There are joint guidelines from the IDSA and the American Association for the Study of Liver Diseases, which are consistent with guidance from the CDC regarding the testing, management, and treatment of patients with HCV infection. A positive HCV antibody test remains positive for life. Repeat HCV antibody testing adds cost but no clinical benefit, so it should not be performed. A common reason for unnecessary repeat testing is the inclusion of this test in order sets (e.g., hepatitis and/or opioid screening order sets), or a result of problematic follow-up in patients positive for HCV in an outpatient setting. A positive HCV serologic test (or a proven history of positive results) should be followed by a hepatitis C viral load test, which distinguishes an active from resolved infection. The result of the hepatitis C viral load establishes a baseline in patients with active disease by which the efficacy of therapy can be monitored. Patients with active infection (i.e., positive serology and hepatitis C viral load) may often need an HCV genotyping assay to guide therapy. Patients who have had a remote and resolved HCV infection who are suspected to have been reinfected should be tested using the hepatitis C viral load test, rather than the HCV antibody test, since this latter test remains positive for life. Viral load reflects the degree and severity of active infection and also acts as a useful component in monitoring antiviral therapy in medication-managed patients.