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Updated: Mar 25, 2026
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Evolving strategy for HCV testing in an Italian tertiary care hospital
Maria Cristina Medici1, Carlo Chezzi1, Flora De Conto1
1Unit of Microbiology and Virology, Department of Clinical and Experimental Medicine, University of Parma, 43126 Parma, Italy.
Background:
Diagnostic tests for hepatitis C virus (HCV) infection should be adapted according to the clinical status of the patient.
Objectives:
We exploited the application of different HCV diagnostic algorithms in a tertiary care hospital practice.
Study Design:
The laboratory clinical reports to the medical orders for HCV testing during three years were clustered by different combinations of assays for anti-HCV antibodies (HCV Ab) (screening and confirmatory), HCV nucleic acid (HCV-RNA), HCV core antigen (HCV Ag). The latter was the first-line assay in acute HCV infections requiring a rapid assessment of the infectious state.
Results:
The majority (91.9%) of the 2726 subjects whose samples were analyzed were inpatients. Most of the patients/subjects were tested for clinical suspicion of viral hepatitis (49.2%), or occupational accident to health care professionals (20.0%). On 66% of samples HCV Ag test alone was performed and resulted positive in 116 cases (6%), while it was detected in 50.3% of anti-HCV positive samples. The agreement between HCV Ag and HCV-RNA was very high (k=0.97); HCV Ag positivity rates increased according to the signal of the HCV Ab screening test.
Conclusions:
The use of different testing strategies according to the patients' history and clinical status allowed a significant reduction of the number of tests performed and the time needed to provide a diagnostic response useful for patients' management without compromising the overall diagnostic accuracy for HCV infection.
