Hepatitis C serology

Keywords: Hepatitis C antibody, Hep C antibody, HCV antibody, HCV

Specimen:

5-10 mL blood in plain tube.

Method:

Immunoassay ± immunoblot.

Application:

Detection of HCV as a cause of acute hepatitis, chronic hepatitis, cirrhosis, hepatocellular carcinoma;

testing for infectivity in blood, semen or tissue transplant donors, after needle stick injury;

testing patients who have received blood or blood products eg renal dialysis patients;

investigation of patients with mixed essential cryoglobulinaemia.

Hepatitis C viral RNA provides a clearer indication of prognosis and infectivity and can be used to monitor treatment (see Hepatitis C nucleic acid).

Interpretation:

A positive initial test for anti-HCV antibodies can only be considered as a definite positive result if it is confirmed by a second immunoassay using different antigens or an immunoblot.

The test usually becomes positive 4 to 6 weeks after infection, but it may take up to 6 months for seroconversion to occur.

The significance of indeterminate results can only be determined by re-testing after 3 to 6 months.

Alternatively, Hepatitis C virus (HCV) RNA may be useful for diagnosis or assessment of infectivity in this circumstance.

A positive HCV antibody test indicates previous or ongoing HCV infection.

Reference:

Rosenberg PM. Clin Infect Dis. 2001; 33: 1728-1732.