Hepatitis C- this viral disease liver. It is also called the "gentle killer". This disease creeps up on the sly, proceeds without clear signs and leads to severe consequences: cancer or cirrhosis of the liver.

The virus was discovered in 1989, before that the disease was called "non-A, non-B hepatitis". Both drug addicts who use the same needle and absolutely safe people can become infected with hepatitis C. After all, you can “catch” the virus in the dentist’s office or in a nail salon.

Once infected, hepatitis is very secretive. Viruses multiply in the liver, gradually destroying its cells. At the same time, in most cases, a person does not feel any signs of the disease. And since there are no complaints and visits to the doctor, there is no treatment. As a result, in 75% of cases, the disease passes into chronic stage, and there are serious consequences. Often, a person feels the first signs of the disease only when cirrhosis of the liver has developed, which cannot be cured.

How common is hepatitis C? There are more than 150 million chronic patients on the planet, in Russia their number is 5 million. Every year, the disease is detected in 3-4 million people. And the death rate from the consequences of hepatitis C is 350 thousand per year. Agree, impressive numbers.

The disease is unevenly distributed. In some countries with low sanitation culture, 5% of the total population is infected. Men and women are equally susceptible to this disease, but in women, treatment is more successful. In children, hepatitis responds better to therapy, only in 20% of cases it becomes chronic. While in adults, 20% of patients are successfully cured, 20% become carriers of the virus, and 60% have chronic diseases liver.

Where can I get information support on the treatment of hepatitis C in 2018?

How is hepatitis C transmitted?

The disease is transmitted through the blood. The source of infection is a person. It can be a patient with an acute or chronic form of hepatitis C, as well as a carrier - someone who has a virus in the blood, but does not get sick himself.

There are many situations in which you can become infected with the hepatitis C virus.

1. Blood transfusion and organ transplantation. Approximately 1-2% of donors have the virus and are unaware of it. People who are forced to do repeated blood transfusions are especially at risk. In the past, this route of transmission of the disease was the main one. But now blood and donor organs are checked more carefully.
2. At sharing single needle addicts. In this way, up to 40% of patients become infected. The small fragments of blood that remain on the needle are enough to contract many serious diseases. Including AIDS and hepatitis C viruses.
3. When using non-sterile instruments. Many medical and cosmetic procedures may be accompanied by skin lesions. If the instruments have not been properly disinfected, they retain infected blood particles with the virus. Such a danger lurks in the dentist's office, at acupuncture sessions, as well as those who do piercings, tattoos or just manicures.
4. During childbirth- "vertical" transmission path. A mother can pass the virus to her baby during childbirth. Especially if at this moment she has an acute form of hepatitis or she suffered the disease in the last months of pregnancy. Milk does not contain the virus, so breastfeeding completely safe.
5. During sexual contact. During sex without a condom, you can take the virus from a sexual partner. However, the risk of such infection with hepatitis C is not too high.
6. When providing medical care. Health workers who give injections, tend to wounds, or work with blood and blood products are also at risk of becoming infected. Especially if infected blood gets on damaged areas of the skin.

Hepatitis C is not transmitted through shared utensils, food and water, towels, washcloths, kisses and hugs. When talking, sneezing and coughing, the virus is also not released.

What is hepatitis C virus?

The hepatitis C virus (HCV) is small virus round shape, it belongs to the Flaviviridae family. Its main part is a single strand of ribonucleic acid (RNA). She is responsible for the transfer of genetic information to descendant viruses. The chain is covered with a shell of protein molecules - the capsid. The outer protective layer of the capsule consists of fats. On their surface there are elevations similar to volcanoes - these are protein molecules that serve to penetrate into human cells.

The virus has an interesting feature. He is constantly changing. To date, there are 11 variants of it - genotypes. But after being infected by one of them, the virus continues to mutate. As a result, up to 40 varieties of one genotype can be identified in a patient.

It is this property of the virus that allows it to remain in the body for so long. While the human immune system learns to produce antibodies to fight one variety, the virus has already managed to change. Then the immune system has to start producing "defenders" again. From such a load, the human immune system is gradually depleted.

What happens in the body when a virus gets there?

Badly affects the human condition and intoxication, which occurs due to the activity of the virus. The condition also worsens because the liver, which should cleanse the blood of toxins, does not perform its functions.

Will the vaccine help prevent hepatitis C?

To date, there are vaccinations against hepatitis A and B. There is no vaccine that would prevent hepatitis C. This is due to the fact that the virus has a huge number of varieties and it is very difficult to create a drug that would contain an element common to all genotypes. But development is ongoing. Perhaps in the future such a tool will appear.

