Optimizing HCV linkage to care: Experiences implementing laboratory-based reflex testing

Optimizing HCV linkage to care: Experiences implementing laboratory-based reflex testing

January 27 2022
11:00 AM
Webinar series
Hep Test
Reflex testing webinar

Hepatitis C (HCV) programs have introduced viral load testing as a strategy to reduce the steps in the HCV diagnostic pathway and improve linkage to care. Laboratory-based HCV reflex virologic testing refers to a testing algorithm in which patients have only a single clinical encounter and only one blood draw or specimen taken (in some cases may be divided in two tubes) and sent to the lab. If the sample for anti-HCV testing in the lab is positive, then the same existing or duplicate sample is used for a “reflex” lab-based HCV viral load test.


Lab-based reflex testing schematic

In the Fall 2020, the Coalition for Global Hepatitis Elimination (CGHE) was requested by the World Health Organization (WHO) to develop a body of programmatic evidence to inform WHO guidance on laboratory-based HCV reflex testing. This set of case studies described real-world experiences in implementing laboratory-based HCV reflex testing and highlighted operational considerations faced by clinics and laboratories. 

Join this webinar to hear from laboratorians, clinicians, and public health officials participating in the case studies and from others who have since been identified as pioneers in implementing HCV reflex testing in new settings. Speakers will present the HCV reflex testing algorithm used by their institution and discuss considerations on issues such as:

  • Start-up investments in staff training, etc
  • Revising lab ordering forms and electronic health records
  • Specimen transfer and storage
  • Quality control measures
  • Costs and economic benefits
  • Equipment requirements
  • Impact on improving linkage to care


  • Reflex testing in British Columbia, Canada | Agatha Jassem, British Columbia Centre for Disease Control Public Health Laboratory (BCCDC PHL), Canada

  • Reflex testing in settings for persons experiencing homelessness | Andrew Seaman,  Oregon Health & Science University, United States

  • Reflex testing in England | Ruth Simmons, Public Health England, and William Irving, Nottingham University Hospital, United Kingdom

  • Panel discussion with comments from Philippa Easterbrook, World Health Organization