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Evaluating Enyzme Immunoassay (EIA) Result for Antibodies to Hepatitis C Virus

Purpose: To evaluate a patient with possible viral hepatitis C (HCV) using the testing algorithm of Dufour et al.

Description

Dufour et al developed an algorithm for evaluating enzyme immunoassay (EIA) results for antibodies to hepatitis C virus (HCV). This can be used to efficiently evaluate a patient for HCV infection. The authors are from the Veterans Affairs Medicial Center, National Institute of Digestive, Diabetes, and Kidney Diseases, and George Washington University in Washington, D.C.


 

Parameters:

(1) EIA test results, including signal-to-cutoff ratio (S/C) if positive (see previous section)

(2) RIBA (recombinant immunoblot assay)

(3) frequency of elevated ALT serum levels (ALT pattern)

(4) HCV RNA testing

(5) decision to treat or not

 

EIA S/C Ratio

Interpretation

Action

<= 1.0

negative

none; diagnose as negative

1.01 – 3.79

low positive

perform RIBA

>= 3.80

high positive

review ALT pattern

 

 

RIBA Result

Action/Interpretation

negative

negative for HCV; EIA false positive

indeterminate

perform HCV RNA

positive

perform HCV RNA

 

 

ALT Pattern

Decision to Treat

Action/Interpretation

<= 1 increased

NA

perform HCV RNA

>=2 increased (multiple)

no

presume positive; no further testing needed

>=2 increased (multiple)

yes

perform HCV RNA

 


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Specialty

Objective

ICD-10