Individuals who test positive for hep C antibodies but who don’t get a confirmation through a genetic screen may fall through cracks in the health care system. They may also be subject to unnecessary care, since an antibody test could always be a false positive; the genetic test clears up this uncertainty.

Researchers combed through records of Veterans Affairs clinics between 1991 and 2010 and found 419 people who received a positive hep C antibody test (HCVab) but who did not receive the required ribonucleic acid (RNA) confirmation. In 31 percent of these cases, the positive HCVab test results went unacknowledged by clinicians.

Amy A. Hirsch, PharmD, clinical pharmacy specialist for HIV and hepatitis at the Cleveland VA Medical Center and the study’s senior author, says that physicians overseeing physical health often didn’t refer patients to hep C care out of fear that the interferon treatment would aggravate mental health conditions. Now that interferon is falling by the wayside, this pattern will hopefully change, she added.

To ensure tests go confirmed, Hirsch says testing facilities should adopt what’s called a “reflex testing policy,” in which two tubes of blood are drawn for a hep C test: one for the HCVab and another for the RNA confirmation if necessary.