RATIONAL USE OF DIAGNOSTIC-TOOLS IN HEPATITIS-C

Six years after the introduction of serological tests for the detectio n of antibodies to HCV these diagnostic procedures have been improved significantly, The ELISA's of the third generation contain 4-5 fragmen ts of structural and nonstructural proteins which have increased the s ensitivity and specificity for antibody detection, Several confirmator y assays have been established to detect non-specific reactions, Virem ia in acute and chronic HCV infection can be detected by RT-PCR, Howev er, studies on the quality of PCR results with serum panels in a large number of diagnostic labs indicate the urgent need to standardize the RT-PCR techniques. Quantification of viral genomes during acute and c hronic HCV infection seem to be of major importance to predict the res ponse rate to IFN, Quantitative RT-PCR techniques using internal stand ards and the branched DNA technology have been established, Techniques for genotyping HCV isolates have been introduced which also seemed to be important for prediction of IFN response, Recently, serotyping of HCV isolates has been evaluated and seems to correlate well with genot yping by RT-PCR and specific probes, The detection of quasispecies in the 5'NCR may, in the future, be an additional prospective test for th e prognosis of IFN treatment. (C) European Association for the Study o f the Liver.