HCV Antibody Testing
- Clinicians should perform HCV screening using either a laboratory-based HCV antibody test or a point-of-care rapid antibody test. (A1)
HCV RNA Testing
- If the HCV antibody test result is positive, clinicians should perform an HCV RNA test. (A1) Some laboratories perform reflex testing and automatically test for HCV RNA after a positive HCV antibody result.
- If the HCV antibody test result is negative and acute HCV infection is suspected, clinicians should perform an HCV RNA test. (A1)
- In patients with a history of a positive HCV antibody test result, clinicians should perform an HCV RNA test (not an HCV antibody test) for screening. (A1)
Testing After Known HCV Exposure
- After a known HCV exposure, which generally occurs in an occupational setting, clinicians should perform a baseline HCV antibody test, and if positive, an HCV RNA test and liver function tests, including a liver enzyme test. (A2)
- See the NYSDOH AI guideline PEP to Prevent HIV Infection > Management of Potential Exposure to Hepatitis C Virus.
Acute HCV
- Clinicians should suspect acute HCV infection if a patient has detectable HCV RNA in the absence of a positive antibody test or a documented negative HCV antibody test result within the previous 6 months and a newly positive HCV antibody test result. (A3)
- Clinicians should perform laboratory screening for HIV, HAV, and HBV infections in all patients with possible acute HCV infection, given the similar risk factors for acquisition. (A3)
- Clinicians should repeat HCV antibody and RNA tests 24 weeks after exposure to assess for spontaneous HCV clearance or chronic HCV infection; earlier testing may be indicated for patients at increased risk of transmitting HCV to others. (A3)
Chronic HCV
- If HCV RNA is detected after a positive HCV antibody test result, the patient has confirmed chronic HCV infection and clinicians should evaluate for treatment. (A2)
- See the NYSDOH AI guideline Pretreatment Assessment in Adults With Chronic HCV Infection.
