Blood on anti hcv. What does a positive anti-HCV test mean? Possible indications for research

Almost every time we go to the hospital, and even more so before inpatient treatment or surgery, we are offered to take an HCV test. What it is for a person far from medicine is not entirely clear. However, it is definitely not worth refusing such an offer.

Anti-HCV assay

The main target of the virus is the liver. The blood vessels carry the gene to its destination. In the liver, the virus begins its action, penetrating the liver cells and forcing them to work for themselves. As a result of a long absence of diagnosis and treatment, liver cells are destroyed, which leads to sad consequences.

The term "Anti-HCV" is used when performing enzyme immunoassay and helps to determine the presence of pathogenic cells and antibodies in the blood, developed to fight hepatitis C.

Class M antibodies are the first to be produced in response to the emergence of the virus. They reach the highest concentration in the first days after infection;
Then IgG come into action and begin to actively fight the virus until it is completely suppressed;
The reaction of class A antibodies is also indicative, since their number increases when there is a threat to the mucous membranes of the body.

The essence of the analysis is as follows:

Serum is isolated from the taken blood from the patient;
Purified pathogen cells are introduced into a pre-prepared sterile plate with recesses;
Serum is added to the cells and observed.

If there is a reaction of attachment of antibodies from the test blood to hepatitis C cells, they are stained due to a special substance and make it possible to draw conclusions.

The result of such an analysis can unequivocally tell you whether or not there are antibodies of a certain type in your blood. It will allow you to identify the amount of these antibodies to understand the stage of the course of the disease.

Self-determination of HCV

First of all, he himself will tell you about problems in the body. The main external signs of infection are:

Yellowness of the skin;
lethargy;
Nausea and vomiting.

In addition, pharmacies sell express tests that are dispensed without a doctor's prescription:

There are tests in which saliva is used as a biological material, which is applied to a special strip - an indicator. However, the probability of error in such a test is extremely high. When using it, you should not eat or drink anything for half an hour, and do not use any hygiene products for the oral cavity;
Tests based on blood sampling are equipped with special needles and pipettes. Next, the collected blood should be dripped onto the cassette, if necessary, add a solvent and wait a while.

The result of such a study, as a rule, is determined by the number of strips on the indicator. If after some time one strip appears on the indicator - the test is negative, if two - positive, if there are no strips - the test was done incorrectly.

How is this related to hepatitis C?

Myself the term HCV stands for hepatitis C virus . Therefore, HCV analysis is done to detect hepatitis C infection in the blood . This type of hepatitis is complex and contains genetic material in the form of ribonucleic acid. It is attributed to both animal and vegetable origin.

A feature of such pathogenic cells is their high propensity to mutate. Medicine has identified 6 main genotypes of the virus, however, in a particular organism or specific conditions, the virus is able to mutate so much that there are about 45 different subspecies of each strain.

It is because of the ability to mutate that chronic hepatitis often occurs. The body does not have time to block pathogenic cells, while antibodies are fighting one subspecies of the virus, it already mutates and turns into another.

Due to the prevalence of hepatitis C and the complexity of its treatment, HCV testing has become very common in the population. They make it:

Before hospitalization;
When planning or during pregnancy;
Medical workers and teachers annually undergo medical examination and pass this analysis;
Regular medical examination involves the delivery of such an analysis;
Anyone can independently apply to the hospital for an analysis. This should be done if you often change sexual partners, suffer from drug addiction and just for prevention purposes, since infection can occur even in a beauty parlor.

Thus, the analysis of HCV is very common in our time and avoids the epidemic of this virus.

Hepatia C virus is not a sentence

The hepatitis C virus is the most dangerous among hepatitis viruses, although not the most common. Increasingly, doctors cannot determine the source of infection. This suggests that not only unprotected sexual contact or interaction with the blood of an infected person is dangerous, but also other contacts, for example, through saliva or sweat.

Despite the difficulty of fighting the virus, a cure is possible. The attending physician is a specialist - a hepatologist. The main task of physicians is to prevent the development of irreversible liver pathologies.

With the rapid detection of the disease, a complex scheme of drug treatment is prescribed. At the same time, the patient must strictly follow the recommendations of the doctor and adjust the diet, eliminating salty foods and alcohol.

Treatment will be long and difficult due to the use of drugs with many side effects. However, in the case of a cure and a regular negative HCV test for five years, the virus can be considered defeated.

