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The authors report no relevant financial disclosures.
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Key takeaways:
- Approximately one-third of patients do not complete the two-step testing process for hepatitis C.
- The CDC now recommends offering both testing steps during the same visit.
In new guidance, the CDC recommended that the two-step testing process for hepatitis C virus be completed in one visit, eliminating the need for multiple visits, which often leads to incomplete testing.
Writing in MMWR, Emily J. Cartwright, MD, and colleagues from the CDC’s Division of Viral Hepatitis said roughly one-third of people who receive a reactive HCV antibody test do not return to receive an HCV RNA test, making their testing incomplete.
“This update clarifies that all sites performing HCV screening should ensure single-visit sample collection,” Cartwright and colleagues wrote. “This approach allows for automatic HCV RNA testing when an HCV antibody test is reactive to avoid incomplete testing.”
Previous CDC guidelines allowed for the two steps to take place over multiple visits. The change will reduce the number of incomplete tests by reducing the patient burden of a second visit, the authors said.
“Complete and accurate testing is the first step to identifying persons with current HCV infection to ensure linkage to care and initiation of curative antiviral therapy,” Cartwright and colleagues wrote.
According to recently published statistics, just 34% of people in the United States diagnosed with HCV are cured or cleared of the virus and up to 1 million people are unaware they have HCV.
Cartwright and colleagues analyzed data from the Chronic Hepatitis Cohort Study, New York City Department of Health and Mental Hygiene, the Veterans Administration, Cherokee Nation Health Services and the Mid-Atlantic Permanente Medical Group, finding that roughly one-third of patients did not complete both steps of HCV testing.
In facilities that later implemented single-visit sample collection, test completion increased to between 85% and 98%, according to the authors.
“Use of strategies that require multiple visits to collect HCV testing samples should be discontinued,” Cartwright and colleagues wrote. “Automatic HCV RNA testing on all HCV antibody reactive samples will increase the percentage of patients with current HCV infection who are linked to care and receive curative antiviral therapy.”
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