A reminder for patients: hepatitis C and B

When the hepatitis C virus (HCV for short) enters the body, the immune system produces special proteins that the blood carries through the body to help fight the hepatitis C virus. They are called antibodies. If you have HCV antibodies, it suggests that you have had contact with HCV. But this does not mean that you have hepatitis C in the active stage. 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 overcome the virus. 

There are two types of tests used to diagnose contact with hepatitis C virus – ELISA (enzyme immunoassay) and ECL (electrochemiluminescence analysis). The sensitivity and specificity of ELISA in this case is about 90%, and ECL is about 98%, therefore, in extremely rare cases, false positive and false negative results are possible.

To determine the presence and activity of the hepatitis C virus, you will need to do additional appropriate tests.

It is important to remember:

· Even if you had contact with the hepatitis C virus, your body could get rid of the virus on its own. Therefore, it is important to do additional tests.

· Try not to worry, even if your antibody test is positive and active hepatitis C has been confirmed by additional tests. It usually takes 10 to 40 years for the virus to damage your liver. In addition, there are a lot of things you can do to keep your liver healthy.

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

To clarify the activity of the virus, your doctor, for the purpose of a detailed examination, will prescribe several additional blood tests to find out exactly what is happening inside you. These tests are called PCR - polymerase chain reaction, which detects the genetic material of the hepatitis C virus present in the blood.  One of the tests will give an answer to the presence of the virus in you. The other one will allow you to determine which genotype the virus has (HCV has several genotypes). Another test will determine the viral load - how much hepatitis C virus you have and how active this virus is. 

If you have hepatitis C virus, then it does not only remain in liver cells, it can also be detected in your blood. HCV is very active and produces many copies of itself. Virus download test is the only way to measure how much HCV you have.

Virus download test is very important for several reasons:

First: Virus download test will tell you if you have a virus present or if you have already gotten rid of it.

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

Third, If you decide to undergo interferon therapy, a virus download test will help the doctor find out if the therapy is working and how long it needs to be continued.

REMEMBER: Always do your tests in the same laboratory. This will allow you to make correct estimates when comparing the results obtained.

What is genotyping?

Hepatitis C virus (HCV for short) has several varieties. In fact, there are six different types of HCV. These species 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 the attending doctor to know the genotype of your virus, since different viruses with different genotypes respond to treatment in different ways (respond to therapy). For example, genotype 1 is a bit more difficult to treat than genotypes 2 or 3. And HCV type 1 therapy requires doses of drugs other than those used in therapy with genotypes 2 or 3.

Having a certain genotype does not mean that you are more or less ill. But some genotypes (for example, 3) may be associated with certain liver conditions, such as obesity.

It is important to remember that in most people hepatitis C does not manifest itself at all in the form of any symptoms - regardless of the genotype of the virus.

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

First, if you decide to go to therapy, a genotype test will predict your chances of getting rid of the virus.

Secondly, the virus genotype test will help your doctor determine the necessary doses of drugs and the duration of your therapy.

REMEMBER: The fact that you have a virus of a particular genotype does not mean that you are more or less ill.

Important information:

Statistics for 100 people infected with hepatitis C (HCV)

In approximately 80 out of 100 people with hepatitis C virus (HCV) detected, the disease will turn into a chronic form: the other 20 people infected with HCV will get rid of the virus on their own. This is due to the fact that some people's bodies are able to cope with HCV naturally.

In about 20 people, the resulting chronic infection will progress and develop into a serious disease over decades: Only about 20 of the initial 100 people infected with HCV will develop hepatitis into a serious, life-threatening disease (cirrhosis). Usually, a person with hepatitis C has a really sick liver for 40 years or more.

Approximately 2-3 people with chronic hepatitis C infection will develop liver cancer: Only 2-3 people out of the initial 100 people who have been diagnosed with hepatitis C virus develop liver cancer. This happens only after the liver is significantly affected by cirrhosis.

Hepatitis B

There are various blood tests available to diagnose hepatitis B. You can do a general test or a series of analysis. Below are some of the main tests and their transcription.

The main test for the detection of hepatitis B is Surface antigen (HBsAg, HBs antigen, HBs Ag, Australian antigen). It is a surface protein of the hepatitis B virus and can be detected in the blood in acute or chronic hepatitis, as well as in hepatitis B virus carriers. There are two types of tests used to detect HBsAg – ELISA (enzyme immunoassay) and ECL (electrochemiluminescence analysis). The sensitivity and specificity of ELISA in this case is about 90%, and ECL is about 98%, therefore, in extremely rare cases, false positive and false negative results are possible.

In order to confirm the presence and detect the activity of the hepatitis B virus, your doctor, for the purpose of a detailed examination, will prescribe several additional blood tests to find out exactly what is happening inside your body. These tests are called PCR - polymerase chain reaction, which detects the genetic material of the hepatitis B virus present in the blood.  One of the tests will give an answer to the presence of the virus in you. The other one will determine the viral load - how much hepatitis B virus you have, how active this virus is. 

A positive PCR test means that the virus is actively multiplying in the human body and such a person carries a potential risk of contracting hepatitis. If a person has chronic hepatitis of viral etiology, the presence of viral DNA also means that the person may be at increased risk of liver damage.

A negative PCR test means that there is no hepatitis B virus in the blood or its extremely low activity.

Important! Only your doctor can interpret your individual test results and establish a clinical diagnosis.