HCV positive: what is it?

A positive Anti-HCV result is not conclusive and requires an additional more advanced blood test.

If IgM is detected, recent infection and active development of pathogenic cells can be judged;
With an increase in IgG, chronic hepatitis C occurs.

This analysis is preliminary and does not reflect the full picture. It indicates the presence or absence of antibodies, but does not give an idea of the presence of the virus itself.

If the result of Anti-HCV is positive, it is necessary to conduct a repeated, deeper blood test. In this case, groups of antibodies and the ribonucleic acid of the virus are examined.

In case of a positive result of the extended analysis, it is necessary to start treatment immediately.

As a rule, to determine the severity of the disease, a liver biopsy is taken, the strain of the virus is determined and treatment options are offered: from medication to liver transplantation, depending on the severity of the lesion.

Thus, one way to determine the presence of the hepatitis C virus is the HCV test. That this is the fastest, easiest and most accurate method for determining the presence of pathology, you now know, and forewarned is forearmed.

Video: erroneous test results and consequences

In this video, doctor Roman Olegov will tell you how an antibody test (HCV) can be erroneous and what it can lead to:

Quite often we have to take biochemistry (from a vein) during a routine medical examination, before an operation or during pregnancy to identify any diseases and abnormalities of the body. As a rule, the most basic components of the test are HIV or hepatitis antibodies, which can be used to establish the fact of infection. Hepatitis C antibodies are called in medicine “Anti-HCV”, that is, “against hepatitis C” and are divided into two groups: “G” and “M”, which in the test results are referred to as “IgG” and “IgM”, where “Ig ...” - immunoglobulin. Anti - HCV total - markers for which a test is carried out that detects hepatitis C diseases. Anti-hcv can be detected after a 5-week incubation period in acute or chronic disease. Anti-hcv total is most often determined in those who have had the disease “on their feet”. In this case, antibodies can be detected for 5-9 years after infection. A positive result of the anti-HCV analysis does not give 100% grounds for making a diagnosis, since in an infectious disease - - proceeding in a chronic form, total antibodies of the virus with a low content of titers are detected.

It is worth noting that the presence of antibodies in the body does not prevent re-infection with HCV infection, and also does not confer any immunity.

An analysis for the detection of hepatitis C is carried out in the laboratory, on an empty stomach (at least 8 hours before meals) and is examined within 1-2 working days.

The most common reasons for such an analysis are:

cholestasis;
pregnancy;
donation;
drug addiction (intravenous administration of drugs);
prerequisites for infectious hepatitis;
upcoming operation;
identification of STIs;
a sharp increase in ALT and AST.

There are antibodies that belong to certain proteins of hepatitis C - the anti-HCV spectrum and determine the degree of viral load, the type of infection and the area affected. Anti-HCVs are made up of non-structural, such as NS5, and structural (core) proteins (proteins).

Antibodies of class "G" - "IgG" belong to nuclear proteins and are detected 10-12 weeks after infection. The highest rate is observed six months after the onset of the disease. In the chronic form of the course of the virus, such bodies are determined throughout life. If a person has suffered this disease “on his feet”, then the “G” titer will decrease.

Anti-HCV - class "M" - "IgM" grow very quickly, so they are diagnosed in human blood as early as 5 weeks after infection. Upon reaching the peak process of the course of the disease - the "acute form" - the value of "IgM" decreases, but it can also suddenly rise with a second disease. If antibodies of the “M” group are detected in the body over a long period of time, then this is the basis for the fact that the disease has become chronic, which in turn can lead to

It should be noted that the presence of anti-HCV IgM in a healthy body indicates infection of the patient, and in the case of a chronic course of the disease, an exacerbation.

If you have found similar bodies in the body, then you need to pass - HCV RNA using PCR (direct detection of the pathogen). If the result is “+”, then genotyping should be done to identify the genotype of the infection. The duration, method of treatment and its cost depend on this study. If, nevertheless, the result is “-”, then this is either a mistake, or you have entered the list of exceptions, which includes 15% of those who have healed themselves. But, it's too early to rejoice, you still need to visit a doctor and monitor your health, at least once a year.

It is important to understand that hepatitis is not a sentence, thanks to modern medicine it can be safely treated, the main thing is to detect the virus in time.

