Hepatitis C Reflex Testing

The 2023 amendment to the New York State Testing Law requires if the hepatitis C screening test is reactive, a hepatitis C ribonucleic acid test (RNA) must be performed on the same speciment, or a second specimen collected at the same time as the initial hepatitis C screening test speciment, to confirm diagnosis of current infection. This is also referred to as reflex testing. This amendment is to ensure complete and timely diagnosis of HCV. If the subsequent HCV RNA test is negative, HCV infection is effectively ruled out for most patients. If the reflex HCV RNA test is positive, a diagnosis of active HCV infection has been confirmed, and the individual should be referred directly for HCV care and treatment.

Reflex testing obviates the need for the patient to return for follow-up testing should the initially HCV antibody test be reactive. If the RNA test is negative, the work-up is done, and the patient may be reassured.