Updated Operational Guidance for Implementing CDC's Recommendations on Testing for Hepatitis C Virus Infection

Area of Science:

• Hepatology and Viral Immunology
• Public Health and Infectious Disease Management

Background:

• Current hepatitis C virus (HCV) diagnostic guidelines recommend a two-step antibody-then-RNA testing sequence.
• Incomplete HCV testing, defined as a reactive antibody test without a subsequent RNA test, historically affects approximately one-third of patients.
• Incomplete testing hinders national efforts to eliminate HCV infection.

Purpose of the Study:

• To clarify and update guidance on HCV testing procedures to ensure complete diagnostic testing.
• To promote strategies that facilitate immediate HCV RNA testing upon reactive antibody results.
• To improve patient linkage to care and curative antiviral therapy for HCV infection.

Main Methods:

• Recommending all HCV screening sites implement single-visit sample collection protocols.
• Advocating for automatic HCV RNA testing on all HCV antibody-reactive samples.
• Discouraging testing strategies that necessitate multiple patient visits for sample collection.

Main Results:

• Single-visit sample collection enables automatic HCV RNA testing for antibody-reactive individuals.
• This approach is projected to significantly reduce instances of incomplete HCV testing.
• Increased complete testing is expected to improve the proportion of patients receiving timely diagnosis and treatment.

Conclusions:

• Implementing single-visit sample collection and automatic RNA testing is crucial for achieving national HCV elimination goals.
• This updated testing strategy ensures comprehensive HCV diagnosis.
• Streamlined testing pathways will enhance patient access to curative antiviral therapies.