Test Id : HCVQG
Hepatitis C Virus (HCV) RNA Quantification with Reflex to HCV Genotype, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detection of acute hepatitis C virus (HCV) infection before the appearance of HCV antibodies in serum (ie, <2 months from exposure)
Detection and confirmation of chronic HCV infection and determining HCV genotype (1 to 5) to guide antiviral therapy in patients with chronic hepatitis C
Quantification of HCV RNA in serum of patients with chronic HCV infection (HCV antibody-positive) before initiating antiviral therapy
Determining cure and detection of relapse of HCV infection after completion of antiviral therapy
Highlights
A reflex test for serum specimens that are hepatitis C Virus (HCV) antibody screen-reactive for diagnosis of chronic hepatitis C.
This test is appropriate for diagnosis of acute hepatitis C in high-risk or immunosuppressed individuals who may be negative for HCV antibodies.
This test can be used to establish a baseline HCV viral load and viral genotype before initiating antiviral therapy for chronic hepatitis C.
This test is appropriate for confirming a sustained virologic response and detecting a relapse of hepatitis C after completion of antiviral therapy.
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HCVG | HCV Genotype, S | Yes | No |
| HCVGR | HCV Genotype Resolution, S | No | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Specimens with hepatitis C virus (HCV) RNA levels greater than or equal to 500 IU/mL will be tested for HCV genotype at an additional charge.
Specimens either generating indeterminate genotype results or results with multiple or mixed HCV genotypes (eg, 1, 5; 1a, 2; or 3, 5) containing genotype 1 but no subtype will be automatically evaluated with by genotype resolution at an additional charge.
For more information see:
-Chronic Hepatitis C Treatment and Monitoring Algorithm: Direct Antiviral Antigen (DAA) Combination
Method Name
A short description of the method used to perform the test
HCVQG: Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR)
HCVG, HCVGR: RT-PCR followed by Hybridization with Sequence-Specific, Fluorescent-Labeled Oligonucleotide Probes
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
HCV (RT-PCR) Quantification
HCV PCR
HCV Quantification
HCV RNA
HCV RNA Quantification
HCV Viral Load
HCVQN
Hepatitis C RNA Quantitation
Hepatitis C Viral Load
HCV Genotype
HCVG
HCV Genotyping
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Specimens with hepatitis C virus (HCV) RNA levels greater than or equal to 500 IU/mL will be tested for HCV genotype at an additional charge.
Specimens either generating indeterminate genotype results or results with multiple or mixed HCV genotypes (eg, 1, 5; 1a, 2; or 3, 5) containing genotype 1 but no subtype will be automatically evaluated with by genotype resolution at an additional charge.
For more information see:
-Chronic Hepatitis C Treatment and Monitoring Algorithm: Direct Antiviral Antigen (DAA) Combination
Specimen Type
Describes the specimen type validated for testing
Serum SST
Ordering Guidance
For detection and quantification of hepatitis C (HCV) RNA and genotype in serum before initiating antiviral therapy for chronic hepatitis C.
Do not order this test to monitor response and progress during antiviral therapy for chronic hepatitis C.
Shipping Instructions
1. Freeze serum immediately, and ship specimen frozen on dry ice only.
2. If shipment will be delayed for more than 24 hours, freeze serum at -20 to -80 degrees C (up to 42 days) until shipment on dry ice.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 3.5 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial within 2 hours of collection.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Microbiology Test Request (T244)
-Gastroenterology and Hepatology Test Request (T728)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
1.6 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Frozen (preferred) | 42 days | |
| Refrigerated | 72 hours |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detection of acute hepatitis C virus (HCV) infection before the appearance of HCV antibodies in serum (ie, <2 months from exposure)
Detection and confirmation of chronic HCV infection and determining HCV genotype (1 to 5) to guide antiviral therapy in patients with chronic hepatitis C
Quantification of HCV RNA in serum of patients with chronic HCV infection (HCV antibody-positive) before initiating antiviral therapy
Determining cure and detection of relapse of HCV infection after completion of antiviral therapy
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
Specimens with hepatitis C virus (HCV) RNA levels greater than or equal to 500 IU/mL will be tested for HCV genotype at an additional charge.
Specimens either generating indeterminate genotype results or results with multiple or mixed HCV genotypes (eg, 1, 5; 1a, 2; or 3, 5) containing genotype 1 but no subtype will be automatically evaluated with by genotype resolution at an additional charge.
For more information see:
-Chronic Hepatitis C Treatment and Monitoring Algorithm: Direct Antiviral Antigen (DAA) Combination
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
About 75% of all individuals infected with hepatitis C virus (HCV) will develop chronic hepatitis C with ongoing viral replication in the liver and detectable HCV RNA in serum or plasma, eventually resulting in cirrhosis. The remaining 25% of the infected individuals recover from the infection without evidence of viral replication or the presence of detectable HCV RNA in serum or plasma. Chronic HCV infection can be cured at variable success rates with either combined interferon-alpha and ribavirin therapy or interferon-free combination of direct-acting antiviral (DAA) agents.
The antiviral response rates correlate with pretreatment serum or plasma HCV RNA levels (viral load) and the HCV genotype found in the infected individuals. The optimal duration of combined interferon and ribavirin therapy can be determined from the patient's pretreatment viral load and HCV genotype. Clinical trial studies indicated that a decrease in HCV RNA levels of more than 2 log IU/mL at 4 weeks or 12 weeks of therapy is predictive of an increased chance of achieving a sustained virologic response (defined as undetectable HCV RNA levels in serum 6 months after completing antiviral therapy). Despite receiving longer duration of antiviral therapy (48 weeks versus 24 weeks), patients with chronic infection due to HCV genotypes 1 and 4 generally have less favorable sustained virologic response rates (40%-50%) than those infected with genotypes 2 and 3 (>80%). Due to the necessary prolonged duration (typically 24- to 48-week duration) and low cure rates of such antiviral therapy, interferon-based therapy has been supplanted with potent interferon-free DAA combination therapy now.
