Hepatitis B and C testing is required regardless of age for clients with any of the
following risk factors:
• Substance use (includes sharing, drug snorting, smoking or injection
equipment);
• High-risk sexual activity or sexual partner with viral hepatitis;
• Household contact with an infected person especially if personal items
(e.g., razors, toothbrushes, nail clippers) are shared;
• Recipient of unscreened blood products (screening of donated blood
products for hepatitis C began in 1990 in Canada);
• Needle-stick injury or other occupational exposure (e.g., healthcare
workers);
• Children born to mothers with chronic hepatitis B or C infection;
• Tattoos and body piercing;
• History of incarceration;
• HIV or other sexually transmitted infection; and
• Haemodialysis.
Additional investigation required for ALL clients
• All clients with any risk factor for hepatitis B or C must be investigated
and tested for hepatitis B and C serology (HBsAg and HCV antibodies).
• All clients with history of hepatitis B or C/liver disease or signs/symptoms
of liver disease must be investigated and tested for hepatitis B and C
serology (HBsAg and HCV antibodies).
• All clients found with active Tuberculosis (TB), and for HIV or syphilis
positive through the IME must be investigated and tested for hepatitis B
and C serology (HBsAg and HCV antibodies).
• For all clients found to have positive serology for hepatitis B or C, we also
require testing for liver enzyme ALT and referral to a gastroenterologist,
liver specialist or an appropriate alternative specialist for assessment
and determination of the prognosis and the requirement for treatment.
Screening for HIV, if not already done, is also required regardless of age.