Immunoassay for the qualitative determination of antibodies against hepatitis C virus (HCV)
Elecsys® Anti‑HCV II is an immunoassay for the in vitro qualitative detection of antibodies to HCV in human serum and plasma1.
Hepatitis C is an inflammatory liver disease caused by infection with the hepatitis C virus (HCV), which can cause both acute and chronic hepatitis2. HCV is a member of the Flaviviridae family and has a single-stranded, positive-sense RNA genome, which encodes 3 structural and 7 non-structural proteins3,4. HCV is classified into eight genotypes with a total of currently 93 subtypes5.
Hepatitis C represents a major global health burden: approximately 170 - 200 million people worldwide have been infected with HCV, of which 58 million live with chronic hepatitis C2,6. In 2019, approximately 290,000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma2. Due to the often asymptomatic nature of the disease, hepatitis C infection remains heavily underdiagnosed7.
Most acute HCV infections (70 – 85 %) are in the beginning asymptomatic and approximately 15 – 45 % of patients will clear acute infection. When symptoms are present during acute hepatitis C, they usually appear within 7 – 8 weeks after exposure and consist of jaundice, malaise, and nausea (similar to hepatitis A and B)3,8-10.
Chronic HCV infection is characterized by persistence of HCV RNA for longer than 6 months. Most chronic infections will lead to hepatitis and to some degree of fibrosis, which may be accompanied by relatively nonspecific symptoms such as fatigue. 20 % of people with chronic hepatitis C will eventually develop cirrhosis3,8-10. Once cirrhosis is established, the risk of HCC is 1 – 4 % per year11.
Anti-HCV antibodies are detected on average 6 – 8 weeks after infection, but can be detected from the onset of symptoms or may develop late (up to 6 months) after infection. The antibody-negative but HCV RNA-positive window period in HCV infections can be as much as 40 – 60 days, but varies from patient to patient. Anti-HCV rises to higher levels during chronic infection12,13. Anti-HCV is used as a first-line test to screen for and diagnose HCV infection. A positive or indeterminate anti-HCV test result should be followed by a sensitive test for HCV RNA to confirm active HCV infection14,15.
Seroconversion sensitivity of the Elecsys® Anti‑HCV II assay was shown by testing commercial anti-HCV seroconversion panels. The Elecsys® Anti‑HCV II assay detected more positive panel members than all other registered anti‑HCV assays tested and was more sensitive in the recognition of early HCV infection than the other registered anti‑HCV screening assays1,19.
Earlier detection of seroconversion by the Elecsys® Anti-HCV II assay in selected anti-HCV seroconversion panels compared to other registered anti‑HCV screening assays20,21
Hepatitis C infection marker profile after natural infection3,10,16-18
~ 15 – 45 % of infected people spontaneously clear the virus within 6 months of infection without any treatment.
Chronic HCV infection is characterized by persistence of HCV RNA for longer than 6 months.
* coefficient of variation
** 95 % confidence interval (2-sided)
References