Diagnostic tests for HCV infection. In 1989, hepatitis C virus (HCV) was cloned and identified as the major cause of parenterally transmitted non-A, non-B hepatitis [22]. The first serologic test for HCV employed an enzyme-linked immunosorbent assay (ELISA-1) that detected a nonneutralizing antibody (anti-HCV) to a single recombinant antigen. Limitations of the sensitivity and specificity of this test led to development of second-generation tests, ELISA-2 and a recombinant immunoblot assay (RIBA-2) [23]. The standard for identifying active HCV infection remains the detection of HCV RNA by reverse transcriptase polymerase chain reaction. (Adapted from Roth [24].)

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