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A controversy
Jan 22, 2002

Dr. Fried, Many experts have different opinions for the accuracy of the HCV PCR tests. Some medical articles claim that "at least two PCR tests should be done to confirm a patient's hepatitis status". No one knows if the lab technician would make a mistake or not while performing the tests. So How many PCRs in your opinions should a patient with high risk to hcv undergo to confirm his status? Is the HCV PCR more easily performed than the HIV PCR? What should be the period between the two tests? Thank you.

Response from Dr. Fried

Anti-HCV antibody is the best screening test for HCV infection. It is very sensitive and specific when patients have had a risk factor for exposure (for example iv drug or transfusions) and an abnormal ALT. A PCR test will determine if the HCV virus itself is present in the blood. The HCV RNA PCR tests mostly have been standardized so the results are more dependable than they were several years ago.

If there is a question of a false-positive anti-HCV test, sometime a supplemental assay called RIBA is used. If the RIBA is positive, the person was exposed to HCV but you still need PCR tests to see if the HCV RNA is still present in the blood. If the RIBA is negative than the person was not exposed to HCV and the anti-HCV test was a FALSE-positive.



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