As of January 13, 2020, the BCCDC Public Health Laboratory (BCCDC PHL) will implement automatic hepatitis C (HCV) RNA nucleic acid testing (NAT) reflex testing for all new HCV cases. This is a change from the previous two-step process that required a follow-up EDTA blood sample which often delayed time to diagnosis.
Under the new process, persons who are positive for anti-HCV antibodies will automatically be tested for HCV RNA by NAT if: (1) they are first-time antibody positive or (2) if they have not been tested by NAT before.
An internal validation at the BCCDC PHL revealed good concordance between serum and plasma HCV RNA NAT results. However, for persons who display low levels of anti-HCV antibodies or are serum HCV RNA NAT negative, a follow-up EDTA blood sample for HCV RNA NAT will still be requested.
The figure below summarizes the new HCV testing algorithm. For other testing details please refer to the BCCDC PHL test menu (http://www.elabhandbook.info/phsa/).