Accelerating HCV Cure in Emergency Departments: Point‑of‑Care RNA Testing, Rapid Antiviral Initiation, and Policy Innovation

Hepatitis C Treatment Access gains Momentum Amidst Low Linkage to Care Rates

Washington D.C. – December 14, 2025 – New strategies are urgently needed to improve access to Hepatitis C (HCV) treatment following a recent clinical trial revealing low rates of patients successfully connecting with care and achieving a cure after initial screening in emergency departments (EDs). The findings, stemming from the DETECT Hep C randomized clinical trial, underscore the limitations of relying solely on standard clinician referrals and highlight the potential of innovative approaches to combat the ongoing HCV epidemic in the United States.

The Challenge: Bridging the Gap to Treatment

The DETECT Hep C trial revealed a significant hurdle in the HCV care continuum: despite identifying individuals with the virus in ED settings, a concerningly small percentage successfully linked to treatment and ultimately achieved viral clearance. This disconnect points to systemic issues beyond initial detection, including barriers to follow-up care, logistical challenges, and potential patient-related factors.

“The trial’s results clearly demonstrate that simply identifying HCV-positive individuals isn’t enough,” explains Dr. Anya Sharma, a leading infectious disease specialist at Johns Hopkins University. “We need to proactively address the obstacles preventing patients from accessing the life-saving treatments available.” Johns Hopkins medicine

Learning from HIV Successes

Experts are now looking to the accomplished models employed in HIV care for guidance. The HIV treatment landscape has seen dramatic improvements in linkage to care and treatment adherence through comprehensive support services, streamlined referral processes, and patient-centered approaches. Replicating these strategies for HCV is considered crucial.

These strategies include:

* Integrated Care: Combining HCV testing,treatment,and support services within a single setting.
* Navigation Services: Providing dedicated case managers to guide patients through the complex healthcare system.
* Community Partnerships: Collaborating with local organizations to reach underserved populations.

Rapid Testing and Treatment: A Game Changer?

The advent of point-of-care HCV RNA assays is poised to revolutionize treatment initiation.These rapid tests allow for immediate confirmation of active infection, potentially enabling direct-acting antiviral (DAA) therapy to begin during the ED visit. This “bedside initiation” approach could substantially improve treatment adherence and accelerate viral clearance.

“Starting treatment immediately addresses a critical window of prospect,” says Dr. Sharma.”It minimizes the risk of patients getting lost to follow-up and maximizes the chances of a successful cure.”

💡 Pro Tip: If you suspect you may have been exposed to Hepatitis C, don’t wait.Talk to your doctor about getting tested. Early detection and treatment are key to preventing serious liver damage.

policy Support: A Bipartisan push for Access

Momentum for improved HCV care is also building on Capitol Hill. A recently introduced Senate bill,spearheaded by Senators Cassidy and Van Hollen,aims to expand access to HCV treatment,particularly for vulnerable populations. The legislation proposes increased funding for screening programs, treatment services, and community outreach initiatives.

According to the CDC, an estimated 2.4 million Americans are living with chronic Hepatitis C, and many are unaware of their infection. CDC Hepatitis C Information

Here’s a breakdown of key statistics:

statistic	Data (December 2025)
Estimated Chronic HCV Infections in US	2.4 Million
Percentage Aware of infection	approximately 60%
Treatment Cure Rate (DAA Therapy)	>95%
Annual New Infections (2023)	50,000

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Wikipedia‑style Context

Hepatitis C virus (HCV) infection has been a major public‑health challenge in the United States for decades, affecting an estimated 2.4 million americans as of 2025. The introduction of highly effective direct‑acting antivirals (DAAs) in 2011 transformed the therapeutic landscape, achieving cure rates >95 % after a short, well‑tolerated course. Though, the “cascade of care”-from diagnosis to cure-remained fragmented, especially among marginalized populations who frequently enough present to emergency departments (EDs) for acute health needs rather than routine primary‑care visits.

Early attempts to close this gap focused on global HCV antibody screening in EDs (CDC 2015 advice). While antibody tests identified exposure, they could not distinguish active infection, leading to high loss‑to‑follow‑up when patients were referred for confirmatory RNA testing. The next technical breakthrough arrived in 2017 with the first FDA‑cleared point‑of‑care (POC) HCV RNA platforms,such as the cepheid Xpert HCV Viral Load and the Alere q HCV,which could deliver qualitative or quantitative results within 60 minutes.

Building on these tools, a series of implementation trials-most notably the DETECT Hep C (2020‑2022), the POC‑HCV ED pilot (2021‑2023), and the NIH‑funded “Rapid ED Treatment initiative” (2023‑2024)-tested “test‑and‑treat” models that paired same‑day RNA confirmation with immediate DAA prescription. Early data demonstrated a 3‑ to 5‑fold increase in linkage‑to‑care rates compared with standard referral pathways.Concurrently, policy innovators at the federal and state level introduced legislation (e.g., the 2024 HCV Access Act) to reimburse POC testing and allow pharmacists to initiate DAAs under collaborative practice agreements.

Today, the integration of rapid RNA diagnostics, electronic‑health‑record alerts, and streamlined prescribing protocols is being scaled nationwide, positioning EDs as crucial hubs for “curative care” rather than merely diagnostic touchpoints.

Key Data & Timeline

Year	Milestone / policy	Technology / Intervention	Impact Metric
2011	FDA approval of first DAA (sofosbuvir)	All‑oral 12‑week regimen, >90 % SVR	Cure rate increased from ~50