NYC Rapid Hep C Testing Guidance and Resources

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: https://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

• Hep Free NYC – Community Coalition: www.HepFree.NYC
• NASTAD Hepatitis Testing Partnership – Listserv: hepatitis-testing-partnership@googlegroups.com
• Hepatitis C Testing Guidance. Centers for Disease Control.
• Hepatitis C Testing Counseling Guides:
  • Hepatitis Counseling Pad – Positive Test Result
  • Hepatitis Counseling Pad – Negative Test Result
  • Hepatitis Screening Bookmark: Should You Be Tested for Hepatitis C? 
• Hep C Treatment Centers: www.nyc.gov/health/hepC

Training

• Hep C Rapid Test Training. NYC Health Department.
• Ensuring Competencies for Hepatitis C Testing. NYS Department of Health.
• Hepatitis C Testing for People Born Between 1945 and 1965 – Overview of the NYS Law. Webcast. NYS Department of Health.

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.

Diana Diaz Muñoz, Hep C Community Navigation Programs

Viral Hepatitis Program, NYC Health Department

CC: Nirah Johnson, Ann Winters