Currently, there are a huge number of ways to diagnose blood. There are those that are familiar to us, for example, a biochemical blood test or a general one, and there are less familiar ones - HCV or HBS.

Hepatitis C RNA kills liver cells, which can lead to cirrhosis. Such a virus can multiply in monocytes and B-lymphocytes against the background of increased mutational activity.

The method of blood testing for HCV (anti-HCV or anti-HCV) is based on the status of detecting antibodies of the “IgG” and “IgM” groups in the blood plasma. With hepatitis C, the immune system begins to produce protective antibodies, that is, immunoglobulins.

The method of blood testing for HBS determines the presence in the blood of an infection of the genus “hepatitis B”, which is caused by the DNA of the virus (HBsAg). Most often, this type of hepatitis is asymptomatic. The indications for an HBS study are:

secondary appearance of hepatitis;
control over the behavior of the virus;
detection of protective antibodies to the disease "hepatitis B" - most often this is done before vaccination, in order to determine its appropriateness.

There are no specific rules for donating blood for HCV or HBS. But doctors recommend donating blood on an empty stomach, and if you already know that you are infected with hepatitis, then in order to get a more accurate picture of the disease, conduct this study 5-6 weeks after the onset of the disease.

Deciphering analyzes

You can take an HCV blood test at any laboratory in a private clinic or clinic. The cost of such a study varies from 500 to 800 rubles. When deciphering the results of the analysis, it is necessary to pay attention not only to the norm indicators, but also to the type and form of the existing disease:

acute form:

ALT - > norm by 7 times;
IgM anti-HAV “-” or HBsAg “-”, anti-HCV “+” by PCR or anti-HCV “+” according to the signal criterion of lethal outcome — >3.8.

chronic form:

anti-HCV “+” in PCR or anti-HCV “+” in accordance with the signal criterion of lethal outcome —> 3.8;
ALT - > 1;
ALT - > 300 U / l (without jaundice).

Serum transaminases:

ALT -< 800 Ед.;
transaminases - > 10 times higher than normal.

Under what conditions the virus is not detected or not detected:

“Not detected” - there is no virus RNA or its value is below 200 copies / ml, that is, 40 IU / ml;
"Discovered" -< 7,5х102 копий/мл — то есть ниже линейного диапазона концентрации;
"Discovered" -< 2х106 копий/мл — при низкой виремии — это самый благоприятный прогноз при инфицировании;
“Detected” - > 2x106 copies/ml - with high viremia;
“Detected” - > 1.0x108 copies / ml - when the concentration of the linear range is exceeded.

Or the name of the analyzer: “anti hcv abbott architect “-” — the absence of a virus, “anti hcv abbott architect “+” or “anti hcv igg m” — the presence of a virus.

Also, do not forget that the analysis for HCV can give a false positive result (the frequency of such cases is 10%). Whenever antibodies of the virus are detected, confirmation of the presence of infection in the blood through PCR is required. The result can be influenced by: the hormonal background of the patient, improper conduct of the study, or blood sampling occurred without observing certain standards.

According to medical statistics, only 4% of the world suffers from hepatitis C. This figure cannot be considered objective, since this disease can be asymptomatic and carried on its feet. In order to avoid this, it is necessary to periodically conduct a comprehensive examination, since any independent test will not give a complete assessment of the disease.

Analysis for RNA-HCV

HCV (viral hepatitis C) is an RNA infection from the group

"Flaviviridae", which gives birth to the liver. Checking for the presence of the virus is carried out by the actual polymerase chain response (RT-PCR), determining the presence of hepatitis C genetic material (RNA) in the body and its viral load on the body. The linear concentration criterion, in which the sum of pathogens is calculated, should be equal to 7.5x102 - 1.0x108 copies / ml.

A quantitative method for the analysis of RNA-HCV reveals an infection in 1 ml of blood, which includes:

chain reaction (PCR and RT-PCR) in reality;
branched DNA - that is, R-DNA;
TMA — transcriptional amplification.

If the concentration of the infection is less than 8x105 IU / ml, then the treatment prognosis is favorable, in which you can completely get rid of the disease, and in the minimum possible place it in a state of remission.

ALT, AST - blood test

A biochemical blood test enables doctors to detect the presence of serious diseases and infections in the human body. AST is an enzyme that provides catalysis for the conversion of oxaloacetate to aspartame. In addition to AST, biochemical analyzes contain indicators of whether ALT is an alanine aminotransferase, which is a protein catalyst in amino acid metabolism (cell-based enzyme).

