Laboratory Diagnostics for Hepatitis C Virus Infection

Kamili, Saleem; Drobeniuc, Jan; Araujo, A Caterino de; Hayden, Tonya

doi:10.1093/cid/cis368

Cited by 154 publications

(147 citation statements)

References 43 publications

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“…This test has high sensitivity (97.2%-100%) and specificity (> 99%); 24,25 however, a positive result indicates only exposure to the virus. Up to 30% of people spontaneously clear HCV within 6 months of infection.…”

Section: Which Screening Test Should Be Performed?mentioning

confidence: 99%

A Canadian screening program for hepatitis C: Is now the time?

Shah

Heathcote

Feld

2013

CMAJ

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Analysis CMAJ• Hepatitis C virus (HCV) infection has an enormous impact on population health in Canada and is likely underdiagnosed.• A national strategy to screen for and treat HCV infections would substantially reduce HCV-related morbidity and mortality.• Birth-cohort screening of people born between 1945 and 1975 coupled with a strategy for follow-up treatment and education is probably the best method to identify and provide care to affected people in Canada.• Population-level data on the prevalence and health impact of HCV infection are needed in Canada. Key points © 2013 Canadian Medical Association or its licensorsCMAJ, October 15, 2013, 185(15) 1325 markedly lower than in countries with active surveillance programs for HCV, and, if correct, would place Canada among the top countries in the world at diagnosing HCV infections despite not having a national screening program. The CDC estimates that 63% of Americans with HCV are unaware of their infection, 7 and underdiagnosis is highly prevalent even among people with insurance and access to care.11 Data from Europe show a similar pattern. Before introducing an intensive national program, 75% of infected individuals in France were unaware of their infection; after introduction of this program, the rate decreased to 44%. 12 Given that it took a major national effort in France to get the diagnosis rate to 56%, it seems unlikely that Canada's estimate that 79% of infected individuals are aware of their diagnosis is correct.The Canadian data may be inaccurate for 2 major reasons. First, diagnosed cases may have been inadvertently counted more than once. Second, and more importantly, the overall prevalence may be considerably higher than estimated, particularly because groups at high risk of HCV infection are often undersampled. With the same number of positive test results, a higher prevalence would lead to a lower diagnosis rate. If Canadian data are similar to those in countries with comparable health care systems (e.g., France), the rate of underdiagnosis is likely much higher than 21%, and strategies to decrease this rate are needed. What are the benefits and risks of screening?Hepatitis C virus meets the criteria for a condition for which screening specific populations is potentially useful. There are many benefits: HCV is a major cause of morbidity and mortality; the prevalence of HCV is increased among baby boomers; many individuals are unaware that they are infected; and HCV infection is curable, with early intervention leading to improved overall health outcomes. Patients whose infection has been eradicated before cirrhosis develops have a life expectancy similar to that of uninfected people.13 If cirrhosis develops before treatment, viral eradication eliminates the risk of liver failure and markedly reduces the risk of hepatocellular cancer. 3,13 There are potential risks associated with screening, including individuals feeling stigmatized by being "targeted," false positive results and a lack of capacity to treat the volume of newly diagnosed cases. ...

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Section: Which Screening Test Should Be Performed?mentioning

confidence: 99%

A Canadian screening program for hepatitis C: Is now the time?

Shah

Heathcote

Feld

2013

CMAJ

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“…The absence of anti-HCV antibodies usually shows that the patient has not been infected. However, anti-HCV antibodies might not be detectable in the first few weeks after the initial infection (window period) in immunosuppressed patients, or in patients who resolve their infection many years later [150,151]. Several countries in the Asia-Pacific region have developed their own individual testing algorithms for anti-HCV antibody testing.…”

Section: Hcv Laboratory Testing Before and After Svr Serologic Assaysmentioning

confidence: 99%

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

et al. 2016

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The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on ''APASL consensus statements and recommendations for management of hepatitis C'' in March 2015 to revise the ''APASL consensus statements and management algorithms for hepatitis C virus infection'' (Hepatol Int 6:409-435, 2012). The working party consisted of expert hepatologists from the Asian-Pacific region gathered at the Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed, and debated during the course of drafting a revision. Participants of the consensus meeting assessed the quality of the cited studies. The finalized recommendations for hepatitis C prevention, epidemiology, and laboratory testing are presented in this review.

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“…HCV-RNA is found in blood, saliva, tears, seminal fluid, ascitic fluid, and cerebrospinal fluid. The diagnosis of HCV infection is based principally on detection of antibodies to recombinant HCV polypeptides and by assays for HCV-RNA [1,9,10]. There have been several generations of EIAs that measure antibodies against NS4, core, NS3, and NS5 sequences.…”

Section: Chronic Hepatitis Bmentioning

confidence: 99%

“…However, supplemental antibody assays are no longer commercially available in the United States. Today, HCV testing recommendations generally call for screening for HCV antibodies followed by RNA testing [1,9,10]. In acute HCV infection or immunosuppressed states, a negative anti-HCV EIA result does not exclude HCV infection.…”

Section: Chronic Hepatitis Bmentioning

confidence: 99%

Microbiological diagnostics of viral hepatitis

Hasdemir¹

2016

MMJ

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Liver may also be target some other viruses including Epstein-Barr virus (EBV), cytomegalovirus (CMV), adenovirus, Herpes simplex virus (HSV), enteroviruses, yellow fever virus, mumps, rubella, and rubeola. However liver is not the primarily infected organ with these viruses and its' involvement is seen on occasion as part of their systemic infections. Additionally a few viruses such as hepatitis G, hepatitis GB, transfusion-transmitted virus, SEN virus may account in cases of hepatitis presenting features similar to hepatitis caused by well known viruses.In this section laboratory diagnostics of well known

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Laboratory Diagnostics for Hepatitis C Virus Infection

Cited by 154 publications

References 43 publications

A Canadian screening program for hepatitis C: Is now the time?

A Canadian screening program for hepatitis C: Is now the time?

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

Microbiological diagnostics of viral hepatitis

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