The reflex algorithm allows 3 important HCV tests to be completed, if necessary, with a single blood draw. Each of the 3 tests provides information that is important when a patient enters care.1
- HCV antibody testing is the initial screening test. A positive result is consistent with prior resolved infection, active infection, or a false-positive antibody, but a supplemental test is needed to confirm active infection.
- The reflex to quantitative HCV RNA testing serves 2 important functions: 1) as a supplemental test to confirm active infection in patients with a positive HCV Ab result; and 2) to establish the baseline viral load (concentration of HCV virus in blood). Knowing the viral load at baseline helps physicians monitor response to therapy.
- HCV genotype testing is used to inform treatment decisions and duration of therapy.
The tests included in this reflex panel are recommended to guide the selection (and, for some patients, duration) of antiviral treatment.1 However, only about half of patients have had confirmatory HCV testing by the time of their first visit to an HCV treatment provider, and an even lower proportion have had quantitative RNA and genotype results.2 The reflex approach should improve the proportion of patients who have this complete series of important HCV assay results.