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2004 Case DefinitionClinical case definitionAn acute illness with a) discrete onset of symptoms (such as nausea, vomiting, abdominal pain and diarrhea) and b) jaundice or abnormal serum aminotransferase levels Laboratory criteria for diagnosis Serum alanine aminotransferase levels greater than 7 times the upper limit of normal, and IgM antibody to hepatitis A virus (IgM anti-HAV) negative (if done) and IgM antibody to hepatitis B core antigen (IgM anti-HBc) negative, or if not done, hepatitis B surface antigen (HBsAg) negative, and Antibody to hepatitis C virus (anti-HCV) screening-test-positive (repeat reactive) verified by an additional more specific assay (e.g. recombinant immunoblot assay [RIBA] for anti-HCV or nucleic acid testing for hepatitis C virus [HCV] RNA) OR Anti-HCV screening-test-positive with a signal to cut-off ratio predictive of a true positive as determined for the particular assay (e.g., ≥3.8 for the enzyme immunoassays) Case classification: Confirmed:a case that meets the clinical case definition and is laboratory confirmed
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