APHL develops best practices and guidelines, and monitors developments in diagnostic testing for viral hepatitis. The term “viral hepatitis” refers to a group of five viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis E virus (HEV). These viruses are grouped together based on the clinical outcome of infection - an inflammation of the liver - rather than by how closely related they are. The CDC has recently created a ​set of Viral Hepatitis Serology Training Videos for each virus that serve as an excellent resource.

Hepatitis A Virus

There have been large outbreaks of Hepatitis A Virus in many states starting in 2017 and ongoing. In response, APHL has worked with CDC and our members affected by this outbreak to create a resource for Hepatitis A Virus testing for laboratories or programs that may need to bring on testing or understand what is available.

Hepatitis C Virus Testing

The recommended testing sequence for HCV requires an initial screen with an FDA-approved HCV antibody test which, if reactive, is followed by an HCV Nucleic Acid Test (NAT) to detect the viral RNA present in a person with a current infection. The APHL HIV and Viral Hepatitis Subcommittee has developed some companion documents to assist public health laboratories and their submitters understand the testing algorithm and how to interpret the results.

APHL hosted a webinar highlighting how two public health laboratories collaborated with their health department to plan and implement HCV NAT testing to ensure the complete testing algorithm was performed to detect current HCV infection. This webinar provides useful lessons for PHLs interested in performing HCV NAT in-house.

In Partnership with NASTAD, APHL co-authored the Integrating HIV and HCV Testing Toolkit​ to assist public health programs and laboratories with identifying strategies to integrate testing at multiple levels. This toolkit and its associated slides will provide health departments and laboratories with current information regarding HIV and HCV testing technologies, describe factors health departments should consider in determining when integration of testing is beneficial, and discuss how various testing technologies and strategies for using these technologies can facilitate integration.

APHL Activities 

Hepatitis C Virus Diagnostic Meeting

APHL held a series was designed to examine and identify the highest-priority diagnostic tools needed to advance hepatitis C elimination in the United States over the next five years.

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HCV NAT Reference Center

As mentioned above, diagnosis of a current HCV infection requires not just an initial screen with an FDA-approved HCV antibody test, but, if reactive, a HCV NAT. APHL offers HCV NAT to interested public health laboratories through the National HCV NAT Reference Center, hosted at Michigan Bureau of Laboratories. If you are interested in participating please contact Sarah Buss (sarah.buss@aphl.o​rg​).

Global Hepatitis Outbreak and Surveillance Technology

APHL has collaborated with CDC's Division of Viral Hepatitis  to pilot and support the Global Hepatitis Outbreak and Surveillance Technology (GHOST) for the molecular surveillance of HCV infection in public health laboratories.​ Learn more. A CDC document providing instructions on how to ship non-clinical specimens collected as part of a hepatitis outbrek and surveillance activities to the Division of Viral Hepatitis (DVH) Laboratory Branch for GHOST testing is available here​. ​​​