consumption by an average of 38.42 grams compared with those who had no intervention.

Up to 75 percent of people with HCV do not know that they are infected. 

In the past, the CDC recommended antibody screening only of individuals with health or lifestyle indicators suggesting potential infection. These indicators include a history of injecting drugs, having a blood transfusion before 1992, or being a chronic hemodialysis patient. Low case identification may result from the difficulty of implementing risk-based screening given the limited time of primary care visits and unease in discussing behavioral risks.