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Laboratory Testing for Hepatitis C

Patient Case

Slide 14

April 2008

Interpretation of laboratory test results depends on the profile that is indicated here. Those with chronic Hepatitis C infection, all three markers -HCV Antibody screen, confirmation with RIBA and HCV RNA -should all be positive. For those with resolved infection, the difference from chronic infection is there should be an absence of HCV RNA.

Now, in acute HCV infection, depending on when the patient presents for medical attention and laboratory testing, the Hepatitis C Antibody may or may not be detectable by screening tests and by confirmatory antibody tests indicated by the plus and minus signs for these two tests. However, HCV RNA should be detectable in these individuals.

As the infection progresses, and if the patient presents later in the course of infection during the acute phase, then all three markers should also be detectable. So, the difference between recent HCV infection versus chronic HCV infection is the absence or presence of symptoms because in the former, symptoms of liver inflammation should be present, whereas in chronic infection, symptoms may be minimal or absent.

It is also important to recognize there may be false-positive HCV Antibody results. In this case, both the HCV Antibody confirmation by RIBA and HCV RNA would be negative. Or the recombinant immunoblot assay could be indeterminate as well. It’s also possible to have an indeterminate or false-negative Hepatitis C Antibody by RIBA, in which case the HCV RNA was positive.

Patient Case


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