The Viral Hepatitis Program acknowledges that community testing programs are in a unique position to identify people at risk for hepatitis C, to provide testing and linkage to care. The following information is provided to support efficient community testing for programs that use rapid hepatitis C tests.

NYC Rapid Hep C Testing Guidance and Resources

There are 116,000 people estimated to be living with chronic hepatitis C in New York City; unfortunately, many are asymptomatic and unaware of their status. Hepatitis C is caused by a virus transmitted through blood that can lead to liver cancer and premature death. People born from 1945-1965, people who have injected drugs, people living with HIV, and men who have sex with men are at risk for hepatitis C and should be tested. Fortunately, hepatitis C can be treated and cured in 8-12 weeks with antiviral medications. However, a person can get infected with hepatitis C again after cure – if they are exposed to infected blood. Our goal is to remind programs that use rapid hepatitis C test kits of the recommended testing and reporting methods for hepatitis C.


Guidance for Community Hepatitis C Testing

  1. Screen for hepatitis C using the antibody test in people who are unaware of their status who have never tested positive for hepatitis C.
  2. Conduct the hepatitis C RNA test on individuals who ever tested hepatitis C positive (antibody or RNA) to determine if they are currently infected.
  3. Link people who test hepatitis C RNA positive to care. Hepatitis C care and treatment is covered by health insurance. Low cost and free care is available: www.nyc.gov/health/hepC
  4. Link people at ongoing risk for hepatitis C to prevention services, including harm reduction and syringe service programs, and medication assisted treatment: www.nycwell.cityofnewyork.us/en/
  5. Report Acute Hepatitis C Infections to the Health Department. NYC Health Department Guidelines: www1.nyc.gov/site/doh/providers/reporting-and-services/reporting-central.page

Key factors to keep in mind:

There are two types of tests used to determine hepatitis C status (see attached Testing Map):

  1. Antibody test: a screening test to determine if a person has ever had hepatitis C.
    • If a person has ever been infected with hepatitis C, the antibody test result will always be positive, even if they spontaneously cleared the virus or were cured with treatment.
    • This test does not tell you if the person is currently infected.
  2. RNA (NAAT/PCR) test: a test to determine if a person is currently infected with hepatitis C.
    • This confirmatory test is used if a person has ever previously tested positive for hepatitis C antibodies.

There are two phases of hepatitis C infection:

  • Acute hepatitis C: the first 6 months of infection. About 25% of people infected “spontaneously clear” the virus within six months. These people can transmit the virus to others until it has cleared. After clearing hepatitis C, the person cannot transmit hepatitis C to others.
  • Chronic hepatitis C: the infection continues after 6 months and can be life-long if not treated. About 75% of people infected with hepatitis C develop chronic infection. People with chronic infection can transmit the virus to others.

Resources for Community Hepatitis C Testing

Training

Contact Hep@health.nyc.gov or call our Hepatitis Navigation Warm-line (917) 890-0834 for assistance helping your patients get tested, treated and cured.

Sincerely,

Diana Diaz Muñoz, Hep C Community Navigation Programs

Viral Hepatitis Program, NYC Health Department

CC: Nirah Johnson, Ann Winters

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