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HCV RNA testing not always performed after positive antibody tests
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Only about 60% of people with a positive hepatitis C antibody test received a follow-up RNA test during the period of 2003 to 2010, new data suggest.
“With curative pharmacotherapy potentially available now for most persons, application of reflex testing to HCV RNA following a positive HCV antibody test is critical to the prompt determination of HCV infection status,” investigators for the Chronic Hepatitis Cohort Study wrote in Clinical Infectious Diseases. “As efforts to expand the use of reflex testing are planned, in part through the clinical validation of quantitative assays, a reassessment of HCV RNA testing trends in the future will be useful to determine the degree to which reflex testing has been implemented.”
The researchers identified adults with a positive HCV antibody test from Jan. 1, 2003, to Dec. 31, 2010. The adults had to have at least two clinic visits recorded, with at least one occurring from Jan. 1, 2006, to Dec. 31, 2010. There were 5,860 people who met these criteria and were included in the study.
Among the 5,860 individuals with a positive HCV antibody test, 3,570 (60.9%) had an HCV RNA performed and among those, 3,047 (85.3%) had a positive result. For those who had a positive RNA test, 2,431 (80%) received their RNA test within 6 months of the positive HCV antibody test.
From 2003 to 2010, the number of people who received a follow-up RNA test did not vary significantly by year. However, the number of people who underwent the RNA test within 6 months of the positive antibody test increased significantly, from 45.3% in 2003 to 57% in 2010. In a multivariate analysis, people born in the baby boomer era, men, and people with an annual income of less than $30,000 were less likely to have an HCV RNA test within 6 months.
“Testing for HCV RNA after a positive test for HCV antibody is necessary to determine the presence of current HCV infection and is imperative for making clinical decisions involving treatment, to counsel those infected to minimize additional hepatic injury and to prevent HCV transmission,” the researchers wrote. “All persons whose HCV infection status is unknown and who test positive for HCV antibody should promptly undergo testing for HCV RNA.”
Disclosure: One researcher reports receiving grants/research support and/or serving as a consultant for Abbott Pharmaceuticals, AbbVie Pharmaceuticals, Amgen, Bristol-Myers Squibb, CVS Caremark, Exalenz BioScience, Gilead Pharmaceuticals, Intercept Pharmaceuticals, Merck Novartis, Up-To-Date and Vertex Pharmaceuticals.
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