Guidelines on Blood-Borne Viruses in the Haemodialysis, CAPD and Renal Transplantation Setting updated
Key Point: If an HCV RNA result is available, it is not necessary to have an HCV Antigen result before managing the patient in accordance with the guidelines
The national guidelines on bloodborne viruses in the renal setting were first published in 2005 as a chapter in the Department of Health and Children document “The Prevention of Transmission of Blood-Borne Diseases in the Healthcare Setting”. These guidelines were revised in 2008, 2010 and 2013. The most recent 2013 revision clarified guidance on the dialysis of patients who are hepatitis C virus (HCV) infected, and patients who are undergoing or have completed anti-viral treatment for HCV infection. The use of the HCV antigen (HCV Ag) assay was extensive in the 2013 guidance to monitor HCV infected individuals and to screen those who were not HCV infected.
The need to revise the 2013 guidelines has arisen however as some laboratories do not use the HCV Ag but HCV RNA investigations to determine if a patient is viraemic The detection of HCV RNA using molecular assays is marginally more sensitive than HCV Ag testing but logistically more difficult.
Therefore, if an HCV RNA result is available, it is not necessary to have an HCV Ag result before managing the patient in accordance with the guidelines. The 2014 guidelines have been modified to reflect this.