<p>The acute hepatitis C virus (HCV) infection can lead to two clinical outcomes: clinical recovery or chronicity. Regardless of the outcome, anti-HCV antibodies will be present in the individual bloodstream who have had contact with the virus, which is why the sensitivity of these antibodies is high in monitoring the infection, except in specific cases. For this reason, epidemiological surveillance of hepatitis C is based on tracking this marker, both in the general population and in the high-risk groups.</p><p>On the other hand, since it is the only marker of infection addressed in hepatitis C surveillance, the detection of anti-HCV antibodies in the bloodstream does not have sufficient specificity to indicate the infection’s clinical classification. On the contrary, their detection can have three very distinct meanings: Active infection (acute or chronic), defined by the detection of these antibodies and HCV RNA in the serum; Past (resolved) following previous exposure, when HCV RNA is not detectable in the serum, or false-positive result, when the anti-HCV antibodies detection is not confirmed. This manuscript discusses the specificity of anti-HCV antibodies in the clinical classification of HCV infection and their sensitivity in the epidemiological surveillance of hepatitis C. This review covers the clinical and epidemiological interpretations of the marker itself, without reference to any specific assays.</p>