With regards to the approach I would say that the patient characteristics and epidemiology have to be more closely linked to the approach they outline, for example if I had a person with past IDU with a single abnormal elevation I would screen them for at least HIV, HCV, HBV and not repeat the enzymes before doing so.  The case has been made for screening all people regardless for HIV and HCV and CDC recommends screening all adults born between 1945 and 1965 for HCV.

Any comments?