Hepatitis C Serology

Aka: Hepatitis C Serology, Hepatitis C Antibody, Hepatitis C Virus Antibody, Anti-HCV RNA, xHCV Antibody, xHCV Ab, xHCV IgG, RT-PCR for HCV RNA, EIA for Anti-HCV

1. See Also
   1. Hepatitis C
2. Course of Anti-HCV Antibody
   1. Present in up to 70% at onset of symptoms
   2. Present in 90% of cases at 3 months
   3. Present in most cases by 6 months post-exposure
3. Screening Tests
   1. ELISA-1 (replaced by ELISA-2)
      1. Detects seroconversion 15-20 weeks after exposure
      2. Sensitivity: 81-89%
      3. Specificity: Poor (High rate of false positives)
   2. ELISA-2 (preferred Screening Test)
      1. First line test
      2. Detects seroconversion 1-6 weeks after exposure
      3. Efficacy improved over ELISA-1
         1. Test Sensitivity: 99%
         2. Test Specificity: 99%
      4. False negative tests if immunocompromised
4. Confirmatory Tests
   1. RIBA-2 (replaced by RT-PCR for confirmation)
      1. Indication: confirm Elisa-2 (RT-PCR preferred)
      2. Small advantage over ELISA-2
   2. Reverse transcriptase PCR for HCV RNA (RT-PCR)
      1. Indication: RIBA is indeterminate
      2. Best available diagnostic test
      3. Sensitivity: High
         1. Detects very low serum and tissue levels
         2. Qualitative test detects HCV to 5-50 copies/ml
      4. Specificity: High
      5. Disadvantages
         1. Expensive
         2. Requires flawless technique for accurate results