With timely medical care and therapeutic procedures, AST returns to normal within a month after the rehabilitation course of treatment. In order for the ALT and AST levels to always be normal, it is necessary to exclude the long-term use of any drugs that destroy liver tissues or disrupt the overall functionality of a vital organ. If this cannot be observed due to, for example, chronic hepatitis, then the analysis of AST and ALT should be carried out frequently and periodically for the timely detection of abnormalities caused by drug intoxication, or the appearance of a chronic form of the disease.

It must also be remembered that during the period of increased enzyme levels, the liver is weakened and should not be at any risk. Therefore, WHO recommends herbal preparations such as Karsil, Essentiale N, Tykveol, which have a positive effect on the liver and take on part of its functions: participation in metabolism and disinfection - the destruction of toxins.

But in no case should you self-medicate. If you find any signs of hepatitis in yourself, or see the words “Detected” in the test results, immediately consult a doctor for a comprehensive examination and an accurate diagnosis. The sooner you do this, the better it will be for you. You can't joke with your health!

In response to foreign particles, such as viruses, entering the human body, the immune system produces immunoglobulins - protective antibodies. These antibodies are detected by a special ELISA test, a screening test used to determine whether a person is infected with the hepatitis C virus. For hepatitis C, all antibodies contain the abbreviation anti-HCV, which stands for "against the hepatitis C virus."

Hepatitis C antibodies come in two classes - G and M, which is written in the analyzes as IgG and IgM (Ig-immunoglobulin (immunoglobulin) is the Latin name for antibodies). Anti-HCV total (anti-HCV, anti-hcv) - total antibodies (IgG and IgM classes) to the antigens of the hepatitis C virus. A test for the determination of these markers is performed on all patients when they want to check if they have hepatitis C. Anti- HCV is present in both acute (they can be detected as early as 4-6 weeks after infection) and chronic hepatitis. Anti-HCV totals are also found in those who have had hepatitis C and recovered on their own. In such people, this marker can be detected for 4 to 8 years or more after recovery.

Therefore, a positive anti-HCV test is not sufficient to establish a diagnosis. Against the background of chronic infection, total antibodies are constantly detected, and after successful treatment they persist for a long time (primarily due to anti-HCV core IgG, which is described below), while their titers gradually decrease.

The spectrum of anti-HCV (core, NS3, NS4, NS5) is specific antibodies to individual structural and non-structural proteins of the hepatitis C virus. They are determined to judge the viral load, infection activity, risk of chronicity, differentiation of acute and chronic hepatitis, degree of liver damage . The detection of antibodies to each of the antigens has an independent diagnostic value. Anti-HCV consists of structural (core) and non-structural (NS3, NS4, NS5) proteins (proteins).

Anti-HCV core IgG — class G antibodies to nuclear (core) proteins of HCV. Anti-HCV IgG appear from 11-12 weeks after infection, therefore, Anti-HCV total, which appear earlier, is used to diagnose possible "fresh" infections. Anti-HCV IgG reach a peak concentration by 5-6 months from the moment of infection and in the chronic course of the disease are detected in the blood for life. With hepatitis C, the titer of IgG antibodies gradually decreases and can reach undetectable values several years after recovery.

Non-structural (NS3, NS4, NS5) proteins.

NS3, NS4, NS5 belong to nonstructural (NS - nonstructural) proteins. In fact, there are more of these proteins - NS2, NS3, NS4a, NS4b, NS5a, NS5b, however, in most clinical diagnostic laboratories, antibodies to NS3, NS4 and NS5 proteins are determined.

Anti-NS3 are detected at the earliest stages of seroconversion. High titers of anti-NS3 are characteristic of acute hepatitis C and may be an independent diagnostic marker of an acute process. In an acute process, a high concentration of anti-NS3 usually indicates a significant viral load, and their long-term preservation in the acute phase is associated with a high risk of chronic infection.

