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    What To Know About False Positives in Hepatitis C Testing

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    Faisal Jamshed
    Hepatitis C testing involves a two-step process using an anti-HCV antibody test followed by an HCV RNA PCR test for those with positive antibody results. The antibody test can produce false positives as it detects antibodies from past infection, while the PCR test determines if the hepatitis C virus is currently present. False positives are more common in low risk groups. Doctors confirm all positive antibody tests with the PCR test to determine if an active infection exists before making a diagnosis.

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    What To Know About False Positives in Hepatitis C Testing

    Uploaded by

    Faisal Jamshed
    148 views6 pages
    Hepatitis C testing involves a two-step process using an anti-HCV antibody test followed by an HCV RNA PCR test for those with positive antibody results. The antibody test can produce false positives as it detects antibodies from past infection, while the PCR test determines if the hepatitis C virus is currently present. False positives are more common in low risk groups. Doctors confirm all positive antibody tests with the PCR test to determine if an active infection exists before making a diagnosis.

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    What to Know About False Positives in Hepatitis c Testing

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    Hepatitis C testing involves a two-step process using an anti-HCV antibody test followed by an HCV RNA PCR test for those with positive antibody results. The antibody test can produce false positives as it detects antibodies from past infection, while the PCR test determines if the hepatitis C virus is currently present. False positives are more common in low risk groups. Doctors confirm all positive antibody tests with the PCR test to determine if an active infection exists before making a diagnosis.

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    © All Rights Reserved
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    Download as pdf or txt
    148 views6 pages

    What To Know About False Positives in Hepatitis C Testing

    Uploaded by

    Faisal Jamshed
    Hepatitis C testing involves a two-step process using an anti-HCV antibody test followed by an HCV RNA PCR test for those with positive antibody results. The antibody test can produce false positives as it detects antibodies from past infection, while the PCR test determines if the hepatitis C virus is currently present. False positives are more common in low risk groups. Doctors confirm all positive antibody tests with the PCR test to determine if an active infection exists before making a diagnosis.

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    WHAT TO KNOW ABOUT FALSE POSITIVES IN

    HEPATITIS C TESTING

    Hepatitis C is a viral liver infection that can become chronic. Some people
    have antibodies associated with the virus in their blood but do not have an
    active hepatitis C infection. These antibodies can lead to false-positive
    results on blood tests for the infection.

    A person can have hepatitis C for a number of years, or sometimes


    decades, without experiencing any symptoms. Blood tests are the only
    tool for determining whether a person has the infection.

    Here, learn about the blood tests that doctors use to check for hepatitis C.
    We describe their accuracy rates, why false-positive results happen, and
    what doctors do next.

    WHY HAVE A TEST FOR HEPATITIS C?


    Share on PinterestA test for hepatitis C is important because a person may
    have no symptoms.

    Many people with hepatitis C are not aware that they have the infection,
    as they may experience no symptoms. This is why testing is important for
    those at risk. According to the Centers for Disease Control and Prevention
    (CDC), 75–85% of people who have hepatitis C go on to develop a
    chronic, or long-lasting, form of the infection.
    The tests to check for the hepatitis C virus (HCV) have a high accuracy
    rate. However, they sometimes give false-positive results.

    A false-positive result means that a test has incorrectly detected an illness


    or disease in someone who does not have that condition.

    One test that doctors regularly use to detect the virus is called the anti-
    HCV test. In a 2017 study, researchers found that this test gave false-
    positive results to 22% of the cohort of low-risk individuals.

    False positives are less common among people who have a higher risk of
    developing hepatitis C.

    A person may have an increased risk of this infection if they were born
    between 1945 and 1965, if they have used injected drugs, or if they
    received a blood transfusion before 1992, for example.

    Because false positives are possible, doctors confirm all positive HCV test
    results with follow-up testing.

    HEPATITIS C TESTING
    The CDC recommend that doctors use a two-step screening process to
    identify hepatitis C infections.
    HEPATITIS C ANTIBODY TEST

    Initially, doctors use the anti-HCV test. It detects antibodies that the
    immune system produces to fight the HCV.

    However, the anti-HCV test cannot tell whether the antibodies are present
    because a person currently has an active hepatitis C infection or whether
    they have had this infection in the past.

    The antibodies can remain, even if a person has had successful treatment,
    or if their body has cleared the virus on its own.

    Anyone who receives a positive result on an anti-HCV test will require


    follow-up testing.

    Learn more about the hepatitis C antibody test here.

    HCV RNA PCR TEST

    The HCV RNA PCR test detects the genetic material, or RNA, of the
    HCV. It does so using a process called a polymerase chain reaction: PCR.

    Doctors can use this test to confirm a positive result from an anti-HCV
    test.

    As well as showing whether the virus is present in the body, the HCV
    RNA PCR test can show the number of viral particles in the blood. The
    medical name for the number of particles is the viral load.
    Learn more about the HCV RNA PCR test here.

    WHY A FALSE POSITIVE HAPPENS


    A doctor will consider two factors when reviewing the accuracy of a test
    result. These two factors are the test's specificity and sensitivity.

    Specificity refers to the ability of a test to correctly identify those who do


    not have a disease. This is called the true negative rate.

    Sensitivity reflects the ability of a test to correctly identify those who do


    have a disease. This is called the true positive rate.

    According to a 2016 review, third-generation anti-HCV tests have an


    average specificity of 97.5% to 99.7%. The sensitivity of these tests varies
    from 61.0% to 81.8%.

    These findings indicate that anti-HCV tests detect true negatives more
    accurately than true positives.

    A person may receive a false-positive test result if they have HCV


    antibodies from a previous infection. They may have received successful
    treatment for this infection, or their body may have cleared it without
    treatment.

    In either case, the antibodies from the previous infection can remain in the
    body and lead to positive results on anti-HCV tests.
    False-positive results can also occur in children who inherit hepatitis C
    antibodies from their mothers.

    Ultimately, a person who receives a positive result from an anti-HCV test


    may not have an active hepatitis C infection. This is why a doctor then
    typically performs another test — the HCV RNA PCR test — before
    making a diagnosis.

    WHAT TO DO
    A person who receives a positive result from an anti-HCV test may wish
    to talk with their doctor about follow-up testing.

    However, in most cases, doctors confirm all positive anti-HCV test results
    with HCV RNA PCR tests.

    A person who receives a negative result from an HCV RNA PCR test does
    not have an active hepatitis C infection. They do not require further testing
    or treatment.

    A positive result from an HCV RNA PCR test indicates an active hepatitis
    C infection. The doctor will then present treatment options.

    PREVENTION
    People who do not have hepatitis C can often prevent exposure to it by:
     not sharing personal care items, such as razors and toothbrushes
     using correct safety precautions when treating open wounds
     not using injected drugs
     not sharing or reusing needles
     wearing gloves when handling blood

    SUMMARY
    A positive anti-HCV test result does not always indicate that a person has
    an active hepatitis C infection.

    People with a low risk of developing this infection are more likely to
    receive false-positive results from this test.

    If the result of an anti-HCV test is positive, the doctor will usually perform
    a second test, called an HCV RNA PCR test to confirm whether the person
    has hepatitis C.

    Several safe and effective treatment options are available for the infection.
    Receiving a diagnosis early on can lead to better treatment outcomes, such
    as preventing permanent liver damage.

    A person who thinks that they may be at risk of hepatitis C should not
    wait for symptoms to appear before getting tested. Speak with a doctor
    about hepatitis C risk and whether testing is a good idea.

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