Hepatitis C virus: Screening, diagnosis, and interpretation of laboratory assays

Area of Science:

• Hepatology
• Virology
• Public Health

Background:

• Hepatitis C virus (HCV) infection is a significant global health concern, affecting an estimated 3% of the world's population.
• Transmission primarily occurs through the blood route, with key risk factors including injection drug use, unsafe injection practices, and blood transfusions.
• Chronic hepatitis develops in approximately 80% of infected individuals, underscoring the need for effective diagnostic and management strategies.

Purpose of the Study:

• To provide an overview of diagnostic and management options for Hepatitis C virus (HCV) infection.
• To guide blood bank staff in diagnosing and managing donors who test positive for HCV.
• To emphasize the importance of accurate HCV diagnosis in preventing hepatic complications and hepatocellular carcinoma (HCC).

Main Methods:

• Initial screening for antibodies to HCV (anti-HCV) in high-risk groups.
• Utilizing serum to cut-off ratio (S/CO) for supplemental assay selection.
• Employing nucleic acid amplification tests (NAT) for confirmation and viral load determination, with quantitative NAT replacing qualitative assays.
• Performing genotyping for treatment response prediction and duration optimization.

Main Results:

• Quantitative NAT is now the standard for viral load assessment.
• Genotyping aids in tailoring therapy for better patient outcomes.
• Understanding diagnostic pathways is essential for healthcare practitioners.

Conclusions:

• Accurate diagnosis and interpretation of HCV tests are critical in the absence of preventive vaccines or post-exposure prophylaxis.
• Addressing unsafe practices like professional blood donation and injection use is vital for controlling HCV spread in India.
• Effective management of HCV-positive donors is essential for blood safety and public health.