From: WHO guidelines on testing for hepatitis B and C – meeting targets for testing
HOW TO TEST FOR CHRONIC HCV INFECTION AND MONITOR TREATMENT RESPONSE | |
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Topic | Recommendationsa |
Which serological assays to use | • To test for serological evidence of past or present infection in adults, adolescents and children (>18 months of ageb), an HCV serological assay (antibody or antibody/antigen) using either RDT or laboratory-based immunoassay formatsc that meet minimum safety, quality and performance standardsd (with regard to both analytical and clinical sensitivity and specificity) is recommended. - In settings where there is limited access to laboratory infrastructure and testing, and/or in populations where access to rapid testing would facilitate linkage to care and treatment, RDTs are recommended. Strong recommendation, low/moderate quality of evidence |
Serological testing strategies | In adults and children older than 18 monthsb, a single serological assay for initial detection of serological evidence of past or present infection is recommended prior to supplementary nucleic acid testing (NAT) for evidence of viraemic infection. Conditional recommendation, low quality of evidence |
Detection of viraemic infection | • Directly following a reactive HCV antibody serological test result, the use of quantitative or qualitative NAT for detection of HCV RNA is recommended as the preferred strategy to diagnose viraemic infection. Strong recommendation, moderate/low quality of evidence • An assay to detect HCV core (p22) antigen, which has comparable clinical sensitivity to NAT, is an alternative to NAT to diagnose viraemic infectione. Conditional recommendation, moderate quality of evidence |
Assessment of HCV treatment response | • Nucleic acid testing for qualitative or quantitative detection of HCV RNA should be used as test of cure at 12 or 24 weeks (i.e. sustained virological response (SVR12 or SVR24)) after completion of antiviral treatment. Conditional recommendation, moderate/low quality of evidence |