A 45 year old caucasian man comes to your clinic after a recent routine screening for antibody to hepatitis C virus (HCV) was positive. His medical history is unremarkable; he has not used illicit drugs or had any history of blood transfusions.
He currently feels well and takes no medications.
Vital signs and physical examination are normal.
Laboratory results are positive for HCV antibody, but negative for HCV RNA. Serum alanine aminotransferase level is normal.
Which of the following is the most appropriate diagnostic test to perform next?
A. Monitor serial alanine aminotransferase
B. Order a liver ultrasound
C. Repeat the HCV RNA testing
D. Repeat the HCV antibody testing
E. Do no further testing
Reference:
Centers for Disease Control and Prevention (CDC). Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR Morb Mortal Wkly Rep. 2013 May 10;62(18):362-5. PMID: 23657112