Anti-NS4 and anti-NS5 tend to appear later. In chronic hepatitis C, the determination of anti-NS4 in high titers may indicate the duration of the infectious process and, according to some data, is associated with the degree of liver damage. The detection of anti-NS5 in high titers often indicates the presence of viral RNA, and in the acute stage it is a predictor of the infection process becoming chronic. A decrease in NS4 and NS5 titers in dynamics may be a favorable sign indicating the formation of clinical and biochemical remission. Anti-NS5 titers may reflect the effectiveness of AVT, and their increased values are typical for individuals who do not respond to therapy. After recovery, anti-NS4 and anti-NS5 titers decrease over time. The results of one study showed that in almost half of patients 10 years after successful treatment with interferons, anti-NS4 and anti-NS5 were not detected. The following table lists the most likely interpretations of the combination of hepatitis C markers.

Viral hepatitis C is a serious medical and social problem. About 180 million people in the world today suffer from this disease, 350 thousand die every year. Long latent (asymptomatic) course of the disease leads to delayed diagnosis. An analysis for hepatitis C is carried out with the aim of diagnosing the disease, differential diagnosis, with its help determine the previously transferred disease "on the legs".

The study is used in people with symptoms of hepatitis C, elevated levels of liver enzymes, when receiving information about a previously transferred disease of unspecified etiology, in people at risk and screening studies.

Diagnosis of hepatitis C is carried out in 2 stages:

Stage 1. Determination of the presence of antibodies to the virus (anti-HCV) in the blood serum.

Stage 2. In the presence of anti-HCV, a test is performed for the presence of RNA (ribonucleic acid) by PCR for hepatitis C. The test allows you to identify the phase of the process - “active / inactive”, to decide on the need for treatment. It is known that about 30% of infected individuals get rid of the infection on their own, as they have a strong immune system and do not need treatment. Using PCR, the genotype of the virus is determined. Different genotypes respond differently to treatment.

The degree of liver damage is determined using a biopsy or other invasive and non-invasive tests (eg, fibrotest). The degree of hepatic steatosis is determined using a steatotest. In all cases, the diagnosis of hepatitis C should be based on the data of an epidemiological investigation, the clinic of the disease and the data of a biochemical blood test.

Rice. 1. Severe consequences of viral liver damage - intense ascites.

Hepatitis C test: anti-HCV

Antibodies to viruses (anti-HCV) are specific markers of infection. In the body of a sick person, specific antibodies are produced to the proteins of the virus (antigens) - immunoglobulins of the IgM and IgG classes (anti-HCV IgM / IgG).

Upon receipt of a positive result for antibodies, a confirmatory test is performed - the determination of total antibodies to the structural and non-structural proteins of the virus. To the structural envelope proteins of the E1 and E2 virus, anti-HCV IgM, the nucleocapsid protein C-cor (anti-HCV IgG), to 7 non-structural NS enzyme proteins (anti-HCV NS IgG) are produced.

An enzyme immunoassay (ELISA) is used to detect antibodies to the hepatitis C virus. To confirm (+) ELISA results, confirmatory tests are used - RIBA (recombinant immunoblotting), less often Inno-Lia (synthetic peptide analysis).

Anti-HCV IgM assay

IgM antibodies appear in the blood serum 4-6 weeks after infection and quickly reach a maximum. At the end of the acute process (after 5-6 months), their concentration drops.
Long-term registration of the presence of anti-HCV IgM indicates that hepatitis C has acquired a chronic course.
An increase in the level of IgM during the chronic course indicates reactivation.
The level of IgM immunoglobulins makes it possible to evaluate the effectiveness of treatment.

Anti-HCV IgG assay

IgG antibodies appear in the patient's blood serum 11-12 weeks after infection. At 5-6 months, a peak concentration is recorded. Further, antibodies remain at a constant level throughout the entire period of the disease in the acute period and the recovery period.

Analysis for total antibodies to hepatitis C virus

Total antibodies to the virus (anti HCV total) are used to diagnose "fresh" cases of the disease. Total antibodies are antibodies to the nucleocapsid protein C-cor (anti-HCV IgG) and 7 non-structural protein-enzymes NS (anti-HCV NS IgG) - anti-HCV NS3, anti-HCV NS4 and anti-HCV NS5.

Total antibodies to the hepatitis C virus appear in the blood serum of the infected person 11–12 weeks after the onset of infection, reach a peak by 5–6 months and remain at a constant level throughout the entire duration of the disease in the acute period and for 5–9 years after the recovery period .

