Hepatitis C Virus Ab 0.1

Diagnosis And Management Of Hepatitis C

THAD WILKINS, MD MARIAM AKHTAR, MD and EUNICE GITITU, MD, Georgia Regents University, Augusta, Georgia

CHRISTINE JALLURI, MD, and JASON RAMIREZ, MD, University of Maryland, Baltimore, Maryland

Am Fam Physician. 2015 Jun 15 91:835-842.

Patient information: See related handout on hepatitis C, written by the authors of this article.

• References

Hepatitis C virus infection is a major cause of chronic liver disease and cirrhosis.1 The World Health Organization reports that there are at least 185 million persons worldwide with the infection, causing 350,000 deaths annually.1 In the United States, an estimated 2.7 million individuals are chronically infected with HCV.2 The burden of HCV infection in the United States is expected to increase because of the high proportion of persons who were infected in the 1960s and 1970s.3 In 2013, the total cost of HCV infection in the United States was estimated at $6.5 billion.4 Chronic HCV infection leads to significantly more lost days of work, decreased productivity, and increased health care costs.5 This article focuses on chronic HCV infection in adults and excludes special groups, such as children, pregnant women, transplant recipients, and persons coinfected with hepatitis B virus or human immunodeficiency virus .

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Periodic HCV screening is recommended in all adults at high risk of infection, and one-time screening is recommended in adults born between 1945 and 1965.

HCV = hepatitis C virus.

Adverse Effects Of Treatment

Adherence to treatment remains a major factor influencing the rates of sustained virologic response.33,42 Discontinuation of therapy because of adverse events is common and has been reported in up to one third of patients. Approximately 50 to 60 percent of patients may exhibit self-limited influenza-like symptoms with interferon-based therapy.2 Effective management of treatment-related adverse events is essential to improve adherence to treatment therefore, patients should be monitored closely for hematologic, renal, and thyroid abnormalities. Approximately 30 percent of patients undergoing treatment for HCV infection experience depression, emotional lability, or anger, but treatment is rarely associated with suicidal ideation or hallucinations.43 Treatment for HCV infection is contraindicated in persons with uncontrolled major depression.32 A recent randomized trial found that the overall adverse effects of pegylated interferon alfa-2b plus ribavirin and pegylated interferon alfa-2a plus ribavirin were similar.40 Adverse effects of pegylated interferon and ribavirin for the treatment of HCV infection are listed in Table 8.32

Adverse Effects of Pegylated Interferon and Ribavirin for the Treatment of Hepatitis C Virus Infection

Information from reference 32.

Adverse Effects of Pegylated Interferon and Ribavirin for the Treatment of Hepatitis C Virus Infection

Information from reference 32.

Once I Have Been Treated And/or Recovered From Hepatitis C Can I Get Infected Again

Yes. A prior infection with HCV does not protect you from another infectionit does not make you immune to HCV. Most people do not have an effective immune response to the virus. Changes that the virus undergoes as it replicates during an infection make it difficult for the body to fight against the initial or subsequent infections.

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What Is An Hcv Antibody Test

An HCV antibody test is used to determine whether youve contracted the hepatitis C virus.

The test looks for antibodies, which are proteins made by the immune system that are released into the bloodstream when the body detects a foreign substance, such as a virus.

HCV antibodies indicate exposure to the virus at some point in the past. It can take anywhere from a few days to a few weeks to get results back.

. The blood panel will either show that you have a nonreactive result or a reactive result.

Time For Processing Hcv Ab Test Results

The turnaround time for 3rd-generation EIAs is at least 1 day. Many labs do not perform the tests on site and must send specimens to another lab for processing, which may further increase the turnaround time.

A point-of-care test is also available. The OraQuick® HCV Rapid Antibody Test is an FDA-approved test that can be performed with a fingerstick . It is also a CLIA-waived test and therefore can be used in clinic offices and outreach facilities. Results are reported as reactive or nonreactive within 20 minutes. Just as for the standard HCV Ab test done in the lab, a positive OraQuick® test must be confirmed by an HCV RNA test. The sensitivity and specificity of the test is similar to that of the laboratory-based assays.

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Meaning Of Hcv Viral Load

The number of HCV RNA international units per milliliter of blood must be measured before treatment and during the course of treatment, to assess response. Before treatment, however, the HCV viral load is not related to the patient’s liver disease severity or HCV prognosis. This is important for patients and providers to understand.

Note: In hepatitis B, unlike hepatitis C, a higher HBV DNA viral load does correlate with increased disease severity and increased likelihood of outcomes such as hepatocellular carcinoma.

