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Use and interpretation of hepatitis C virus diagnostic assays
1Department of Virology (EA 3489), Henri Mondor Hospital, University of Paris XII, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France. jean-michel.pawlotsky@hmn.ap-hop-paris.fr
Insights
Virologic assays significantly improve hepatitis C management by detecting HCV RNA and guiding treatment. Further standardization and accuracy of these tests are needed for optimal patient care and understanding antiviral resistance.
Area of Science:
- Hepatology
- Virology
- Clinical Diagnostics
Background:
- Hepatitis C virus (HCV) infection diagnosis and management rely on specific biologic markers.
- Current markers include HCV genotype, HCV RNA, HCV core antigen, and anti-HCV antibodies.
Purpose of the Study:
- To review the role of virologic assays in diagnosing and managing hepatitis C.
- To highlight areas for improvement in current HCV diagnostic and monitoring tools.
Main Methods:
- Review of current diagnostic and monitoring techniques for hepatitis C.
- Discussion of the utility of HCV RNA detection, quantification, and genotyping.
Main Results:
- Virologic assays have substantially enhanced the management of HCV infection.
- Standardization, automation, and clinically relevant cut-off values for assays require further development.
Conclusions:
- Improved HCV RNA assays are crucial for assessing antiviral treatment response and understanding resistance.
- Optimizing HCV treatment necessitates advancements in virologic assays and new antiviral drugs.
Abstract:
The HCV genotype, HCV RNA, HCV core antigen, and anti-HCV antibodies are the four biologic markers currently used in hepatitis C. Acute and chronic hepatitis C are diagnosed by anti-HCVantibody (enzyme immunoassay) and HCV RNA detection with sensitive molecular biology techniques. Other virologic tools include HCV genotype determination and HCV RNA quantification; these are used to guide the individual treatment choice, and also to monitor treatment efficacy. Overall, the management of HCV infection has been vastly improved by the use of virologic assays. These assays remain to be fully standardized and automated, however, and more clinically relevant cut-off values are required on which to base management recommendations. More sensitive and accurate HCV RNA assays will improve not only the assessment of the response to antiviral treatment, but also our understanding of antiviral resistance. These improvements, and the development of new antiviral drugs (see the article by Drs. DeFrancesco and Rice elsewhere in this issue), should help to optimize the treatment of HCV infection.