PMID: 11465848

Issn Print: 0891-3668

Publication Date: 2001/07/01


Print

TIMING AND INTERPRETATION OF TESTS FOR DIAGNOSING PERINATALLY ACQUIRED HEPATITIS C VIRUS INFECTION

David T. Dunn; Diana M. Gibb; Mary Healy; Ruth L. Goodall; Karina Butler; Mary Cafferkey; Penny Neave

    loading  Checking for direct PDF access through Ovid

Excerpt

The diagnosis of hepatitis C virus (HCV) infection in children born to HCV-infected women is based on serologic assays and HCV RNA measurement by PCR. Interpretation of the results of these tests is hampered by uncertainty about the age distribution of loss of maternal antibody and the sensitivity and specificity of PCR at different ages. On the basis of findings from a recent vertical transmission study, we estimated the posttest probability of a child’s being infected or uninfected under several test result scenarios. These estimates may assist clinicians in assessing the likelihood of infection in an individual child and in using the currently available assays cost effectively.
The diagnosis of hepatitis C virus (HCV) infection in children born to HCV-infected women is currently based on the detection of specific (nonmaternal) IgG antibody and/or the detection of HCV RNA by PCR. 1 However, the age at which passively acquired maternal antibody declines to undetectable levels and the sensitivity and specificity of PCR at different ages have not been accurately determined, with two important consequences for clinical management: (1) it is unclear how confidently infection can be excluded or inferred after a negative and positive PCR result, respectively, or when infection can be definitively diagnosed on the basis of a positive antibody test; (2) it hinders consideration of the most effective diagnostic test strategy, i.e., which assays should be performed at different ages. The high cost of PCR tests, the possibility of viral clearance and potential difficulties in maintaining follow-up of infants of indeterminate infection status, are other important factors that should be taken into account in this decision.

Related Topics

    loading  Loading Related Articles