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Guidance

Annexe 3: Text version of hepatitis C testing algorithm

Updated 15 September 2026

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This publication is available at https://www.gov.uk/government/publications/improving-testing-rates-for-blood-borne-viruses-in-prisons-and-other-secure-settings/annexe-3-text-version-of-hepatitis-c-testing-algorithm

Note: BBV testing should be recommended to all prisoners, including those already in prison.

Step 1: HCV Ab test (screening test – shows exposure)

Review the result:

If the HCV Ab test is negative

  1. Provide reassurance and harm-minimisation.
  2. Repeat risk assessment (and recommend test) after each risk event or every 12 months.
  3. Following any new risk event or repeat testing, return to Step 1 (HCV Ab test).

If the HCV Ab test is positive

  1. PCR/Ag test (same sample) (confirmation test – shows infection).
  2. Review the PCR/Ag result:

PCR/Ag result negative

  1. Provide reassurance and harm minimisation.
  2. Repeat risk assessment (and recommend test) after each risk event or every 12 months.
  3. Following any new risk event or repeat testing, return to Step 1 (HCV Ab test).

PCR/Ag result positive

  1. Acute/chronic infection confirmed.
  2. Refer to a specialist service.
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