In the meantime, avoidance of drugs and the use of condoms during sexual intercourse can be considered preventive measures. Medical workers should wear rubber gloves to protect their hands. Sanitation stations constantly monitor how instruments that come into contact with blood are processed. But only you can decide where to treat your teeth, get manicures and piercings.

What can be the result of a blood test for hepatitis C?

If there is a suspicion that a person could become infected with hepatitis, then a number of tests are prescribed:

• Coagulogram (blood clotting test)
• Test for the determination of hepatitis C virus RNA by PCR (for HCV-RN) qualitative, quantitative, genotyping
• Antibody test to the hepatitis C virus(anti-HCV, ELISA, enzyme immunoassay)
• Test for the presence of class M antibodies to hepatitis C virus (anti-HCV IgM)
• Test for the presence of class G antibodies to hepatitis C virus (anti-HCV IgG)

Let's take a closer look at each type of study:

1. General blood analysis . A decrease in the level of platelets is found in the blood. At the same time, the number of leukocytes increases. It's a sign inflammatory process in the liver.


2. Biochemical analysis blood. During hepatitis C, enzymes and other substances appear in the blood that are not in the tests. healthy person.
   • Alanine aminotransferase (ALT) is an enzyme found in hepatocytes. If it is found in the blood, then this indicates liver damage. This test is considered very sensitive in order to detect acute hepatitis in early stages.
   
   
   • Aspartate aminotransferase (AST) It is also an enzyme that is found in the tissues of the liver. If both enzymes (AST and ALT) are found in the blood, then this may indicate that the death of liver cells has begun - necrosis. In the event that the amount of AST is much higher than ALT, it is possible that connective tissue has begun to grow in the liver (liver fibrosis). Or it indicates damage to the organ by toxins - medicines or alcohol.
   
   
   • Bilirubin- one of the components of bile. If it is found in the blood, then this indicates a violation in the functioning of liver cells, their destruction by viruses.
   
   
   • Gamma-glutamyl transpeptidase (GGT) is an enzyme found in the liver tissue. Elevated levels may indicate cirrhosis of the liver.
   
   
   • Alkaline phosphatase(SHF) is an enzyme found in the bile ducts of the liver. If it is present in the blood, then hepatitis has disrupted the outflow of bile.
   
   
   • Protein fractions- proteins that appear in the blood with liver damage. There are a lot of proteins, but if the liver suffers, then the amount of 5 of them increases: albumins, alpha1 globulins, alpha2 globulins, beta globulins and gamma globulins.


3. Coagulogram is a set of tests for the study of blood clotting. With hepatitis, blood clotting decreases, clotting time increases. This is due to the fact that the level of the prothrombin protein, which is synthesized in the liver and is responsible for stopping blood during bleeding, decreases.


4. Test for the determination of hepatitis C virus RNA by PCR qualitative, quantitative, genotyping (PCR for HCV-RNA) is a blood test that determines the presence of hepatitis C virus (HCV) and its component - the RNA chain. The study is carried out by the polymerase chain reaction (PCR). It allows you to determine the amount of virus in the blood and its genotype. This information will help to choose the right treatment and predict how the disease will proceed.

   If the analysis is positive, this indicates that the body is infected with the hepatitis C virus and the pathogen is actively multiplying. Knowing the amount of the virus, you can determine how contagious a person is and whether the disease is easily treatable. The lower the amount of virus in the blood, the better the prognosis.



5. Hepatitis virus antibody test FROM (anti-HCV, ELISA, linked immunosorbent assay) is an analysis that aims to detect antibodies that are produced by the immune system to fight the hepatitis C virus. The test for total antibodies includes the determination of immunoglobulins, regardless of their type.

   Positive result analysis suggests that the body is infected with a virus, and the immune system is actively fighting it. Antibodies are produced during acute and chronic form illness. They are also present for 5-9 years in the blood of a person who has been ill and recovered on his own. Therefore, a more accurate study is needed to determine what processes occur during illness.



6. Hepatitis C class M antibody test(anti-HCV IgM) - immunoglobulins M appear in the blood 4 weeks after infection. They remain in large numbers while the disease rages in the body. After 6 months, when the condition improves, they become smaller. But they can reappear if the disease becomes chronic and exacerbation begins.

   A positive analysis for M antibodies indicates that the patient has an acute form of hepatitis C or an exacerbation of the chronic form of this disease. If the IgM test is negative and there is no ALT in the blood, but there are traces of RNA or IgG, then the person is considered a carrier of the virus.



