REPLY
Chronic Hepatitis C Virus Infection
Steven K. Herrine, MD
2 September 2003 | Volume 139 Issue 5 Part 1 | Page W-68
IN RESPONSE:
Dr. Kleinhaus's anecdote successfully describes the limitations of HCV tests. Although the accuracy of molecular testing for HCV and its subtypes has improved over the past several years, the diagnosis of HCV needs to made in the context of the clinical scenario. If the patient in question has a known risk factor and elevated aminotransferase levels, true infection is more likely. From a technical standpoint, discrepancies between HCV viral measures and genotyping may be seen at very low viral loads, since the primers used for these tests differ. Other causes of discordant test results may be a sample mix-up or reaction failure due to a variety of technical reasons. Retesting the patient using a fresh specimen often resolves these issues.
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From Thomas Jefferson University; Philadelphia, PA 19107.
Acknowledgment: The author thanks David Gretch, MD, PhD, for consultation on this matter.
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