Each of the types of antibodies has an independent diagnostic value:

Anti-HCV C (cor) are the main indicators of exposure to hepatitis C viruses.
Anti-HCV NS3 are among the first detected in the process of seroconversion (production of antibodies in response to the presence of the virus), indicate the severity of the infectious process and indicate a high viral load. With their help, hepatitis C is determined in patients who do not suspect that they have an infection. Long-term presence of anti-HCV NS3 in the blood serum indicates a high risk of chronicity of the process.
Anti HCV NS4 suggests that hepatitis C has a long course. The level of antibody titers can be used to judge the degree of liver damage.
Anti-HCV NS5 indicate the presence of viral RNA. Their detection in the acute period is a harbinger of a chronic process. High antibody titers during treatment indicate that the patient is not responding to treatment.
Anti-HCV NS4 and anti-HCV This type of antibody appears late in the development of hepatitis. Their decrease indicates the formation of remission of the infectious process. After treatment, NS4 and NS5 antibody titers decrease within 8 to 10 years. This type of antibody does not protect against re-infection.

Rice. 2. Macropreparation. Cirrhosis of the liver is a severe complication of hepatitis C.

Deciphering the analysis for hepatitis C - anti HCV

The absence of antibodies to the hepatitis C virus is designated by the term "Normal". However, this does not always mean the absence of a disease in a person. So the absence of antibodies in the blood of an infected person is recorded until the moment they appear in the blood - up to 6 months from the moment of infection (on average, after 12 weeks). The period of absence of antibodies in the blood of an infected person is called the “serological window”. 3rd generation test systems (ELISA-3) have high specificity (up to 99.7%). About 0.3% is due to false positive results.

The presence of anti-HCV is indicative of current infection or past infection.

The detection of IgM antibodies and Core IgG antibodies, an increase in titers of Core IgG antibodies and (+) PCR results in the presence of clinical and laboratory signs of acute hepatitis indicate an acute period of the disease.
Detection of IgM antibodies, anti-HCV Core IgG, anti-HCV NS IgG and (+) PCR result in the presence of clinical and laboratory signs of the disease indicates reactivation of chronic hepatitis C.
The detection of anti-HCV Core IgG and anti-HCV NS IgG in the absence of clinical and laboratory signs of the disease and a negative PCR result indicates that the patient has chronic hepatitis in the latent phase.

Rice. 3. Macropreparation of the liver. Primary liver cancer is a serious complication of hepatitis C.

PCR for hepatitis C

Polymerase chain reaction (PCR) is the "gold standard" for diagnosing viral hepatitis C. The high sensitivity of the test makes it possible to detect the genetic material of viruses (RNA), even if there are only a few of them in the test material. PCR is able to detect viral RNA long before the appearance of antibodies in the blood serum, but not earlier than from the 5th day from the moment of infection. With the help of PCR, RNA viruses are detected not only in blood serum, but also in liver biopsies.

Polymerase chain reaction allows you to determine the presence or absence of hepatitis C viruses in the blood and decide on the start of treatment. It is known that up to 30% of patients get rid of the infection on their own, as they have a strong immune system and do not need treatment.
Using PCR, the genotype of the virus is determined. Different genotypes respond differently to treatment.
PCR is used to monitor the effectiveness of treatment.
PCR is used in the absence of antibodies in the blood, but in the presence of significant suspicions of the disease (increased levels of alkaline phosphatase, total bilirubin, 2 times the hepatic enzymes AST and ALT).
The PCR test for hepatitis C is used to monitor intrauterine transmission of hepatitis viruses.

Viral load in hepatitis C

Using PCR analysis, it is possible to determine not only the presence of RNA viruses in the blood - a qualitative analysis (detected / not detected), but also their number - viral load (the number of viral RNA units in 1 ml of blood). A quantitative PCR indicator is used to monitor the effectiveness of treatment.

The methods used for PCR have different sensitivities. In the Russian Federation, according to the guidelines of 2014, it is recommended to use methods with a sensitivity of 25 IU/ml or less. According to the recommendations of the European Association for the Study of the Liver 2015, it is proposed to use methods for the determination of viral RNA with a sensitivity of 15 IU/ml or less.