7. Test for the presence of class G antibodies to the hepatitis C virus(anti-HCV IgG) is the detection of immunoglobulins G, which neutralize the "nuclear" elements of viruses. This analysis will not show a recent case of the disease. After all, IgG appear only 2.5-3 months after infection. Their number decreases after six months, if the treatment was successful. In patients with the chronic form, immunoglobulins G remain in the blood until the end of life.

   A positive test result indicates that the acute phase is over. Either the healing process began or the disease went underground and a chronic form appeared, without exacerbations.

   If the result of blood tests for hepatitis is negative, it means that there are no viruses and antibodies to them in your body. But in some cases, the doctor may advise you to take a second test in a few weeks. The fact is that the signs of hepatitis C do not appear immediately.

In order for the analysis result to be as accurate as possible, it is necessary to follow simple rules. Blood for research is taken from the cubital vein. It is necessary to take tests in the morning, before meals. On the eve you can not drink alcohol, actively engage in sports. Be sure to tell your doctor if you are taking any medications. They can affect test results.

Additional Research

Usually the doctor prescribes ultrasound procedure liver (ultrasound). It helps to determine the enlargement of the liver and areas affected by the virus. But the most accurate results are obtained by biopsy. This is taking a sample of cells directly from the liver with a special needle. The procedure is fast. In order for the patient not to feel discomfort, he is given an injection with an anesthetic drug.

After conducting all the studies, the doctor determines the level of development of the disease and the degree of liver damage, and also selects the most effective and safe treatment.

What are the genotypes of the virus?

The hepatitis C virus is highly variable. He mutated, adapted to the conditions for several thousand years and almost reached perfection. That is why the disease resists immune attacks well and often becomes chronic. To date, the World Health Organization has recognized the existence of 11 genotypes of the hepatitis C virus.

The genotypes of a virus are its variants, which differ from each other in the structure of the RNA chain. They are numbered from 1 to 11. Each genotype differs from its counterparts by about a third. But within each such group there are several options. The differences between them are not so great - these are subtypes. For their designation, numbers and letters (1a or 1c) are used.

Why determine the genotype of the virus? The fact is that different genotypes cause different forms illness. Some subtypes may disappear on their own without treatment. Others, on the contrary, do not respond well to therapy. If you determine the type of virus, then you can choose the right dose of the drug and the duration of the course of treatment. For example, genotypes 1 and 4 are more resistant to interferon treatment.

The genotypes have one more interesting feature– they affect people in different regions:

1a - in America and Australia;
1b - throughout Europe and Asia;
2a - on the islands of Japan and in China;
2b - in the USA and Northern Europe;
2c - in Western and Southern Europe;
3a - in Australia, Europe and South Asia;
4a - in Egypt;
4c - in Central Africa;
5a - c South Africa;
6a - in Hong Kong, Macau and Vietnam;
7a and 7b - in Thailand
8a, 8b and 9a - in Vietnam
10a and 11a - in Indonesia.

In Russia, genotypes 1, 2, and 3 are more common than others. Genotype 1 is the most common in the world and is less susceptible to treatment with modern drugs than others. This is especially true of subtype 1c, the prognosis of the course of the disease in which is worse compared to other varieties. Genotypes 1 and 4 are treated for an average of 48-72 weeks. For people with genotype 1, large doses of drugs are required and they depend on body weight.

While subtypes 2, 3, 5 and 6 give a small amount of virus in the blood and have a more favorable prognosis. They can be cured in 12-24 weeks. The disease quickly recedes when using Interferon and Ribavirin preparations. Genotype 3 causes serious complication- deposition of fat in the liver (steatosis). This phenomenon greatly worsens the patient's condition.

There is evidence that a person can simultaneously become infected with several genotypes, but one of them will always be superior to the others.

What antibodies indicate infectious hepatitis C?

As soon as foreign particles enter the body - viruses, bacteria, the immune system begins to produce special proteins to fight them. These protein formations are called immunoglobulins. For each variety of microorganisms, special immunoglobulins are formed.

In hepatitis C, immune cells produce 2 types of "defenders", which are indicated in the analyzes with a label anti-HCV, which means against the hepatitis C virus.

Class M antibodies(immunoglobulins M or anti-HCV IgM). They appear a month after infection and quickly increase their numbers to a maximum. It happens in acute stage illness or exacerbation of chronic hepatitis C. This reaction of the body indicates that the immune system is actively destroying viruses. When the disease subsides, the amount of anti-HCV IgM gradually decreases.

Class G antibodies(immunoglobulins G or anti-HCV IgG). They are produced against the proteins of the virus and appear approximately 3-6 months after the pathogen has settled in the body. If only these antibodies are present in the blood test, then the infection occurred a long time ago, and the active stage is left behind. If the level of anti-HCV IgG is low and gradually decreases with re-analysis, it can speak about recovery. In patients with the chronic form, immunoglobulins G remain in the blood permanently.

