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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.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] HCV Ab RIBA	+ 0 -	94%	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	+ 0 -	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
Finding	Result	Sensitivity	Specificity
[ + ] Elevated Serum Transaminases	+ 0 -	80%	32%
vs RIBA gold standard Study: J Clin Microbiol 1992 Aug;30(8):2145-9. PMID 1323578

Findings With Unspecified Accuracy
Finding	Result	Sensitivity	Specificity
[ + ] 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