A 40-year-old woman donating blood is found reactive on a third-generation anti-HCV ELISA. She is asymptomatic and her liver enzymes are normal. Which statement best interprets this result?
- A She is immune to hepatitis C and needs no further testing
- B She has active hepatitis C and must start antiviral therapy now
- C Anti-HCV only indicates past exposure; current infection must be confirmed by detecting HCV RNA ✓
- D Normal liver enzymes exclude hepatitis C entirely
Correct answer: C. Anti-HCV only indicates past exposure; current infection must be confirmed by detecting HCV RNA
Explanation
Antibody to HCV shows only that the person has been exposed to the virus. In about 15 to 25% of infected adults the virus is cleared spontaneously and antibody persists for life, so active infection requires detection of HCV RNA by PCR. Normal liver enzymes do not exclude chronic infection, since chronic hepatitis C can be clinically silent for decades, and unlike hepatitis B there is no protective antibody response against HCV.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.