Investigation of hepatitis C infection by HCV antibody testing confirmed by antigen 1st Assay 2nd Assay 3rd assay Interpretative comments Notes HCV Ab HCV Ag HCV NAAT In the case of suspected acute hepatitis C or in immunocompromised patients, HCV RNA testing should be part of the initial evaluation. HCV core antigen assays are less 7 Not reactive Not tested Not tested HCV antibody not detected. sensitive than HCV RNA assays as a result core antigen becomes detectable in peripheral blood a few days after HCV RNA in patients with acute HCV 26. Consistent with active HCV Consider HCV RNA testing in addition to requesting HCV infection. Advise referral to an genotyping testing. Recommend other BBV testing unless appropriate specialist for further already performed. assessment/treatment. Reactive or 8 Reactive Not tested Equivocal Hepatitis A and B vaccine recommended if appropriate. Please send a repeat sample to confirm by NAAT. EASL 2016 recommend that positive, HCV RNA “Anti-HCV negative individuals should be retested for HCV RNA 3 Reactive or Equivocal or Not No evidence of active HCV 9 Not detected months later to confirm definitive clearance”26. Equivocal reactive infection. Recommend other BBV testing unless already performed. HCV RNA detected. Consider HCV RNA testing in addition to requesting HCV genotyping testing. Recommend other BBV testing unless Reactive or Evidence of active HCV infection. 10 Equivocal Detected already performed. Equivocal Advise referral to an appropriate specialist for further
Investigation of hepatitis C infection by HCV antibody testing confirmed by antigen 1st Assay HCV Ab 2nd Assay HCV Ag 3rd assay HCV NAAT Interpretative comments Notes 7 Not reactive Not tested Not tested HCV antibody not detected. In the case of suspected acute hepatitis C or in immunocompromised patients, HCV RNA testing should be part of the initial evaluation. HCV core antigen assays are less sensitive than HCV RNA assays as a result core antigen becomes detectable in peripheral blood a few days after HCV RNA in patients with acute HCV 26. 8 Reactive or Equivocal Reactive Not tested Consistent with active HCV infection. Advise referral to an appropriate specialist for further assessment/treatment. Hepatitis A and B vaccine recommended if appropriate. Consider HCV RNA testing in addition to requesting HCV genotyping testing. Recommend other BBV testing unless already performed. 9 Reactive or Equivocal Equivocal or Not reactive Not detected No evidence of active HCV infection. Please send a repeat sample to confirm by NAAT. EASL 2016 recommend that “Anti-HCV positive, HCV RNA negative individuals should be retested for HCV RNA 3 months later to confirm definitive clearance”26. Recommend other BBV testing unless already performed. 10 Reactive or Equivocal Equivocal Detected HCV RNA detected. Evidence of active HCV infection. Advise referral to an appropriate specialist for further Consider HCV RNA testing in addition to requesting HCV genotyping testing. Recommend other BBV testing unless already performed.
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