Hawaii DOH partners with local laboratories to expand testing for hepatitis C


Shane Ersland


The Hawaii Department of Health (DOH) is partnering with Diagnostic Laboratory Services (DLS) and Clinical Laboratories of Hawaii (CLH) to encourage providers to “reflex” hepatitis C testing, which will help more people get diagnosed with and cured of hepatitis C.


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Hepatitis C is currently screened through antibody testing, but requires an RNA test to confirm infection. Reflex testing assures that when an antibody screening test is positive, the specimen is automatically processed by the laboratory to confirm hepatitis C infection using an RNA test.  DOH, DLS, and CLH officials urge healthcare providers to order the “reflex” option when screening for hepatitis C to ensure more accurate and timely diagnoses.

The CDC currently recommends that all adults over age 18 get tested for hepatitis C at least once, regardless of any known risk. Testing for hepatitis C involves a simple blood draw and can be requested through healthcare providers.

“By promoting the option to reflex hepatitis C screening tests to confirmatory tests, our local labs are helping to improve the pathway to cure for many people in Hawaii,” DOH Viral Hepatitis Prevention Coordinator Thaddeus Pham said. “Our labs have always been essential partners in public health, and we are excited and grateful for their partnership to ensure more people get timely access to hepatitis C curative treatment, starting with diagnosis.”

Hepatitis C is primarily spread by blood-to-blood transmission, especially through shared injection equipment.

Hawaii has one of the highest rates of liver cancer in the US. Its leading causes are viral hepatitis B and C. Across the US, new cases of hepatitis C are on the rise, increasing by more than 60% from 2015 to 2019. Almost half of people with hepatitis C are unaware of their infection. Timely and complete testing is the first step to accessing curative treatment. However, one in three people with a positive HCV-antibody test do not receive a confirmatory RNA test.

Hepatitis C is curable for most people within 12 weeks. A positive test for HCV RNA is needed to diagnose current HCV infection and initiate oral curative treatment. Without treatment, 15-20% of adults with chronic HCV infection will develop progressive liver fibrosis and cirrhosis which can lead to death.

Both DLS and CLH have the option for positive HCV antibody tests to be reflexed to an HCV RNA test automatically from the same blood sample.

“DLS is proud to partner with the DOH to help our community fight liver disease and liver cancer through reflex hepatitis C testing,” DLS President Mark Wasielewski said. “It is only by working together that we can realize a Hep Free 2030 Hawaii.”

This partnership aligns with Hep Free 2030, the statewide strategy to eliminate viral hepatitis in Hawaiʻi by 2030, which was developed by the DOH in collaboration with Hep Free Hawaii and over 160 community stakeholders.

This press release was provided by the Hawaii Department of Health.