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New Guidelines for Hepatitis C Testing

New Guidelines for Hepatitis C Testing

In 2003, the CDC published recommendations on the laboratory testing and reporting of hepatitis C virus (HCV) infection. The guidance focused on testing for the HCV antibody, a marker of HCV exposure. Since 2003, several efficacious antiviral drugs have been approved by the FDA for the treatment of hepatitis C. “These newer drugs are increasingly being prescribed by physicians,” says Chong-Gee Teo, MD, PhD. “They offer patients the likelihood of a cure from hepatitis C.” Rapid testing for the HCV antibody with similar sensitivity and specificity to bench testing has also become widely available in the last decade. In addition, there has been increasing evidence that many patients who are reactive to an HCV antibody test are not then tested for current HCV infection. As a result of these developments, the CDC updated its guidance on HCV testing and published it in the Morbidity and Mortality Weekly Report. Targeted Testing “The current CDC guideline is geared toward identifying current infection with hepatitis C,” says Dr. Teo, who co-authored the document. “Rather than targeting the HCV antibody as a marker of infection, the target of testing is now the actual HCV genome itself, or HCV RNA. This is a marker of the virus in the blood and, therefore, current infection.” The concern with focusing testing only on the HCV antibody is that this approach cannot distinguish between patients whose past HCV infection has resolved and those who are currently infected. A reactive result to an HCV antibody test can also be a false-positive. Accurate testing of current infection through HCV RNA testing helps identify patients who require preventive services, counseling,...
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