How is hepatitis C diagnosed?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

Both acute and chronic hepatitis C virus (HCV) infections are often asymptomatic; therefore, the diagnosis often relies on the identification of a potential risk factor and on subsequent screening for HCV-directed antibodies. Obtaining serum alanine aminotransferase (ALT) levels may be helpful.

Genotyping of HCV has proven to be a useful clinical tool, as the response to therapy and prognosis is influenced by the viral genotype. Genotype 1 is less than half as likely as other genotypes to respond to therapy, and combination therapy regimens vary depending on the different genotypes. In addition, early work by one group suggests that alpha-fetoprotein may have a prognostic significance, at least for genotypes 1 and 4; the likelihood of treatment failure was 6 times higher for patients with serum AFP above the median value (5.7 ng/ml). [4]

Imaging studies are not generally warranted to establish the etiology of hepatitis. However, ultrasonography is useful to monitor for HCV-related complications.


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