- Order it “Qualitative, with Reflex to Quantitative”
RESULTS
Undetectable “qualitative” HCV RNA means NO Chronic Hep C
Detectable HCV RNA means Chronic Hep C Infection- If too low to quantitate, repeat in 6 mos. to R/O acute infection en route to resolution
- <1,000,000 is better than >1-3 million
- Genotypes 2 & 3 respond much better than 1 & 4
- All Genotypes have same disease-progression
- 10% develop cirrhosis in 10 years
- 30% develop cirrhosis in 30 years
- 50% develop cirrhosis in 50 years
- Cirrhosis usually fatal within 5 years
- Hepatocellular Carcinoma usually only occurs after cirrhosis
- Stage 1 = No liver damage
- Stage 2 = Mild damage, ? repeat biopsy in 4-5 yrs.
- Stage 3 = Significant damage, urge Tx
- Stage 4 = Cirrhosis; poor response to Tx
- “Inflammation” (Grades 1-4) estimates likelihood of future progression of fibrosis