Depending on the sensitivity of the test system, the patient receives one or another test result:

The minimum sensitivity of the COBAS AMPLICOR analyzer is 600 IU/mL (old generation analyzer).
The minimum sensitivity of the COBAS AMPLICOR HCV-TEST analyzer is 50 IU/ml, which is 100 copies in 1 ml.
The minimum sensitivity of the RealBest HCV RNA analyzer is 15 IU/ml, which is 38 copies per 1 ml (included in the group of modern test systems). The specificity of these analyzers is 100%. With their help, RNA of hepatitis C viruses of subtypes 1a and 1b, 2a, 2b, 2c and 2i, 3, 4, 5a and 6 are detected.

In the presence of RNA copies below the sensitivity threshold of this analyzer, the patient receives the answer “not detected”.

Rice. 4. Example of PCR analysis (quantitative test). Determination of viral load.

Interpretation of Hepatitis C PCR Test Results

The absence of viral RNA indicates the absence of infection.
The absence of RNA in the analysis against the background of the presence of antibodies in the blood indicates the disappearance of the disease under the influence of treatment or self-healing.
In some cases, the virus is present in the blood, but at subthreshold levels, when its concentration is not captured by the analyzers. Such patients remain dangerous in terms of infection.
Detection of virus RNA for 6 consecutive months in patients with acute hepatitis C indicates that the disease has taken a chronic course.
A decrease in viral RNA in analyzes during treatment indicates the effectiveness of the therapy and vice versa.

Rice. 5. Macropreparation. Fatty hepatosis is one of the consequences of the disease.

Basic biochemical blood tests for hepatitis C

Biochemical blood tests help to establish the functional state of many human organs and systems.

Blood test for liver enzymes ALT and AST

Liver enzymes are synthesized intracellularly. They take part in the synthesis of amino acids. A large number of them are found in the cells of the liver, heart, kidneys and skeletal muscles. When organs are damaged (violation of the integrity of cell membranes), enzymes enter the bloodstream, where their level rises. An increased level of enzymes is recorded with damage (lysis, destruction) of liver cells, myocardial infarction and other diseases. The higher the level of transaminases in the blood serum, the more cells were destroyed. ALT predominates in liver cells, AST - in myocardial cells. With the destruction of liver cells, the level of ALT increases by 1.5 - 2 times. With the destruction of myocardial cells, the level of AST increases by 8-10 times.

When diagnosing chronic viral hepatitis, it is necessary to pay attention to the ratio of AST / ALT (de Ritis ratio). Exceeding the level of AST over ALT indicates damage to the liver cells.

The norm of AST for men is up to 41 units / l, women - up to 35 units / l, children over 12 years old - up to 45 units / l.
The ALT norm for men is up to 45 units/l, for women - up to 34 units/l, for children 12 years and older - up to 39 units/l.
Normally (in healthy people), the AST / ALT ratio has a value of 0.91 - 1.75.

Blood test for bilirubin

Bilirubin is a breakdown product of hemoglobin. Bilirubin in the blood is contained in the form of indirect (up to 96%) and direct (4%). The process of decomposition of this substance occurs mainly in the liver cells, from where it is excreted from the body with bile. With the destruction of liver cells, the level of bilirubin in the blood serum increases. Normally, the content of total bilirubin is less than 3.4 - 21.0 µmol / l. At a level of 30 - 35 µmol / l and above, bilirubin penetrates into the tissues, due to which the skin and sclera become icteric.

Rice. 6. Jaundice is one of the signs of liver damage.

Modern medicine is based on the principles of overdiagnosis, this is due to the fact that very often the true cause of certain symptoms is not detected during the initial examination or laboratory tests. Viral agents that affect liver cells are no exception, and hepatitis C, the treatment of which is expensive and does not always give a positive outcome, must be identified with absolute certainty in order to prevent its further spread.

HCV blood test, what is it?

This is an enzyme immunoassay. , which allows you to detect antibodies and in the direction of a doctor is usually indicated as Anti-HCV. When conducting this study, it is possible to identify three classes of immunoglobulins that provide insight into:

The presence of a disease.
Stages of development - refers to the incubation period, acute course or chronic form, as well as the presence of a disease already transferred without hospitalization and treatment.

HCV analysis is based on the detection of different classes of immunoglobulins and allows you to determine antibodies to the causative agent of hepatitis C. Specialists distinguish two classes of globular proteins that provide information about the stage of the disease - these are M and G.

The first indicates an acute phase of the development of the disease and its titer increases during the first few months after infection. At this stage, over ninety-five percent of infections are cured by the modern three-component regimen.

