{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:17:05Z","timestamp":1788175025438,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Labcorp"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In 2019 and 2020, universal hepatitis C screening of adults was recommended by clinical guideline authorities, including the Centers for Disease Control and Prevention (CDC). In 2023, CDC recommendations emphasized the importance of reflexive hepatitis C testing in which samples positive for hepatitis C virus (HCV) antibody (Ab) automatically reflex to viral RNA nucleic acid amplification testing (NAAT). Laboratory stewardship initiatives to guide compliance with expanded guidelines were implemented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of 38 233 788 specimens with HCV Ab testing and 1 423 543 follow-up HCV RNA NAAT performed from 2018 to 2024 to evaluate the impact of expanded hepatitis C guidelines and laboratory stewardship initiatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2018 to 2024, reflexive hepatitis C testing volumes increased annually, while orders for standalone HCV Ab testing and HCV Ab positivity rates steadily declined. Among HCV Ab\u2013positive individuals, the percentage with reflexive testing increased from 21.9% in 2018 to 82.2% in 2024 (\u01ac = 1.00, P = .003) and RNA testing rates increased from 66.4% in 2018 to 89.3% in 2024 (\u01ac = 1.00, P = .003). Follow-up RNA testing was increasingly completed earlier in HCV Ab\u2013positive individuals with the same-day RNA testing rate increasing from 38.0% in 2018 to 82.2% in 2024. HCV RNA positivity decreased 19.2% during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Expanded hepatitis C screening guidelines highlighting the importance of reflexive HCV testing and subsequent internal laboratory stewardship initiatives likely contributed to the increased utilization of reflexive hepatitis C testing and the decreased time to identification of active hepatitis C infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag227","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T11:28:20Z","timestamp":1775561300000},"page":"988-992","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Reflexive Hepatitis C Virus Testing in a National US Laboratory: A Retrospective Study From 2018 to 2024"],"prefix":"10.1093","volume":"82","author":[{"given":"Min Kyung","family":"Lee","sequence":"first","affiliation":[{"name":"Labcorp Diagnostics, , Burlington, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0465-9131","authenticated-orcid":false,"given":"David","family":"Alfego","sequence":"additional","affiliation":[{"name":"Labcorp Diagnostics, , Burlington, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Walworth","sequence":"additional","affiliation":[{"name":"Labcorp Diagnostics, , Burlington, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0965-6043","authenticated-orcid":false,"given":"Laura","family":"Gillim","sequence":"additional","affiliation":[{"name":"Labcorp Diagnostics, , Burlington, North Carolina 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