Also in laboratories, antibodies to NS3, NS4 and NS5 proteins are determined. These viral proteins are also called non-structural proteins.

Antibodies that are produced against the NS3 protein(Anti-NS3). They appear at the very beginning of the disease. This analysis allows you to identify the disease at an early stage. It is believed that the higher the Anti-NS3 value, the more virus in the blood. And the higher the likelihood that hepatitis C will go into the chronic stage.

Antibodies that are produced against the NS4 protein(Anti-NS4). They appear late. Allows you to find out how long ago the infection occurred. It is believed that the higher their number, the more affected the liver.

Antibodies that are produced against the NS5 protein(Anti-NS5). These antibodies are present in the blood when the RNA of the virus is present there. In the acute period, they may indicate that there is a high probability of chronic hepatitis C.

How to treat hepatitis C with medicines?

Can hepatitis C be completely cured?

Yes, since 2015 Hepatitis C has been officially recognized as a completely curable disease. What does this mean? Modern drugs do not just stop the reproduction of the virus - they completely kill the virus in the body and return the liver to healthy state.

Currently, there are very effective methods for the treatment of hepatitis C. With the use of modern drugs, the cure occurs in 95-98% of cases. Given the good tolerability of the currently used drugs, hepatitis C can be attributed to a completely curable disease.

Since 2015 wide application in the treatment of hepatitis C found such drugs as: Sofosbuvir + Velpatasvir. Complex application this combination of drugs for a duration of 12 weeks leads to almost 100% cure of the disease.

Sofosbuvir

This is a highly effective antiviral drug related to nucleotide analogues. Mechanism therapeutic action This drug consists in blocking the enzyme involved in copying the genetic material of the virus. As a result, the virus cannot multiply and spread throughout the body.

Velpatasvir

It is a highly effective antiviral drug that affects the protein (protein coded as: NS5A) involved in the assembly of the components of the virus. Thus, this drug prevents the reproduction and spread of the virus in the body.

Combinations of drugs Sofosbuvir and Velpatasvir used according to the treatment regimen have double action to different types of hepatitis C virus, which is optimal treatment all 6 hepatitis C genotypes.

The duration of treatment with a combination of drugs Sofosbuvir and Velpatasvir is 12 weeks. The result is 98% cure of hepatitis C.

Previous regimens for the treatment of hepatitis C involved the use of Interferon preparations in combination with Ribavirin. Below are the treatment regimens and mechanisms of therapeutic action

Interferon

This protein structure, which is usually produced by human cells to fight viruses. To prepare a drug, the corresponding section of human DNA is implanted into E. coli using methods genetic engineering. The protein molecules are then isolated and purified. Thanks to this technology, interferon is produced on an industrial scale.

Interferon alfa 2a or 2b injection is suitable for the treatment of hepatitis C. Other forms, such as candles, do not help.

The mechanism of action of interferon:

• Protects healthy cells from virus entry
• strengthens the cell wall so that pathogens cannot penetrate inside
• prevents the reproduction of the virus
• slows down the production of virus particles
• activates the genes in the cell that fight viruses
• stimulates the immune system to fight the virus

Additional administration of interferon helps the body cope with the infection. In addition, it prevents the development of cirrhosis and liver cancer.

1. Simple interferons - are from the cheapest and therefore publicly available drugs:
   • Roferon-A(interferon alpha-2a) Increases the resistance of cells to the virus. Strengthens the immune system so that it actively destroys the pathogen. Assign 3-4.5 million IU (international units) 3 times a week. The duration of treatment is from 6 months to a year.
   
   
   • Intron-A(interferon alfa-2b). It binds to receptors on the surface of the cell and changes its work. As a result, the virus can no longer reproduce in the cell. Also, the drug increases the activity of phagocytes - immune cells that ingest viruses. The first 6 months, the dose is 3 million IU 3 times a week. The duration of treatment can last up to a year.
2. Peligated interferon - this is the same interferon, but it remains in the body for more long term. This is due to the addition of polyethylene glycol, which enhances the action of interferon. Types of drugs:
   • Pegasis(peginterferon alfa-2a). Stops the division of the RNA virus and its reproduction. immune protection strengthened. Liver cells multiply properly without losing their functions. Stimulates those genes in hepatocytes that can resist the attack of the hepatitis C virus. Dosage: 180 mcg once a week subcutaneously in the abdomen or thigh. The duration of treatment is 48 weeks.
   
   
   • Pegintron(peginterferon alfa-2b) Activates enzymes that are produced inside cells to fight viruses. The dose of the drug depends on body weight. On average, it is 0.5 ml once a week. The duration of treatment is from 6 months to a year.