The second class indicates the long-term persistence of the virus in the liver cells. The chronic form of hepatitis C is considered the most prognostically unfavorable, since it is less treatable and rarely completely eliminates viral particles from hepatocytes.

Methods for detecting hepatitis C virus

In addition to HCV analysis, it is possible to determine the presence of the so-called "gentle killer" in the blood in several other ways, including:

- is considered one of the most effective and accurate diagnostic methods. It allows you to identify the RNA of the virus in the human body and carried out even with a positive result HCV analysis for the final diagnosis .
Conducting a rapid test for the presence of the causative agent of hepatitis C- the sensitivity of this method is about ninety-six percent, which allows you to quickly give information about the presence of a pathogen in human biological media.

There are also research methods that usually precede the referral of a patient for HCV analysis. It is these diagnostic tools that provide information that prompts the specialist to think about the presence of inflammation of the liver cells of viral etiology:

Ultrasonic diagnostics and elastometry.
Clinical blood test.
Coagulogram.
Biochemical with liver tests.

Accuracy of anti-HCV blood test

Anti-HCV diagnostics is a modern and fairly accurate method, it allows you to determine the presence of the causative agent of hepatitis C from the fifth to sixth week after infection. The virus will not be detected in plasma if it replicates less than two hundred copies per milliliter. If the calculation is carried out in international units, this is less than forty international units per milliliter. In the presence of more than a million viral particles in one milliliter of plasma, the presence of viremia is established.

A false-positive result for the carriage of the hepatitis C virus is established in approximately one in ten cases. The reason for such statistics is a violation of the method of blood sampling and analysis, a change in the hormonal background, or non-compliance with the doctor's recommendations for preparing for the test. According to WHO data, four percent of the world's population are convalescents for hepatitis C.

Possible indications for HCV testing

To undergo a study for the presence of hepatitis C, you do not need permission or a referral from your doctor, today there are a lot of laboratories and medical centers where anyone can take an HCV blood test. However, there is a list of conditions that are indications for this study, these include:

Desire to become a donor.
The presence in the anamnesis of life of an exchange transfusion of blood or its components.
An increase in the level of ALT and AST against the background of medical intervention.
Exclusion of hepatitis C in the presence of its secondary signs.
Finding out the effectiveness of hepatitis C treatment.

It is necessary to take an HCV blood test no earlier than 5-6 weeks after the initial alleged infection, otherwise, even if there is an infection in the body, immunoglobulins may not be produced in sufficient quantities and give a false negative result.
It is necessary to take after a twelve-hour break in food - food intake affects the rheological characteristics of plasma.
The fence should be taken in the morning - this is due to the fact that most of the standard indicators were calculated in the morning, so to reduce the likelihood of a false positive result, you must follow this rule.
It is necessary to exclude the intake of hormonal, antiviral and cytostatic drugs per day.
You should also refrain from drinking alcohol in the evening before visiting the laboratory.

HCV blood test procedure and result evaluation

For analysis, it is necessary to take biological material, in this case it is blood. After taking twenty milliliters of blood from a peripheral vein, it is centrifuged in order to obtain its liquid component - plasma, which will be examined. In order to prevent the development of false positive results, it is recommended to take blood samples in the morning before meals. The results obtained from HCV analysis should be interpreted as follows:

Negative- this indicates the absence of antibodies to hepatitis C in the patient's body, as a result - the person is healthy.
Positive- means that antibodies to hepatitis C virus particles were found in the patient's blood, which may indicate the presence of the disease in an acute or chronic form. However, even if a positive result is obtained, it is necessary to carry out.
1. The presence of IgG indicates a chronic form of pathology.
2. The amount of IgM detected indicates the severity of the process - the more it is, the earlier the disease is considered.

PCR diagnosis of hepatitis C

Polymerase chain reaction is considered the most accurate and modern method for detecting RNA and DNA chains of any nature. Viral hepatitis C contains ribonucleic acid, and the high incidence of false positives in anti-HCV blood tests makes it an ideal candidate for this study.

Allocate a qualitative and quantitative type of diagnostics, of which the second is the most significant. The negative side of this diagnostic tool is its high cost, as well as the duration of the study, in connection with which the HCV blood test is the most accessible, and if performed correctly, the number of errors is minimal.