Family Nurse Practitioner Exam

Following a positive anti-hepatitis C virus test, which test is most appropriate for follow-up?

1. HCV RNA

2. HCV antibodies

3. HCV core antigen

4. Hepatitis C surface antigen

The correct answer is: HCV RNA

After a positive anti-hepatitis C virus (anti-HCV) test, the most appropriate follow-up test is HCV RNA. This testing is crucial because it confirms the presence of the virus itself, indicating whether the infection is active and assessing the viral load. A positive anti-HCV test signifies that the patient has been exposed to the hepatitis C virus, but it does not differentiate between a resolved infection and an active one. Therefore, further assessment with the HCV RNA test is necessary to determine if there is an active infection that may require treatment. In clinical practice, detecting HCV RNA is vital for managing hepatitis C, as it informs the provider about the need for intervention and helps guide treatment decisions. High levels of HCV RNA indicate active replication of the virus, while undetectable levels could suggest either a resolved infection or low-level viremia. The other tests such as HCV antibodies check for previous exposure but don't clarify whether the virus is currently active. HCV core antigen is less commonly used in routine practice compared to HCV RNA testing, and hepatitis C surface antigen is not a standard test for hepatitis C. Thus, HCV RNA is the definitive follow-up test in this scenario.