3. Consensus interferon - a drug obtained thanks to the latest bioengineering technologies.
   • Infergen(interferon alfacon-1) It differs in that the sequence of amino acids in interferon is changed. Due to this, the effect of the drug is enhanced. It helps even those people who have not been treated with other medicines. Dose 15 mcg - 1 vial. Enter daily or three times a week under the skin of the abdomen or thigh. Minimum term treatment - 24 weeks.

Ribavirin

This synthetic drug, which stimulates the immune system and greatly enhances the effect of drugs based on interferon. Used in conjunction with any of the interferons.

Arviron. The drug easily penetrates into the cells affected by the virus, stops the division of the virus and contributes to the death of the pathogen. The dose depends on body weight. Take 2-3 tablets with meals in the morning and evening. The capsules must not be chewed. The duration of treatment is 24-48 weeks.

Rebetol. It enters the liver cells affected by the disease. There, it prevents new viruses from forming a shell around the RNA and thus inhibits their reproduction. The number of capsules depends on body weight. Usually prescribed 2 in the morning and 3 in the evening during a meal. Do not chew capsules. Take in parallel with interferon 24-72 weeks.

Hepatoprotectors

These are drugs that are designed to hold the liver in a difficult period for it. They do not fight the virus, but help the affected cells recover faster. Thanks to these medicines getting better general state, weakness, nausea and other manifestations of intoxication decrease.

Phosphogliv. Provides phospholipids to the body. They are designed to "repair" the walls of the affected liver cells. Take 1-2 capsules 3-4 times a day every time with meals. The duration of the course is six months or more.

Heptral. Performs many functions in the body: enhances the production of bile, improves the functioning of the gastrointestinal tract, accelerates the recovery of liver cells, relieves intoxication and protects nervous system. To enhance the effect of the first 2-3 weeks, the drug is administered intravenously using droppers. Then tablets are prescribed. Inside take 3-4 weeks, 1 tablet 2 times a day. The medicine is recommended to be taken on an empty stomach half an hour before meals. Better in the morning. The minimum treatment period is 3 months.

Ursosan. The most effective drug of all hepatoprotectors. Based on ursodeoxycholic acid. Protects cells from destruction, strengthens the immune system, reduces the amount of toxins, prevents fat from being deposited in hepatocytes, delays development connective tissue in the liver. Take 1 capsule 2-3 times a day with meals. The capsules must not be chewed. The dose may vary depending on body weight. The duration of treatment is from 6 months to several years.

Drugs to reduce the side effects of treatment.

Interferon antivirals are not always well tolerated. Young people quickly adapt to such therapy, but if the body is weakened, then it needs help.

Derinat. Immunomodulator - normalizes the functioning of the immune system, increases the number of protective cells: leukocytes, lymphocytes, phagocytes, granulocytes. Assign in injections intramuscularly. Daily or 2-3 times a week. Course from 2 weeks.

Revolade. Designed to normalize blood functions. Increase its coagulability and prevent bleeding. Take 1 tablet per day for 1-2 weeks.

Neupogen. Normalizes the composition of the blood (the number of neutrophils), allows you to reduce the temperature. It is administered subcutaneously or intravenously in droppers. The doctor prescribes according to the results of blood tests.

Hepatitis C can be cured, but for this you need to contact a specialist who has experience working with this disease. A person will have to be patient, strictly follow the doctor's recommendations and follow a diet.

When various foreign particles, like viruses, enter the human body, the human immune system begins to produce substances called immunoglobulins. These are special cells that help the body start fighting the virus. They are called hepatitis C antibodies. What should you know about them?

What are hepatitis C antibodies?

These antibodies are found special method an ELISA test or a screening test that is used to determine whether a person has hepatitis C virus. Such antibodies to hepatitis C come in 2 classes:

So these antibodies to hepatitis C are called in Latin. At the same time, in total, these antibodies are antibodies against hepatitis C.

What does the presence of antibodies to hepatitis C mean?

Absolutely all patients are checked for the presence of such markers to determine whether they have hepatitis C virus. If the disease is already acute form or chronic, then they have Anti-HCV antibodies, these antibodies to hepatitis C can be detected only after 4 or 6 weeks of onset of the disease.

There are cases when, in the presence of Anti-HCV total antibodies, people recovered without the help of specialists, but on their own. In these people, this market can be found for another 4-8 years after their recovery. Even if the anti-HCV test is positive, this is still not enough to correctly establish the diagnosis. In chronic hepatitis, such antibodies to hepatitis C are constantly secreted, and after a positive result of treatment, they can remain in the body. long time, but their titers at the same time gradually begin to decline.

