STD HEPATITIS C: THE TESTS IF THE ELISA RESULTS ARE POSITIVE
Two tests are commonly used to determine if the ELISA test results are accurately positive. The first is the recombinant immunoblot assay (RIBA), which also looks for antibody to the virus but is more sensitive than the ELISA (enzyme-linked immunosorbent assay). The second is the polymerase chain reaction (PCR) test, which looks for the genetic material of the virus. Both of these tests are very sensitive, but they are also expensive. Nor are they 100 percent accurate. Sometimes the test shows up as negative if the person was infected with hepatitis C but cleared the infection and has no active virus in the body, or if the person is still infected with hepatitis C but the virus is not active enough to be seen on the assay at the time the test is performed. The interpretation of these tests is best done in consultation with a hepatologist (liver specialist) because of the potentially confusing results. A liver biopsy is frequently performed to help determine the progression of the infection. As noted previously, a biopsy is the best way in which to determine whether a person is experiencing continuous damage to the liver and therefore may be a good candidate for treatment with interferon (described later in this section). A liver biopsy may identify someone with advanced liver disease even if he or she is symptom free.
Tests of liver function or status, such as those that are carried out as part of a routine blood test, are not an adequate screen for hepatitis C. These tests can often be normal even when someone is infected. For most people with hepatitis C, the results of liver function tests fluctuate from normal to slightly elevated over time.
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