Despite significant effort to encourage testing of populations within the community which are at high risk of having acquired HCV infection, it is evident many have still not been tested.

HCV infection should be considered in patients with abnormal liver function tests, acute hepatitis, chronic liver disease or liver cirrhosis, hepatocellular carcinoma (liver cancer), or in the presence of other clinical conditions associated with HCV (e.g. porphyria cutanea tarda, vasculitis, cold agglutinin presentations).24

 Other situations where HCV testing may be indicated include:

  • healthcare workers who perform or may be expected to perform exposure prone procedures (EPPs) must be aware of their hepatitis C (and HIV and hepatitis B) status25
  • contact tracing where exposure to blood of a person with a potential infection is documented; testing of a source person in an occupational exposure
  • diagnosis of another infection with shared mode of acquisition, such as hepatitis B virus or HIV
  • the report of a reactive result on a HCV test not approved for supply in Australia
  • a person who requests a HCV test in the absence of declared risk factors – a small number of people may request a HCV test but choose not to disclose risk factors. A person’s choice not to declare risk factors should be respected and HCV testing should be offered.

A history considering risk factors for acquisition of HCV infection should be taken and where risk exists, patients should be informed of their risks and of the benefits of testing.

In appropriate clinical circumstances, the absence of a declared risk factor should not preclude HCV testing.