hepatic and biliary disorders
Hepatitis C, Acute
Diagnosis of Acute Hepatitis C
Serologic testing HCV RNA measurement In the Initial diagnosis of acute hepatitis , viral hepatitis should be differentiated from other disorders causing jaundice (see figure If acute viral hepatitis is suspected, the following tests are done to screen for hepatitis viruses A, B, and C: IgM antibody to hepatitis A virus (IgM anti-HAV) Hepatitis B surface antigen (HBsAg) IgM antibody to hepatitis B core (IgM anti-HBc) Antibody to HCV (anti-HCV) and HCV RNA If the anti-HCV test is positive, HCV RNA is measured to distinguish active from past hepatitis C infection (see table Hepatitis C Serology ). In hepatitis C, serum anti-HCV represents chronic, past, or acute infection; the antibody is not protective. When cases are unclear or when suspicion for hepatitis C is high, HCV RNA is measured. Anti-HCV usually appears within 2 weeks of acute infection but is sometimes delayed; however, HCV RNA is positive sooner. Liver tests are needed if not previously done; they include serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase. Other tests should be done to evaluate liver function and disease severity; they include serumalbumin, bilirubin, platelet count, and prothrombin time/international normalized ratio (PT/INR). 