Hepatitis C Positive Antibody Test Leads to Molecular Assay

Conventional laboratory and medical practice for Hepatitis C virus infection involves referring a patient for a second office visit and blood draw if the initial antibody screening test produces a positive result.

A hepatitis C screening test identifies viral antibodies while a molecular test identifies viral ribonucleic acid (RNA) when the infection is active. In some people, the immune system clears hepatitis C infection on its own, but antibodies may linger in the blood for decades. As a result, a positive antibody screening test can signify resolved or active infection, and as much as 3% of antibody screens produce a false positive.


Quest Diagnostics (Madison, NJ, USA) will automatically perform molecular testing on all patient specimens whose antibody screening results indicate Hepatitis C virus infection, and remove standalone positive antibody screening as a test option. The change to the company’s service menu eliminates the prospect a patient may receive a positive screening result but fail to undergo additional molecular testing, as recommended by medical guidelines, to help confirm a diagnosis of active hepatitis C infection, the cause of chronic hepatitis C.

With the change to the Quest menu, any specimen that an antibody screening test indicates is positive will automatically reflex to molecular testing. Pricing for the screen and molecular tests are the same as before; positive screening results will reflex to molecular testing automatically and be charged the additional molecular test fee. Early diagnosis, through laboratory blood tests, and treatment can help prevent liver damage, cirrhosis, liver cancer and death.

Rick L. Pesano, MD, PhD, vice president of development, science and innovation at Quest Diagnostics, said, “This change to Quest's test offerings is medically responsible and appropriate. It closes a gap in current hepatitis C care by reducing the possibility a patient will undergo multiple office visits and blood draws or be inappropriately referred to specialists based on incomplete testing. With this change to our offering, we will help more people receive insights they can use to access effective treatment and ultimately lead healthier lives.”

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