Other Hepatitis C Tests

After an individual has received a reactive or positive result from a hepatitis C antibody test, they will need to have two follow-up tests.

The first test checks to see whether a person still has the virus the other measures the amount of the virus in the blood.

The first test is the hep C RNA qualitative test, also known as the PCR test. A positive result means that a person has the hepatitis C virus. A negative result means that the body has cleared the virus without treatment.

The second test is the hep C RNA quantitative test. The result of this test is given as a number rather than a positive or negative. This is because the test compares the amount of the virus in the body before, during, and after treatment.

The number given as a result of this test is known as the viral load. The lower amount of the hepatitis C virus in the blood, the better the chances that a person can eliminate the virus from their body.

After hepatitis C virus is diagnosed, other tests may be needed:

Certain behaviors, experiences, and medical procedures increase the risk of getting the hepatitis C virus, which is transmitted by contact with blood.

The following are risk factors for contracting the virus:

The Centers for Disease Control and Prevention advise all baby boomers get tested for hepatitis C. Baby boomers are people born between 1945 and 1965. They are five times more likely to have the virus than other adults.

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Clustering Of Hepatitis C Virus Antibody Positivity Within Households And Communities In Punjab India

Published online by Cambridge University Press: 07 October 2019

A. Trickey*

Affiliation:Population Health Sciences, University of Bristol, Bristol, UKNational Institute of Health Research Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK

A. Sood

Dayanand Medical College, Civil lines, Tagore Nagar, Ludhiana, Punjab, India

V. Midha

Dayanand Medical College, Civil lines, Tagore Nagar, Ludhiana, Punjab, India

W. Thompson

Centers for Disease Control and Prevention, Atlanta, GA, USA

C. Vellozzi

Centers for Disease Control and Prevention, Atlanta, GA, USA

S. Shadaker

Centers for Disease Control and Prevention, Atlanta, GA, USA

V. Surlikar

MSD India Pvt. Ltd, Mumbai, India

S. Kanchi

MSD India Pvt. Ltd, Mumbai, India

P. Vickerman

Affiliation:Population Health Sciences, University of Bristol, Bristol, UKNational Institute of Health Research Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK

M. T. May

Affiliation:Population Health Sciences, University of Bristol, Bristol, UKNational Institute of Health Research Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK

F. Averhoff

Centers for Disease Control and Prevention, Atlanta, GA, USA

*

Hepatitis C Virus Antibody With Reflex To Hcv Rna Pcr Symptomatic Serum

Diagnosis of recent or chronic hepatitis C virus infection in symptomatic patients

This test is not offered as a screening or confirmatory test for hepatitis C virus for blood, human cells, or tissue donors.

This test profile is not useful for detection or diagnosis of acute HCV, since HCV antibodies may not be detectable until after 2 months following exposure and HCV RNA testing is not performed on specimens with negative anti-HCV screening test results.

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Are Test Results Accurate

Although no test is perfect, hepatitis C testing is an important and accepted method of testing for HCV. In order to reduce the risk of inaccurate results, doctors take steps to verify a patients diagnosis. For example, a positive test result for hepatitis C antibody requires confirmation with HCV RNA testing.

Taking A Hepatitis C Test

Hepatitis C testing is conducted on a sample of blood. Blood samples can be collected by a doctor, nurse, technician, or other health care provider from an adult patients vein using a small needle or a skin prick on a childs heel.

For an at-home hepatitis C test, patients collect a blood sample according to the manufacturers directions. Instructions provided in the test kit detail the steps to obtain a small sample of blood and mail it for testing.

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What Causes Hepatitis C

Hepatitis C is more prevalent in young people and the hepatitis C virus usually spreads through blood to blood contact like in the case of intravenous drug use, poorly sterilized medical equipment, needlestick injuries and transfusions. Hepatitis C can also be passed down from an infected mother to its baby during child birth. Hepatitis C is also spread through sex with an infected person.

What Does This Hep C Virus Ab 0 1 Mean

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How To Get Tested

Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.

What Is Hepatitis C Test

Hepatitis C Test is a blood test that is used for the detection of the Hepatitis C virus. There are several types of Hepatitis C test that is used by doctors for the diagnosis of Hepatitis C. The varied Hepatitis C tests are

Hepatitis C Antibody Test : Hepatitis C antibody test is used by doctors to ascertain whether or not a person has been affected by the HCV at any point of his/her life by detecting Hepatitis C antibodies in the blood.

