Hepatitis C

Hep C Testing

An estimated 3.5 million persons in the United States are infected with HCV, and as many as half of those infected remain undiagnosed. HCV is the primary cause of adult liver transplant candidacy, representing 30 percent of all adults on the transplant waiting list. Baby boomers (those born between 1945 and 1965) account for 75 percent of all chronic HCV infections.

Testing Recommendations

Reflex Testing

Hepatitis C virus (HCV) is a virally mediated disease of the liver with a propensity to cause chronic infection, leading to cirrhosis and an increased risk of hepatocellular carcinoma. Adults born between 1945 and 1965 should be screened for HCV infection; individuals with certain risk behaviors (eg, injection drug use) or risk exposures (eg, healthcare workers) should also be screened. Laboratory testing involves screening for HCV antibodies followed by confirmatory RNA testing for positive results.

Laboratory Testing

ARUP has designed testing methods that are economical, reduce turnaround time, and help avoid multiple patient draws/visits. Each test can be ordered individually or as part of the reflexive tests to meet our clients’ various testing requirements.

• HCV antibody screen by immunoassay: initial testing for    individuals at risk for HCV infection.
• HCV quantification by NAAT if reactive: used to confirm    active HCV infection, establish baseline viral load for    prognosis and to monitor response to therapy.
• HCV genotype by sequencing: guide selection of direct    acting antiviral (DAA) therapy.
• HCV antibody, with reflex to HCV quantification by NAAT:    preferred reflex test for screening and confirming HCV in at-risk individuals. If positive, reflexes to quantitative HCV NAAT to confirm HCV infection.

Reflex Testing Options

Test Number Test Name
2010784Hepatitis C Virus Antibody by CIA with Reflex to HCV by Quantitative NAAT
3000576Hepatitis C Virus (HCV) by Quantitative NAAT with Reflex to HCV Genotype by Sequencing
2009255Hepatitis C Virus (HCV) Genotype with Reflex to HCV High-Resolution Genotype by Sequencing
3000577Hepatitis C Virus (HCV) by Quantitative NAAT with Reflex to HCV High-Resolution Genotype by Sequencing
2014598Hepatitis C Virus (HCV) Genotype with Reflex to HCV NS5A Drug Resistance by Sequencing

Additional Testing Options

Test Number Test Name Method
2014139Hepatitis C Virus (HCV) NS5A Drug Resistance by Sequencing Sequencing
2002483Hepatitis C Virus Antibody by CIA Qualitative
3000572Hepatitis C Virus (HCV) by Quantitative NAAT Quantitative NAAT
0055593Hepatitis C Virus Genotype by Sequencing Sequencing
2006898Hepatitis C Virus High-Resolution Genotype by Sequencing Sequencing
2004680Interleukin 28 B (IL28B)-Associated Variants, 2 SNPs PCR/high-resolution melt
2006344Inosine Triphosphatase (ITPA) and Interleukin 28 B (IL28B)-Associated Variants, 4 SNPs PCR/SNE

Additional Resources

Chronic Viral Hepatitis and Liver Fibrosis

If left untreated, chronic viral hepatitis can lead to liver fibrosis, the scarring of liver tissue. Staging fibrosis is important for prognosis and monitoring therapy, as the accumulation of fibrosis can lead to cirrhosis and end-stage liver disease. A liver biopsy is considered the gold standard for staging fibrosis but has several limitations. FibroMeter is a blood test used to aid in the evaluation and management of liver fibrosis. This test was specifically designed for patients with chronic viral hepatitis (with or without HIV co-infection). This non-invasive blood analysis is from the creators of the FibroScan instrument.

Visit our Echosens FibroMeter (Liver Fibrosis, Chronic Viral Hepatitis) section for more information.


David R. Hillyard, MD

Medical Director, Molecular Infectious Diseases

Patricia R. Slev, PhD

Section Chief, Immunology

Medical Director, Serologic Hepatitis and Retrovirus
Medical Director, Immunology Core Laboratory
Co-Medical Director, Microbial Immunology

For additional information, please call ARUP Client Services at (800) 522-2787 and mention keyword: HEPC.