TEST INTERPRETATION FOR DIAGNOSIS OF ACUTE HCV
HCV Antibody
  • Test may be negative during the first 6 weeks after exposure.
  • Seroconversion may be delayed or absent in immunosuppressed individuals.
  • Presence of HCV antibody alone does not distinguish between acute vs chronic infection.
  • A low signal-to-cutoff ratio may be present during acute HCV infection or represent a false-positive result.
HCV RNA
  • Viral fluctuations >1 log10 IU/mL may indicate acute HCV infection.
  • HCV RNA may be transiently negative during acute HCV infection.
  • Presence of HCV RNA alone does not distinguish between acute vs chronic infection.
ALT
  • Fluctuating ALT peaks suggest acute infection.
  • ALT may be normal during acute HCV infection.
  • ALT may be elevated due to other liver insults, such as alcohol consumption.

https://www.hcvguidelines.org/unique-populations/acute-infection

Araujo AC, Astrakhantseva IV, Fields HA, Kamili S. Distinguishing acute from chronic hepatitis C virus (HCV) infection based on antibody reactivitiesto specific HCV structural and nonstructural proteins. J ClinMicrobiol. 2011;49(1):54-57.

McGovern BH, Birch CE, Bowen MJ, Reyor LL, Nagami EH, Chung RT, et al. Improving the diagnosis of acute hepatitis C virus infection with expanded viral load criteria. ClinInfect Dis. 2009;49(7):1051-1060.