Hepatitis C RNA Qualitative Test : Also referred to as PCR test, this test screens for current infection of the virus.

Hepatitis C RNA Quantitative Test: As the name suggests it is a quantitative test and measures the amount of Hepatitis C virus in the body. The Hepatitis C RNA Quantitative Test is also referred to as viral load test.

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How Is The Test Used

The various hepatitis C tests have different uses:

How Can We Help

Hepatitis C test only require basic blood sample, which can also be collected from help to get the test done and to help you do so is our highly reliable and well established at home healthcare services, wherein you can not only get Hepatitis C home test but, can also get doctors consultation at home. So, you neednt have to worry of getting tested, collecting the hepatitis test reports and then running to a doctors. As we have designed our at home healthcare services keeping the comfort of patients at mind. So, if you need Hepatitis C home test done or hepatitis C treatment at home or any other healthcare services at home just give us a call and we will be there at your service.

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Other Things To Know:

• After a successful course of treatment for hepatitis C, the hepatitis C antibody remains detectable, but the hepatitis C RNA will be undetectable.
• If you plan to donate blood, you will be tested for the hepatitis C antibody and will be turned away even if you do not have an active infection.
• Any patient with a positive test result for the hepatitis C antibody should have additional tests to determine whether or not the virus is still active.

Diagnosis And Hepatitis C Elimination

In one report, the National Academies of Sciences, Engineering, and Medicine explored the feasibility of hepatitis C elimination and concluded that hepatitis C could be eliminated as a public health problem in the United States, but that substantial obstacles exist . In another report, specific actions were recommended to achieve elimination considering information, interventions, service delivery, financing, and research . These reports were the culmination of decades of progress in the development of HCV infection diagnostic and therapeutic tools.

In 1990, serologic tests to detect immunoglobulin G anti-HCV by enzyme immunoassay were licensed and became commercially available in the United States, and U.S. blood banks voluntarily began testing donations for anti-HCV . In 1991, U.S. Public Health Service issued interagency guidelines addressing hepatitis C screening of blood, organs, and tissues . These guidelines recommended hepatitis C testing for all donations of whole blood and components for transfusion, as well as testing serum/plasma from donors of organs, tissues, or semen intended for human use .

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Explanation Of Test Results:

If this test result is positive, it means your body was exposed to the hepatitis C virus and made antibodies . However, it does not tell you whether you are still infected with hepatitis C. If the antibody test result is positive, you should be tested for hepatitis C RNA , which determines whether you are chronically infected. The lab will perform this RNA test automatically if your hepatitis C antibody test is positive.

If the antibody test result is negative, it means you have not been infected with the hepatitis C virus, and further testing for hepatitis C usually is not needed.

Discusses Conditions That May Cause Diagnostic Confusion Including Improper Specimen Collection And Handling Inappropriate Test Selection And Interfering Substances

A single negative hepatitis C virus RNA test result together with a reactive HCV antibody screen result with a signal-to-cutoff ratio of 8.0 or greater does not rule out the possibility of chronic HCV infection. Repeat testing for HCV RNA in 1 to 2 months is recommended in patient at risk for chronic hepatitis C.

Infants born to HCV-infected mothers may have false-reactive HCV antibody test results due to transplacental passage of maternal HCV IgG antibodies. HCV antibody testing is not recommended until at least 18 months of age in these infants.

Performance characteristics have not been established for the following types of serum specimen:

-Individuals under 10 years of age

-Grossly icteric

-Grossly lipemic

-Grossly hemolyzed

-Presence of particulate matter

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Enzyme Immunoassays For Detection Of Hepatitis C Antibody

The HCV Ab test is used for initial screening for hepatitis C. The test is performed by enzyme immunoassays , which detect the presence of hepatitis C antibodies in serum. The result of the test is reported as positive or negative. Third-generation EIAs have a sensitivity/specificity of approximately 99%. However, the presence of HCV Ab does not indicate whether the infection is acute, chronic, or resolved. A positive antibody test result should be followed up with an HCV RNA test to confirm that viremia is present.

What Is Hepatitis C

Hepatitis C is an infectious disease of the liver caused by hepatitis C virus . During the primary stage of infection, there is mild or no symptoms associated with the disease and as the disease progresses into chronic infection the symptoms become noticeable and acute symptoms are noticed in about 15%v of cases.

Hepatitis C virus infection can lead to liver disease and sometime cirrhosis, and people suffering from cirrhosis can develop complications like liver, failure, liver cancer and dilated blood vessels in the stomach and oesophagus.

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