Viral Hepatitis

Public health laboratories offer critical diagnostic testing and surveillance for viral hepatitis, a group of viruses prone to outbreaks. Testing approaches and laboratory capacity overlaps significantly with HIV. APHL supports these efforts by developing best practices and guidelines, and monitors developments in diagnostic testing for viral hepatitis.

Questions?

Contact the Infectious Diseases team: [email protected]

APHL's Role

Supporting Best Practices in Viral Hepatitis Testing

APHL, in collaboration with the US Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis, develops and promotes resources for the detection and characterization of hepatitis viruses. We provide training modules, toolkits, publications and partner resources designed to support laboratory professionals in strengthening hepatitis diagnostic and surveillance capacity.

Evaluation and Assistance

APHL in collaboration with DVH supports member laboratories in the evaluation and implementation of new approaches or testing methods for viral hepatitis testing through funding opportunities and pilot projects.

HCV Best Practice Resources

APHL’s HIV, Viral Hepatitis and STI Subcommittee created several resources to assist public health laboratories with testing for Hepatitis viruses. Several focus on assisting laboratories and their submitters understand the HCV testing algorithm and how to interpret the results.

Advancing HCV Diagnostics

APHL regularly hosts consultations in partnership with CDC to advance HCV diagnostics. A summary report of the 2021 consultation documents the meeting and outcomes regarding the examination and identification of the highest-priority diagnostic tools needed to advance hepatitis C elimination in the United States over the next five years.

In 2025, the focus shifted to discussions of accelerating diagnosis of current HCV infection through same day diagnosis and treatment, and viral first testing. Recordings of the 2025 consultation are available upon request: [email protected].

NEW: Hepatitis B and Hepatitis Delta Best Practices

APHL's HIV, Viral Hepatitis and STI Subcommittee has developed and published Hepatitis B and Delta Viruses: Best Practices for Testing, Reporting and Referral covering testing recommendations, considerations, results reporting and interpretation for hepatitis B and hepatitis delta viruses.

What is '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.

HCV Testing Algorithm

Tool / Work Aid

2024

This short guide, intended for laboratorians, health departments and healthcare providers, explores operational strategies to enable reflex RNA testing of Hepatitis C Virus (HCV) antibody reactive specimens to detect active infections.

Infectious Diseases, HIV and Hepatitis

Guide / Guidance

2019

This document provides guidance to laboratories on how to interpret test results using available FDA-approved HCV qualitative and quantitative RNA tests.

Infectious Diseases, HIV and Hepatitis

Fact Sheet

2013

APHL created this FAQ to accompany the 2013 CDC HCV Testing Guidelines for Clinicians and Laboratorians.

Infectious Diseases, HIV and Hepatitis

Utilization of Advanced Detection Techniques

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 is available that provides instructions on how to ship non-clinical specimens collected as part of a hepatitis outbreak and surveillance activities to the Division of Viral Hepatitis Laboratory Branch for GHOST testing.

Testing Support

HCV NAT Reference Center

Established in 2016, the HCV Nucleic Acid Testing Reference Center ensures that all public health laboratories have access to HCV NAT, a required second step following a reactive result from an FDA-approved HCV antibody test. Currently, Michigan’s Bureau of Laboratories serves as the Reference Center.

ELIGIBILITY

All US public health laboratories, not currently performing this testing in-house are eligible to submit specimens to the Reference Center. The specimens must meet the submission requirements outlined in the resource below.

ENROLLMENT

To enroll or if you have questions contact [email protected].

TESTING SERVICES AVAILABLE

Qualitative HCV NAT

RESOURCES

Guidance for shipping specimens to the HCV NAT Reference Center

Additional Tools and Resources

HIV and Viral Hepatitis Testing Resources

Alternative Specimen Types

Toolkit

2021

The toolkit is designed to support health departments in their efforts to strengthen HIV, viral hepatitis, and STI testing and linkage programs.

Infectious Diseases, HIV and Hepatitis, STIs

FDA Approved HIV, Viral Hepatitis and STI Assays

Tool / Work Aid

2026

Infectious Diseases, HIV and Hepatitis, STIs, Testing Methodology

Integrated Testing

APHL partnered with NASTAD to develop 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 (HDs) and laboratories with current information regarding HIV and HCV testing technologies, describe factors HDs 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.

Surveys

APHL surveys public health laboratories every few years to assess HIV and HCV testing capacities, capabilities and practices to help understand the landscape and inform education, training and advocacy efforts. For historic HIV and HCV survey reports:

Visit the ID Resources and Trainings Page

Learn and Grow

Viral Hepatitis News, Events, Training and Webinars

Archived Webinars

Opportunities to Strengthen HIV and/or HCV Testing and Linkage Programs, Webinar 2025 (slides only)

Search all Infectious Diseases Trainings and Events

Visit the APHL Training Hub to search our training materials, access courses through the APHL Learning Center, and find upcoming webinars via the Event Calendar.

Visit the Training Hub

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