1. How do you test for Hep C?
2. What test would you order for a pt with positive anti-HCV and negative HCV RNA?
The anti-HCV antibody test is the screening test for at-risk persons; a positive test in a person with one of the risk factors confirms exposure to the virus. The HCV RNA test is required to determine active infection rather than just exposure to the virus. In patients with none of the risk factors who have a positive anti-HCV antibody test and a negative HCV RNA test, the recombinant immunoblot assay (RIBA), which detects antibodies to any of several viral antigens, should be done. A positive RIBA, in the absence of detectable HCV RNA confirms that the patient has been infected with hepatitis C but has spontaneously cleared the infection.