Specific features of laboratory examination in viral hepatitis B and C

When the hepatitis B or C virus enters your body, your immune system makes special proteins that the blood carries around the body to help fight viruses. These are called antibodies.

The main test for detecting hepatitis B is the Surface Antigen (HBsAg, HBs antigen, HBs Ag, Australian antigen). It is the surface protein of the hepatitis B virus and can be detected in the blood in acute or chronic hepatitis, as well as in carriers of the hepatitis B virus.

Hepatitis C is characterised by the detection of anti-HCV antibodies. But this does not mean that you have active hepatitis C. In some people (2-3 out of 10), the immune system is able to get rid of the virus on its own, but in the remaining 7-8 people, the body cannot fight off the virus.

There are two types of tests used to diagnose prior exposure to hepatitis B or C virus - ELISA (enzyme-linked immunosorbent assay) and EHL (electrochemiluminescence assay). The sensitivity and specificity of ELISA is about 90 per cent and of EСL about 98 per cent, so false positives and false negatives can occur in extremely rare cases.

To determine the presence and activity of the hepatitis B or C virus, you will need to have additional tests done.

It's important to remember:

Even if you have viral hepatitis markers such as HBs antigen or anti-HCV, this does not mean that the infection process is active. Therefore, it is important to have additional tests.

Only your doctor can interpret your individual test results and make a clinical diagnosis.

To find out more about the activity of the virus, your doctor will order some additional blood tests to find out exactly what is going on inside you. These tests are called PCR - polymerase chain reaction, which detects the genetic material of the hepatitis B or C virus present in the bloodstream. One of the tests, qualitative PCR, will answer whether you have the virus. Another, quantitative PCR, will determine your viral load - how much hepatitis B or C virus you have and how active the virus is. Another PCR assay, genotyping, is used for hepatitis C and can determine the genotype of the virus. 

Its important to know! A negative result of a qualitative PCR test means that the hepatitis B or C virus is not present in the blood or is extremely low in activity.

If you have the hepatitis B or C virus, it doesn't just stay in your liver cells, it can also be found in your blood. Hepatitis viruses are very active and produce many copies of themselves. A viral load test is the only way to measure how many hepatitis B or C viruses are present in you.

Virus Download Test is very important for several reasons:

First: A Virus Download Test will tell you whether you have a virus or whether you have already been freed from it.

Second: If you are a pregnant woman, the risk of passing the virus to your baby is very low, but if you are a pregnant woman with a high viral load, the risk of passing the virus to your baby will be slightly higher.

Third: If you decide to undergo interferon therapy, a viral load test will help the doctor know if the therapy is working and how long you need to continue it.

REMEMBER: Always have your tests done in the same laboratory. This will allow you to make correct judgements when comparing your results.

What is genotyping?

Hepatitis C virus (abbreviated HCV) has several varieties. In fact, there are six different types of HCV. These are called genotypes and are numbered from 1 to 6. Some genotypes have further divisions called subtypes (e.g. 1a and 1b).

It is very important for your doctor to know the genotype of your virus, because different viruses with different genotypes are treated (respond to therapy) differently. For example, genotype 1 is a little harder to treat than genotypes 2 or 3. And therapy for HCV type 1 requires different doses of drugs than therapy for genotypes 2 or 3.

Having a certain genotype does not mean you are sicker or less sick. But some genotypes (like 3) may be associated with certain liver conditions, such as obesity.

It's important to remember that in most people, hepatitis C doesn't show any symptoms at all - regardless of the genotype of the virus.

Knowing the genotype of the virus is important for several reasons:

Firstly: If you decide to go for therapy, a genotype test will predict your chances of getting rid of the virus.

Secondly: A genotype test will help your doctor to determine the doses of drugs needed and the length of your therapy.

REMEMBER: Having a virus of one or another genotype does not mean that you are lighter or more severely ill.

Important: OLYMP CDL branches offers comprehensive hepatitis B and C testing using European equipment that ensures high quality and reliable results.