Hepatitis C: Likelihood Ratios

Introduction: None written.

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Tags: Hepatic Infection Tag this Diagnosis.

The likelihood ratios of findings for Hepatitis C are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

HCV Ab RIBA

15.7

0.1

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

13.1

0.1

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

1.2

0.6

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