HCV reinfection has been described after spontaneous or

treatment-induced HCV clearance, essentially in patients at

high-risk of infection. Reinfection is defined by the reappearance
of HCV RNA at least 6 months after an SVR and the demonstration
that infection is due to a different HCV strain (different genotype
or distantly related strain by phylogenetic analysis if the genotype
is the same).
The diagnosis of chronic hepatitis C is based on the detection
of both anti-HCV antibodies and HCV RNA in the presence of biological
or histological signs of chronic hepatitis. Since, in the case
of a newly acquired HCV infection, spontaneous viral clearance is
very rare beyond 4 to 6 months of infection [10], the diagnosis of
chronic hepatitis C can be made after that time period.
HCV core antigen is a surrogate marker of HCV replication.
Core antigen detection can be used instead of HCV RNA detection
to diagnose acute or chronic HCV infection. HCV core antigen
assays are less sensitive than HCV RNA assays (lower limit of
detection equivalent to approximately 500 to 3000 HCV RNA
IU/ml, depending on the HCV genotype [11,12]). As a result,
HCV core antigen becomes detectable in peripheral blood a few
days after HCV RNA in patients with acute hepatitis C. In rare
cases, core antigen is undetectable in the presence of HCV RNA.