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Hepatitis C, Chronic
2016 Case Definition

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 15-ID-03

Clinical Criteria

No available evidence of clinical and relevant laboratory information indicative of acute infection (refer to the criteria for classification Table VII-B in CSTE position statement 15-ID-03). Most hepatitis C virus (HCV)-infected persons are asymptomatic; however, many have chronic liver disease, which can range from mild to severe.

Laboratory Criteria for Diagnosis

  • A positive test for antibodies to hepatitis C virus (anti-HCV)
  • Hepatitis C virus detection test:
    • Nucleic acid test (NAT) for HCV RNA positive (including qualitative, quantitative or genotype testing)
    • A positive test indicating presence of hepatitis C viral antigen(s) (HCV antigen)*
* When and if a test for HCV antigen(s) is approved by FDA and available.

Criteria to Distinguish a New Case from an Existing Case

A new chronic case is an incident chronic hepatitis C case that meets the case criteria for chronic hepatitis C and has not previously been reported. A confirmed acute case may not be reported as a probable chronic case (i.e., HCV antibody positive, but with an unknown HCV RNA NAT or antigen status).

States and territories may choose to track resolved hepatitis C cases in which spontaneous clearance of infection or sustained viral response to treatment are suspected to have occurred before national notification or are known to have occurred after national notification as a confirmed or probable case to CDC.

Case Classification

Probable

  • A case that does not meet clinical criteria or has no report of clinical criteria,
    AND
  • Does not have test conversion within 12 months or has no report of test conversion,
    AND
  • Has a positive anti-HCV antibody test, but no report of a positive HCV NAT or positive HCV antigen test.

Confirmed

  • A case that does not meet clinical criteria or has no report of clinical criteria,
    AND
  • Does not have test conversion within 12 months or has no report of test conversion,
    AND
  • Has a positive HCV NAT or HCV antigen test.



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