Hepatitis C Testing at the Point of Care in Indigenous Communities
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By
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Jorge Mera
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Andrea Blair
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Kendra Lewis
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Savana Christy
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Molly Feder
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Ashley Comiford
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April 15, 2026
Clinical Scorecard: Hepatitis C Testing at the Point of Care in Indigenous Communities
At a Glance
| Category | Detail |
|---|
| Condition | Hepatitis C Virus (HCV) Infection |
| Key Mechanisms | Disproportionate impact on American Indian and Alaska Native populations due to high rates of substance use and injection drug use. |
| Target Population | American Indian and Alaska Native people, aged 22 years or older. |
| Care Setting | Community-based settings, including the Cherokee Nation Infectious Disease Department and harm reduction sites. |
Key Highlights
- Highest acute HCV incidence among American Indian and Alaska Native people at 3.5 cases per 100,000.
- 28% to 93% of individuals with positive HCV antibody tests do not receive confirmatory RNA testing.
- Point-of-care (POC) HCV RNA testing allows same-day confirmation and treatment initiation.
- Cherokee Nation's HCV Engagement and Linkage Program (CN HELP) enhances community-based care.
- Incentives provided to participants to promote testing and treatment engagement.
Guideline-Based Recommendations
Diagnosis
- Universal, one-time HCV screening for adults 18 years or older.
- Targeted testing for individuals with risk factors.
Management
- Linkage to care for those with detectable HCV RNA.
Monitoring & Follow-up
- Follow-up on confirmatory RNA testing for those with positive antibody tests.
Risks
- Higher mortality rates in American Indian and Alaska Native populations compared to other racial groups.
Patient & Prescribing Data
American Indian and Alaska Native individuals eligible for treatment through CNHS.
Treatment limited to American Indian and Alaska Native participants; non-tribal participants referred to nontribal facilities.
Clinical Best Practices
- Implement POC testing to reduce diagnostic delays.
- Utilize community partnerships for enhanced outreach and support.
- Provide incentives to encourage participation in testing and treatment programs.
Related Resources & Content
