Health care exchange traded funds started 2014 in fine fashion, lead in large part by ebullience toward biotechnology stocks carried over from 2013.

Last year was the third consecutive year in which at least one biotech ETF ranked among the year’s 10 best non-leveraged ETFs. In 2013, the iShares Nasdaq Biotechnology ETF (NYSEArca: IBB) and the Market Vectors Biotech ETF (NYSEArca: BBH) fought for top honors among health care funds, each posting gains north of 64%. [Duel to be the Best Health Care ETF]

Soaring biotech issues were among the catalysts that helped the Health Care Select Sector SPDR (NYSEArca: XLV) rank as the second-best of the nine sector SPDRs through the first two months of the year. Then came the biotech sell-off. [Investors Depart Biotech ETFs]

From its February peak to its April nadir, IBB, the largest biotech ETF, slumped over 21%, entering a bear market along the way. XLV, which currently has an 18.3% allocation to the biotech industry, experienced a more modest decline of 7.1% from its March high to its April low.

It could be time for XLV, the largest health care ETF, to reclaim its old highs.

“XLV has held up well as of late, but the recent downtrend line breakout was on very light volume with Thursday’s action closing below the 50-day MA on a pick up in volume,” according to Deron Wagner of Morpheus Trading Group.