Hepatitis is an inflammation of the liver. This is mainly transmitted by various viruses such as the hepatitis A, B or C virus. The hepatitis C virus belongs to the group of flaviviruses. Transmission of the pathogen (route of infection) usually occurs parenterally through contact with contaminated blood. Therefore, drug addicts in particular are at high risk. Meanwhile, drug abuse is one of the most common sources of new hepatitis C infections. Furthermore, medical personnel who frequently come into contact with blood are considered to be at risk. Furthermore, parenteral infection through sexual intercourse is possible. In heterosexuals, the infection rate during 100 patient-years is on average only 0.4 persons with hepatitis C infection; in homosexuals, the infection rate is 4.1. Transmission of the pathogen is also possible vertically (from the mother to the unborn/newborn child), but occurs less frequently than with hepatitis B – approximately 2-7 % depending on the viral load of the mother. The risk of infection from a needle-stick injury with virus-positive blood is 3%. Worldwide, approximately 3% of the population are chronic carriers of hepatitis C virus. If hepatitis C virus (HCV) infection is suspected, the following laboratory tests should be performed:
- Serology
- Detection of hepatitis C-typical antigens (ELISA test: hepatitis C antibodies are formed after 4-6 weeks at the earliest; usually after 2-6 months)* .
- Anti-HCV – but is not suitable for ruling out acute hepatitis C, as it does not become positive until several weeks after infection.
- HCV immunoblot – specific confirmatory test (to clarify a positive ELISA test).
- HCV-PCR* * (HCV RNA: detection of fresh (seronegative) or chronic or infectious HCV disease/parameter to determine the activity and infectivity (contagiousness) of hepatitis C).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (γ-GT, gamma-GT; GGT); alkaline phosphatase, bilirubin.
* In particular, the suspected disease, the disease as well as death from acute viral hepatitis must be reported in the sense of the Infection Protection Act. * * As a surrogate marker (measured value, the influence of which is to indicate the effect of a therapy, on the occurrence of a disease) of a cure is considered the sustained virologic response (SVR). This is defined as the absence of detection of HCV RNA in the blood six months after the end of therapy.
The procedure
Material needed
- Blood serum (HCV, HCV immunoblot).
- EDTA blood (HCV PCR)
Preparation of the patient
- Not known
Disruptive factors
- Not known
Standard values
| Parameter | Normal value |
| HCV | Negative |
| HCV immunoblot | Negative |
| HCV PCR | Negative |
Indications
- Suspected hepatitis C infection
- Therapy monitoring
Interpretation
Serological parameters in hepatitis C infection.
Overview of possible constellations of laboratory diagnostic results and their evaluation:
| HCV RNA / antigen | HCV antibody (IgG+IgM) | Infection status |
| negative | negative | susceptible (receptive) |
| positive | negative | acute infection |
| positive | questionable | acute infection |
| positive | positive | Acute or chronic infection |
| negative (with sensitivity 10- 25 IU/ml ) | positive | Cured (spontaneously or at least six months after end of therapy) |
Other indications
- Suspicion of, illness from, and death from hepatitis are reportable.
