Gastroenterology Book


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

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