Antibodies to hepatitis C and what should you know about them?

The most important thing to know is that such antibodies will not be able to protect against the development of the infection itself, nor will they be able to provide immunity from reinfection.

There is also such a thing as the anti-HCV spectrum. These are also antibodies, moreover, specific, they are suitable for individual, both structural and non-structural proteins of this virus. Their definition is important in order to assess how high the viral load, infection activity, the risk of chronicity, and also to distinguish between acute or chronic hepatitis and how much the liver is already affected.

Antibodies to hepatitis C from the IgM class belong to the antigens of this virus. They can be determined already after 6, and in some cases even 4 weeks immediately after infection, in which case their concentration can reach a maximum. And after the completion of this process, the level of IgM will begin to fall, but when the infection is reactivated, the level will rise again. Therefore, it is believed that such antibodies are a direct sign of a chronic or acute infection with a sign of reactivation.

HCV - blood test - what is it?

One of the most complex and widespread diseases of the end of the last century is infection with the hepatitis C virus. developed countries the prevalence of the disease reaches 2%, while total amount patients worldwide is 500 million people. The infection was identified much later than its predecessors: hepatitis A and B - and at first was called "neither A nor B infection." Along with the growth of drug addiction, the number of infected people is growing every year. The reason for everything is the mode of infection: when intravenous administration drug.

The virus is also transmitted during childbirth from mother to child if there has been damage skin. Therefore, it is so important to know HCV blood test - what is it? During pregnancy, it is necessary for every expectant mother to go through it. This disease is a leader among the reasons that require a liver transplant to a sick person.

How does hepatitis C develop?

Infection with the hepatitis C virus occurs as follows: the blood of a sick person must enter the blood of a healthy person. The first blood flow carries the virus particles dissolved in healthy blood to the liver and reproduction immediately begins. At the same time, the human liver suffers doubly: on the one hand, liver cells are damaged by the activity of the virus itself, on the other hand, the human body begins to fight: it sends immune responses, namely special lymphocyte cells that will be called upon to destroy infected liver cells.

The immune system recognizes the virus by the content of foreign genetic material. Everyone who has experienced this, as well as some patients undergoing without fail know what an HCV blood test means. That these are very important indicators both at the stage of detection and at the stage of treatment, everyone who has ever encountered this problem will say.

When is the HCV test done?

When a patient has complaints about the liver, doctors usually prescribe an HBS and HCV blood test for such a patient. In order to determine whether the disease is due to the presence in the blood of the hepatitis C virus or other concomitant diseases just need an HCV blood test. What is this indicator?

The analysis detects antibodies in human blood that may belong to one of 2 classes:

• Antibodies to HCV. They are the main marker. The presence of infection in the body is confirmed by the detection of HCV RNA. These antibodies are found during the recovery phase and may also remain in the blood for another 1-4 years. The main indicator of the presence of chronic hepatitis is the rising levels of anti-HCV.
• The level of IgA, IgM, IgG in blood serum. The growth of these markers indicates liver damage when exposed to alcohol, with billiard cirrhosis and some other diseases.

What do the markers say?

From the moment the antigen enters the human body, an HCV blood test can detect it as early as 4-5 weeks. What exactly is the hepatitis C virus is still impossible to say with accuracy. These data are needed by the doctor to decide whether such a patient needs antiviral therapy. Moreover, if less than 750 RNA copies per 1 ml of blood are found in the blood, then this indicates a minimal viral attack.

Hepatitis C antibodies always belong to one of two classes - G or M, data on which are mandatory entered into the HCV blood test. The transcript explains these parameters as immunoglobulin class G(IgG) and M(IgM). A positive result for the first marker does not yet indicate a definite diagnosis. Immunoglobulin class G reaches maximum performance at 5-6 months from the moment the infection enters the body and remains the same in chronic hepatitis.

Class M immunoglobulins can be detected as early as 1-1.5 months after infection and reach their maximum concentration very quickly. There is another indicator - anti-NS3, which by its high rates is an unequivocal harbinger of the presence of an acute process in the body.

How to donate blood for HCV analysis?

There are no specific instructions for donating blood to the laboratory to determine the presence of HCV antibodies. The only recommendation of doctors: the fence should be made on an empty stomach. Blood is taken from the vein of the patient being tested using a disposable syringe.

Deciphering indicators

So, the alleged patient did an HCV blood test. What are the pluses and minuses as a result? The following table will answer this.

Types of tests for HCV

There are qualitative and quantitative tests that detect HCV (blood test). What it is?

Quantitative tests are used if the lower limit reaches 500 RNA copies per 1 ml or 200 units per 1 ml. These tests determine HCV-RNA. Measurements are carried out twice, since the data often differ. If positive, anti-HCV and quantitative tests are positive in about 75% of cases. In addition, such a result can be obtained in almost 95% of cases in patients with acute or chronic hepatitis C. Such tests are used in the diagnosis acute infections, as well as in immunodeficient patients whose antibody test gave negative result however, HCV infection is suspected.

Qualitative tests are more sensitive, the lower limit is 100 RNA copies per 1 ml. Used to diagnose acute HCV infection by making a blood test for HCV. A positive result can be detected as early as the first two weeks after infection. A qualitative test is different in that it can also give a false positive or false negative result.

HCV blood test: what does it mean and when is it prescribed?

A blood test for HCV is one of the methods for diagnosing the hepatitis C virus. This test is prescribed in the presence of symptoms of hepatitis C, an increase in the level of hepatic transaminases, as well as examinations of persons at risk for infection with viral hepatitis.
In the latter case, together with a blood test for HCV, an analysis is carried out blood HBs Ag.

HCV (hepatitis C virus) belongs to the flavivirus family. It was first discovered in 1988 by a group of researchers from the American biotechnology company Chiron. The HCV genome is represented by an RNA molecule, so the mutation rate of the virus is very high. In people with hepatitis C virus, viral particles are detected, the genomes of which differ by 1-2%. This feature of the virus population allows it to successfully multiply despite the protective reactions of human immunity. Differences in the genomes of the virus can affect the course of infection and the results of treatment.

According to World Organization health care, to date, about 150,000,000 people are infected with the HCV virus, every year the hepatitis C virus is the cause of death of more than 350,000 patients.

Ways of transmission of hepatitis C

The hepatitis C virus is transmitted through infected blood, for example, to a recipient from a blood or organ donor, to an infant from an infected mother, through sexual contact, through the use of non-sterile syringes in medical institutions and tools for tattoos and piercings in salons.

The disease can occur in an acute form, lasting several weeks, and in a chronic form, which can result in cancer or cirrhosis of the liver.

HCV blood test: what does it mean in terms of immunology?

A blood test for HCV is based on the detection of specific immunoglobulins of the IgG and IgM classes, therefore this species The test is sometimes called an anti-HCV blood test. Immunoglobulins are specific proteins of the immune system, they are produced by B-lymphocytes in response to the detection of foreign proteins in the body. When infected with the hepatitis C virus, immunoglobulins are produced against the envelope proteins of the virus, the nucleocapsid core protein and non-structural proteins NS. The appearance of the first antibodies to the virus occurs no earlier than 1-3 months after infection. By detecting antibodies, the doctor can determine the phase of the infection (acute, latent, or reactivation). Specific antibodies to hepatitis C can be detected even after 10 years after the disease, but their concentration is low, and from reinfection they are unable to protect against the virus.

Interpretation of analysis results

• Positive HCV blood test. What does it mean? This result speaks of hepatitis C disease in acute or chronic form or a previously transferred disease.
• Negative HCV blood test. What does it mean? There is no hepatitis C virus in the blood, or the infection has occurred recently, so there are no antibodies to it yet. In some patients, antibodies to this virus are not produced at all. This scenario of the development of the disease is called seronegative, it occurs in 5% of cases.
• PCR for HCV RNA showed the absence of the virus, a positive HCV blood test was previously obtained. What does it mean? The result of a blood test for HCV was false positive, the reason for this may be some infections, neoplasms, autoimmune diseases.

HCV antibodies were found in the blood, what could this mean?

Natalka

Antibodies to the hepatitis C virus (anti-HCV) - a method for diagnosing hepatitis C infection by detecting both IgG and IgM class antibodies in the blood (total specific antibodies formed to hepatitis C virus proteins by ELISA enzyme immunoassay). Normally, there are no antibodies to the hepatitis C virus in the blood.
Detection of total antibodies (anti-HCV) makes it possible to diagnose hepatitis C starting from 3-6 weeks or more after infection. However, the detection of antibodies by ELISA is screening and is not enough to make a diagnosis of viral hepatitis C and requires confirmation by immunoblot.

