Diagnosis and evaluation of chronic hepatitis C virus infection
- Norah A Terrault, MD, MPH
Norah A Terrault, MD, MPH
- Professor of Medicine
- University of California San Francisco
- Sanjiv Chopra, MD, MACP
Sanjiv Chopra, MD, MACP
- Editor-in-Chief — Gastroenterology/Hepatology
- Section Editor — General Hepatology; Gallbladder and Biliary Tract Disease
- Professor of Medicine
- Harvard Medical School
- Senior Consultant in Hepatology
- James Tullis Firm Chief
- Beth Israel Deaconess Medical Center
Diagnostic tests for hepatitis C virus (HCV) can be divided into two broad categories:
●Serologic assays that detect antibodies to hepatitis C
●Molecular assays that detect or quantify HCV RNA
Other investigations such as genotype testing, serum fibrosis panels and liver biopsy may help to predict the response to treatment and prognosis.
This topic will review the approach to diagnostic testing and evaluation of chronic HCV infection.
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- WHOM TO TEST
- DIAGNOSIS AND TESTING APPROACH
- Testing algorithm
- Nonreactive anti-HCV antibody
- - Severely immunocompromised and hemodialysis patients
- - Patients with acute hepatitis or recent exposure
- Reactive antibody and positive RNA test
- Reactive antibody and negative RNA test
- DIAGNOSTIC TESTS
- Antibody testing
- - Standard immunoassay testing
- - Rapid immunoassay tests
- - Self-collected tests
- - Recombinant immunoblot assay
- HCV RNA assays
- - Methods of RNA detection
- - Quantitative tests
- - Qualitative tests
- HCV core antigen test
- ADDITIONAL EVALUATION
- History and physical exam
- Basic laboratory testing
- HCV genotype testing
- Assessment of fibrosis stage
- Testing for HIV, hepatitis B, and hepatitis A
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS