How is the hepatitis C virus detected?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Hepatitis C virus–directed antibodies may be detected. Antibody screening using enzyme immunoassay (EIA) is inexpensive and reliable; generally, this is the screening test of choice for diagnosis. Recombinant immunoassay (RIBA) can then be used to confirm positive EIA results.

The US Food and Drug Administration (FDA) has approved OraQuick HCV Rapid Antibody Test, which uses a venipuncture whole blood sample and provides results in approximately 20 minutes. [6] The test can be used for persons at risk for hepatitis or for those with signs or symptoms of hepatitis.

Hepatitis C virus RNA may be detected with the polymerase chain reaction (PCR) test. Several FDA-approved test kits that can be used for blood product screening or diagnostic testing are currently available. (Kits are not usually approved for both uses.) Hepatitis C virus RNA is usually detectable within 1-2 weeks of exposure. Quantitative assays are available, but hepatitis C viral load has not been definitively shown to be useful in predicting outcome (unlike HIV viral load). It may be useful in predicting risk of recurrence in transplant recipients.

PCR testing is useful to confirm positive EIA results in the setting of indeterminate RIBA test results and to distinguish between resolved and chronic HCV infection in patients with positive EIA and RIBA results.

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