Unique nucleotide sequences of certain regions (eg, 5'-noncoding, core, NS5b) of the HCV genome allow classification of HCV into 6 major genotypes or clades (1-6), based on the most recently proposed HCV genotype nomenclature. In the United States, the most commonly encountered HCV genotypes are 1a and 1b, followed by genotypes 2 and 3. Worldwide geographic distribution, disease outcome, and response to antiviral therapy differ among the genotypes. HCV genotype determination is important for proper selection of antiviral therapy and optimal patient management.
Therapeutic response rates for chronic HCV infection have improved significantly (cure rates of >90%) over the past 5 years when oral DAA agents are used in lieu of interferon-based combination therapy. However, antiviral resistance can emerge during such combination therapy, and occurrence of such resistance is more frequent with HCV subtype 1a than 1b for simeprevir-treated patients.
The American Association for the Study of Liver Diseases and Infectious Disease Society of America recommendations for testing, managing, and treating hepatitis C are available at www.hcvguidelines.org/contents.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Undetected
Interpretation
Provides information to assist in interpretation of the test results
This assay has a result range of 15 to 100,000,000 IU/mL (1.18 log to 8.00 log IU/mL) for quantification of hepatitis C virus (HCV) RNA in serum. Only those specimens with HCV RNA levels greater than or equal to 500 IU/mL will be tested for HCV genotype (HCVG / Hepatitis C Virus Genotype, Serum or HCVGR / Hepatitis C Virus Genotype Resolution, Serum).
An "Undetected" result indicates that the HCV is absent in the patient's serum specimen. Such specimens will not be tested for HCV genotype.
A result of "<15 IU/mL (<1.18 log IU/mL)" indicates that HCV RNA is detected, but the HCV RNA level present cannot be quantified accurately below this lower limit of quantification of this assay. Such specimens will not be tested for HCV genotype.
A result of ">100,000,000 IU/mL (>8.00 log IU/mL)" indicates the presence of active HCV viral replication, and the HCV RNA level present cannot be quantified accurately above this upper limit of quantification of this assay.
An "Inconclusive" result reported with a comment indicates that testing failed, likely due to the presence of inhibitory substances in the submitted serum specimen. A new specimen should be collected for retesting. Such specimens will not be tested for HCV genotype.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Except for immunocompromised patients or patients with suspected acute hepatitis, laboratory evaluation of hepatitis C virus (HCV) infection status should begin with HCV serologic testing, including testing for the presence of HCV antibodies (See Hepatitis C: Testing Algorithm for Screening and Diagnosis). A diagnosis of chronic HCV infection should not be based solely on the presence of detectable or quantifiable HCV RNA in a single serum specimen.
An "Undetected" HCV RNA test result with a "Reactive" HCV antibody screen result may be due to:
1. A false-reactive HCV antibody screen result
2. Resolved or past HCV infection
3. Transient low viremia (ie, episodic viral replication) of active HCV infection.
To distinguish between the first 2 conditions, another HCV antibody test (eg, HCCAD / Hepatitis C Virus Antibody Screen for Cadaveric or Hemolyzed Specimens, Asymptomatic, Serum) can be requested. To distinguish between the latter 2 conditions, patients should be retested for HCV RNA in 1 to 2 months, as clinically indicated.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. de Leuw P, Sarrazin C, Zeuzem S. How to use virological tools for the optimal management of chronic hepatitis C. Liver Int. 2011;31 Suppl 1:3-12
2. Centers for Disease Control and Prevention: Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR Morb Mortal Wkly Rep. 2013;62(18):362-365
3. American Association for the Study of Liver Diseases and Infectious Diseases Society of America: HCV guidance: Recommendations for testing, managing, and treating hepatitis C. Accessed May 10, 2024. Available at www.hcvguidelines.org/contents
Method Description
Describes how the test is performed and provides a method-specific reference
The cobas hepatitis C virus (HCV) assay is an US Food and Drug Administration-approved, in vitro nucleic acid amplification test for the quantification of HCV RNA in human serum using the cobas x800 Systems for fully automated viral nucleic acid extraction (generic silica-based capture technique) and automated amplification and detection of the viral nucleic acid sequence. This polymerase chain reaction (PCR) assay amplifies sequences within the highly conserved 5' noncoding region of the HCV genome and generates amplification products that are detected and quantified in real-time with 2 sequence-specific TaqMan probes. A non-HCV armored RNA quantitation standard (RNA QS) is introduced into each specimen during sample preparation to serve as internal control for nucleic acid extraction and PCR amplification/detection processes. Fluorescent reporter dye-labeled TaqMan probes hybridized to the complementary HCV target sequences and RNA QS sequence undergo hydrolysis during PCR amplification step to generate fluorescent signal detected in 2 different dye channels. Concentration of the HCV RNA in a patient's serum sample is determined by a ratio of the intensity of the fluorescent dye from the cleaved HCV target sequence probes and that from the RNA QS target probe detected throughout the PCR process.(Package insert: cobas HCV-Quantitative nucleic acid test for use on the cobas 5800/6800/8800 Systems. Roche Molecular Systems, Inc; Rev. 5.0, 5/2023)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
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- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87522
87902 (if appropriate)
87902 (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| HCVQG | HCV RNA Detect/Quant Reflex Geno, S | 11011-4 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 603602 | HCV RNA Detect/Quant, S | 11011-4 |