Hepatitis C: Sensitivity and Specificity

Introduction: None written.

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Tags: Hepatic Infection Tag this Diagnosis.

The sensitivity and specificity of findings for Hepatitis C are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

HCV Ab RIBA

94%

RIBA (recombinant immunoblot assay), vs HCV PCR

RIBA is not intended to be used as a screening test but rather as a confirmatory test. In addition, note that there are 3 outcomes of RIBA: positive (>= 2 antigens reactivity), intermediate (1 antigen reactive), or negative. Intermediate RIBA does carry a higher PPV than negative but lower than a positive test.

Study: J Clin Microbiol 1992 Aug;30(8):2145-9. PMID 1323578

Anti-HCV Ab

92%

93%

first-generation enzyme immunoassay, vs HCV PCR

Second generation tests are more sensitive (~95%) and reportedly more specific - PPV in high risk pool ~88% or 50% in lower risk pool.

The mean time to seroconversion improves with the generation (16 wk with 1st gen, 10wk with 2nd gen, and 8wk in 3rd gen) per UpToDate (http://www.uptodate.com/online/content/topic.do?topicKey=heptitis/8251).

Study: J Clin Microbiol 1992 Aug;30(8):2145-9. PMID 1323578

Hepatology 1997 Sep;26(3 Suppl 1):43S-47S. PMID 9305663

Poorly Diagnostic Findings

Elevated Serum Transaminases

80%

32%

vs RIBA gold standard

Study: J Clin Microbiol 1992 Aug;30(8):2145-9. PMID 1323578

Findings With Unspecified Accuracy

HCV RNA

No accuracy specified.

now considered the "gold standard" - though note that some patients can have +ELISA and negative RNA PCR. In these patients, RIBA should be done to confirm past/current infection.

Study: UpToDate http://www.uptodate.com/online/content/topic.do?topicKey=heptitis/8251