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NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 11-ID-05

Clinical Description

An acute illness with a discrete onset of any sign or symptom* consistent with acute viral hepatitis (e.g., fever, headache, malaise, anorexia, nausea, vomiting, diarrhea, and abdominal pain), and either a) jaundice, or b) elevated serum alanine aminotransferase (ALT) levels >400IU/L.

*A documented negative HCV antibody laboratory test result followed within 6 months by a positive test (as described in the laboratory criteria for diagnosis) result does not require an acute clinical presentation to meet the surveillance case definition.

Laboratory Criteria For Diagnosis

One or more of the following three criteria:

  • Antibodies to hepatitis C virus (anti-HCV) screening-test-positive with a signal to cut-off ratio predictive of a true positive as determined for the particular assay as defined by CDC. (URL for the signal to cut-off ratios:, OR
  • Hepatitis C Virus Recombinant Immunoblot Assay (HCV RIBA) positive, OR
  • Nucleic Acid Test (NAT) for HCV RNA positive (including qualitative, quantitative or genotype testing)

AND, if done meets the following two criteria:

  • Absence of IgM antibody to hepatitis A virus (if done) (IgM anti-HAV), AND
  • Absence of IgM antibody to hepatitis B core antigen (if done) (IgM anti-HBc)

Case Classification


A case that meets the clinical case definition, is laboratory confirmed, and is not known to have chronic hepatitis C.

Related Case Definition(s)