Testing for HCV Infection

Jane P. Getchell, DrPH; Kelly E. Wroblewski, MPH; Alfred DeMaria Jr, MD; Christine L. Bean, PhD; Monica M. Parker, PhD; Mark Pandori, PhD; D. Robert Dufour, MD; Michael P. Busch, MD, PhD; Mark E. Brecher, MD; William A. Meyer, PhD; Rick L. Pesano, MD, PhD; Chong-Gee Teo, MD, PhD; Geoffrey A. Beckett, MPH; Aufra C. Araujo, PhD; Bernard M. Branson, MD; Jan Drobeniuc, MD, PhD; Rikita Hatia, MPH; Scott D. Holmberg, MD, MPH; Saleem Kamili, PhD; John W. Ward, MD

Disclosures

Morbidity and Mortality Weekly Report. 2013;62(18):362-365. 

In This Article

Identifying Current HCV Infections

In 2011, FDA approved boceprevir (Victrelis, Merck & Co.) and telaprevir (Incivek, Vertex Pharmaceuticals) for treatment of chronic hepatitis C genotype 1 infection, in combination with pegylated interferon and ribavirin, in adult patients with compensated liver disease. Boceprevir and telaprevir interfere directly with HCV replication. Persons who complete treatment using either of these drugs combined with pegylated interferon and ribavirin are more likely to clear virus (i.e., have virologic cure), compared to those given standard therapy based on pegylated interferon and ribavirin.[9] Viral clearance, when sustained, stops further spread of HCV and is associated with reduced risk for hepatocellular carcinoma[10] and all-cause mortality.[11] Other compounds under study in clinical trials hold promise for even more effective therapies.[6]

Because antiviral treatment is intended for persons with current HCV infection, these persons need to be distinguished from persons whose infection has resolved. HCV RNA in blood, by nucleic acid testing (NAT), is a marker for HCV viremia and is detected only in persons who are currently infected. Persons with reactive results after HCV antibody testing should be evaluated for the presence of HCV RNA in their blood.

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