The Hawai‘i Department of Health (DOH), Diagnostic Laboratory Services (DLS) and Clinical Laboratories of Hawaiʻi (CLH) are encouraging health providers to implement “reflex” hepatitis C testing, which will help more people get diagnosed with and cured of hepatitis C.

Currently, hepatitis C is screened through antibody testing, but requires an RNA test to confirm infection. Reflex testing assures that when an antibody screening test is positive, the specimen is automatically processed by the laboratory to confirm hepatitis C infection using an RNA test. DOH, DLS, and CLH urge healthcare providers to order the “reflex” option when screening for hepatitis C, to ensure more accurate and timely diagnoses.

The Centers for Disease Control and Prevention (CDC) currently recommends that all adults over age 18 get tested for hepatitis C at least once, regardless of any known risk. Testing for hepatitis C involves a simple blood draw and can be requested through healthcare providers.

Hepatitis C is primarily spread by blood-to-blood transmission, especially through shared injection equipment.

Hawaiʻi has one of the highest rates of liver cancer in the U.S. The leading causes are viral hepatitis B and C.

Across the U.S., new cases of hepatitis C are on the rise however almost half of those with hepatitis C are unaware of their infection. Timely and complete testing is the first step to accessing curative treatment. However, one in three people with a positive HCV-antibody test do not receive a confirmatory RNA test.

Hepatitis C is curable for most people within 12 weeks. A positive test for HCV RNA is needed to diagnose current HCV infection and initiate oral curative treatment. Without treatment, 15-20% of adults with chronic HCV infection will develop progressive liver fibrosis and cirrhosis which can lead to death.

Both the CDC and the American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA) recognize HCV antibody screening followed by a confirmatory RNA test as best practice to identify hepatitis C infection.