The NYC Board of Health Amended the Health Code to Improve Complete Hepatitis C Diagnostic Testing in NYC

In order to improve complete hepatitis C diagnostic testing, care and treatment rates in New York City at the population level, the Board of Health adopted an amendment to the Health Code to require laboratories to automatically perform an hepatitis C RNA confirmatory test when there is an initial positive antibody test for hepatitis C.

Complete diagnostic testing for hepatitis C is an important first step to ensuring that people are aware of their status and have the opportunity to be treated and cured. Combining these two steps will ensure that patients with hepatitis C are diagnosed immediately the first time they are tested, rather than having to return to the clinician for follow-up visits and testing. The Board of Health approved the Amendment in September 2017, and the law went into effect on October 20th 2017.

In the newly released Annual Report, “Hepatitis B and C in New York City 2016” , the Health Department reported that among 11, 847 newly reported cases of hepatitis C in 2016, 23% never received hepatitis C RNA confirmatory testing to determine whether they have active, current infection. The Health Department also reports on an analysis of patient outcomes for people reported with active hepatitis C infection in 2015, finding that only a third initiated treatment. And more than half of deaths related to hepatitis C in 2015 occurred prematurely, in people aged 65 or younger.

Hepatitis C related liver disease progression, cancer, premature death and ongoing transmission of the virus can be prevented by ensuring that people with active hepatitis C are appropriately tested and treated to cure the infection. Treatment is now only eight to twelve weeks with all oral well tolerated medications, and almost all people treated can be cured regardless of comorbid conditions, drug use or alcohol consumption.

The Health Department’s policy approach to improving hepatitis C clinical practice is important as 146,500 people are estimated to be infected hepatitis C and only 16% are estimated to be cured. New York City is the first in the nation to mandate hepatitis C antibody to reflex RNA testing by laboratories, an important health policy advancement strategy that may be replicable across the nation.

This letter has been sent to NYC laboratories informing them of the amendment.