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Hepatitis C in primary care: screening, interpretation, and referral

A Canadian clinical summary of hepatitis c in primary care: screening, interpretation, and referral, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Hepatitis C virus: Screening and testing for health professionals. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:PHAC hepatitis C

Source-attributed clinical priorities

  • Offer screening for current or past exposure risk and use a reflex pathway from antibody to RNA testing.
  • A positive antibody alone does not establish current infection; document confirmatory RNA and assess liver disease and coinfection.
  • Link confirmed infection to direct-acting antiviral care and harm-reduction services, with provincial drug-access criteria checked.
  • A reactive antibody shows exposure; active infection requires confirmatory RNA testing.
sources for this section:PHAC hepatitis C

Practical assessment and management workflow

1
Assess birth or origin risk, injection equipment, transfusion history, incarceration, tattoos and sexual or household exposures.
2
Use reflex antibody-to-RNA testing where available and assess liver enzymes, platelets and fibrosis.
3
Link RNA-positive patients directly to curative-treatment assessment and vaccination for preventable hepatitis.
4
Confirm treatment response and arrange ongoing liver surveillance only when residual fibrosis risk warrants it.
sources for this section:PHAC hepatitis C

Safety, red flags and urgent escalation

  • Jaundice, coagulopathy, encephalopathy or major bleeding suggests decompensated liver disease.
  • Review drug interactions and pregnancy before direct-acting antiviral treatment.
  • Do not require abstinence from substance use as a blanket condition for hepatitis C care.
sources for this section:PHAC hepatitis C

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:PHAC hepatitis C

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:PHAC hepatitis C

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Public Health Agency of CanadaHepatitis C virus: Screening and testing for health professionalsaccessed 2026-08-20
    view source
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