The EIA test is suitable for screening for HCV infection. A positive RT-PCR is definitive proof of HCV infection. Liver biopsy can demonstrate the extent of liver injury. Many gastroenterologists are now questioning the need for routine biopsy in all HCV patients before treatment.
Recent studies indicate important considerations when using interferon.
Neutralizing anti-interferon antibodies have been shown to develop in some patients with chronic HCV receiving treatment with interferon. Interferon monotherapy remained the standard treatment for HCV until last year, when the combination of interferon and oral ribavirin won FDA approval because of its improved efficacy. Most clinicians now initiate treatment with this form of combination therapy, rather than using interferon alone. Non-responders to interferon monotherapy can be identified early by assessing the serum ALT level and the presence of serum HCV RNA after 3 months of therapy. If the ALT level remains abnormal, and the serum HCV RNA remains detectable, interferon therapy should be stopped, because further treatment is unlikely to produce a response.