Testing for HCV Infection

Jane P. Getchell, DrPH; Kelly E. Wroblewski, MPH; Alfred DeMaria Jr, MD; Christine L. Bean, PhD; Monica M. Parker, PhD; Mark Pandori, PhD; D. Robert Dufour, MD; Michael P. Busch, MD, PhD; Mark E. Brecher, MD; William A. Meyer, PhD; Rick L. Pesano, MD, PhD; Chong-Gee Teo, MD, PhD; Geoffrey A. Beckett, MPH; Aufra C. Araujo, PhD; Bernard M. Branson, MD; Jan Drobeniuc, MD, PhD; Rikita Hatia, MPH; Scott D. Holmberg, MD, MPH; Saleem Kamili, PhD; John W. Ward, MD

Disclosures

Morbidity and Mortality Weekly Report. 2013;62(18):362-365.

Benefits of Testing for Current HCV Infection

Accurate testing to identify current infection is important to 1) help clinicians and other providers correctly identify persons infected with HCV, so that preventive services, care and treatment can be offered; 2) notify tested persons of their infection status, enabling them to make informed decisions about medical care and options for HCV treatment, take measures to limit HCV-associated disease progression (e.g., avoidance or reduction of alcohol intake, and vaccination against hepatitis A and B), and minimize risk for transmitting HCV to others; and 3) inform persons who are not currently infected of their status and the fact that they are not infectious.

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Introduction
Changes in HCV Testing Technologies
Identifying Current HCV Infections
Benefits of Testing for Current HCV Infection
Recommended Testing Sequence
Supplemental Testing for HCV Antibody
Laboratory Reporting
Future Studies
References

Table. Interpretation of results of tests for hepatitis C virus (HCV) infection and further actions
Test outcome	Interpretation	Further action
HCV antibody nonreactive	No HCV antibody detected	Sample can be reported as nonreactive for HCV antibody. No further action required. If recent HCV exposure in person tested is suspected, test for HCV RNA.*
HCV antibody reactive	Presumptive HCV infection	A repeatedly reactive result is consistent with current HCV infection, or past HCV infection that has resolved, or biologic false positivity for HCV antibody. Test for HCV RNA to identify current infection.
HCV antibody reactive, HCV RNA detected	Current HCV infection	Provide person tested with appropriate counseling and link person tested to medical care and treatment.^†
HCV antibody reactive, HCV RNA not detected	No current HCV infection	No further action required in most cases. If distinction between true positivity and biologic false positivity for HCV antibody is desired, and if sample is repeatedly reactive in the initial test, test with another HCV antibody assay. In certain situations^§ follow up with HCV RNA testing and appropriate counseling.

* If HCV RNA testing is not feasible and person tested is not immunocompromised, do follow-up testing for HCV antibody to demonstrate seroconversion. If the person tested is immunocompromised, consider testing for HCV RNA.
^†It is recommended before initiating antiviral therapy to retest for HCV RNA in a subsequent blood sample to confirm HCV RNA positivity.
^§If the person tested is suspected of having HCV exposure within the past 6 months, or has clinical evidence of HCV disease, or if there is concern regarding the handling or storage of the test specimen.

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Testing for HCV Infection

Benefits of Testing for Current HCV Infection

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Testing for HCV Infection

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