Julia

Unlike HBV, in the diagnosis of which antigenic and antibody markers are taken into account, with HCV, only antibodies are detected by ELISA. HCV antigens, if they enter the bloodstream, then in quantities that are practically not captured. HCV antigens can be detected in liver biopsies using immunohistochemical methods. This significantly limits the ability to assess the course and activity of the infectious process.
Recently there have been indications of the development of a new approach to the indication of HCV antigens in the blood. The first step is the release of antigens from cellular structures by lysing the serum, the second is the capture of antigens using specific monoclonal antibodies. The introduction of this method into clinical practice is intended to significantly enrich the possibilities of diagnosing and monitoring the course of HCV.
Anti-HCV in their majority (with the exception of antibodies to coreAg class M) do not indicate ongoing virus replication, do not characterize its activity, and may correspond to post-infection. It should also be taken into account that in recipients who have been transfused with infected blood, anti-HCV of the donor may be detected, which, with a single indication, does not necessarily indicate post-transfusion infection with HCV. Indication of anti-HCV mainly solves the problem of etiological diagnosis, but does not characterize the course of infection (acute, chronic) and does not solve the problem of prognosis. In patients with chronic HCV, anti-HCV is found in the blood not only in free form, but also as part of circulating immune complexes. Their content is relatively higher in the development of HBV/HCV mixed hepatitis.
Antibodies are formed to each of the viral proteins located in the structural and non-structural region of HCV. This determines their unequal specificity and, accordingly, different diagnostic information content of the indication. For screening indication of anti-HCV, the ELISA method is used, and the immunoblot method (RIBA) is used as a confirmatory reference test. The first test system based on the indication of antibodies to C-100-3 in ELISA quickly became widespread in clinical, epidemiological practice, and in the selection of donors. However, it made it possible to capture antibodies in a zone that characterizes only 12% of the viral polyprotein, and only in the nonstructural region (NS3, NS4). In addition, the artificial recombinant C-100-3 antigen does not completely coincide with natural viral proteins, which predetermines its weak immunogenicity.
Antibodies to C-protein (core Ag) are not captured at all by the C-100-3 antigen. All this predetermined the low specificity of anti-HCV indication and a large number of false negative results, especially in the phase of chronic HCV. In patients with severe hypergammaglobulinemia, on the contrary, the C-100-3 test often gives false positive results. When indicating antibodies to C-100-3 special difficulties arise when solving a problem differential diagnosis chronic HCV with autoimmune hepatitis, cryoglobulinemia, collagenoses.
The 2nd generation test systems make it possible to capture antibodies to proteins in different zones of the genome, not only in the non-structural, but also in the structural region. Their advantage was primarily high specificity, as well as the possibility of a more complete representation of the antigenic spectrum of HCV. The use of 2nd generation test systems has significantly improved the selection of donors and reduced the risk of developing post-transdiffuse HCV.
At the same time, when using the 2nd generation test systems, false-negative results are not excluded, in particular, in patients with HCV genotypes unusual for this region. The most perfect test systems of the 3rd generation.
The information content of research is significantly increased with a comprehensive assessment a wide range anti-HCV, mandatory under dynamic control conditions. Such a monitoring system allows capturing changes in the ratio of antibodies to different HCV antigens.

Evgeny Stefantsov

AT k HCVAg was found in my son. And HB s Ag was not found, could it be a mistake. And what it is better to hand over the analysis for the exact diagnosis? My 27 year old son has never used drugs. Donated blood 2 times in Tambov for HIV and in the river. Inzhavino for a medical examination in the army and then they make such a diagnosis.

My wife and I were examined, tests showed the hepatitis virus. I have Anti HCV-total positive. The rest are negative. My wife does too. How dangerous is it, how long does it take to heal? How much is it? And what about work, is it possible to work during the treatment period? I feel great!

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. That's why positive analysis on anti-HCV is not sufficient to establish a diagnosis. On the background chronic infection total antibodies are constantly detected, and after successful treatment persist for a long time (primarily due to anti-HCV core IgG, they are described below), while their titers gradually decrease.

Ekaterina Gustova

Hepatitis C is transmitted through blood and body fluids through parenteral, sexual and transplacental routes. group increased risk are people who practice intravenous drug addiction, promiscuity, as well as medical workers, patients requiring hemodialysis or blood transfusions, prisoners. Penetrating into the body, HCV enters the blood macrophages and hepatocytes of the liver, where it replicates. Liver damage occurs mainly due to immune lysis, and the virus also has a direct cytopathic effect. The similarity of the antigen of the virus with the antigens of the human histocompatibility system causes the occurrence of autoimmune ("systemic") reactions. In a programme systemic manifestations HCV infections can occur autoimmune thyroiditis, Sjögren's syndrome, idiopathic thrombocytopenic purpura, glomerulonephritis, rheumatoid arthritis etc. Compared to other viral hepatitis, hepatitis C has a less pronounced clinical picture more often becomes chronic. In 20 - 50% of cases, chronic hepatitis C leads to the development of cirrhosis of the liver and in 1.25 - 2.50% - to the development of hepatocellular carcinoma. FROM high frequency autoimmune complications occur.
I want to upset you! Hepatitis C is not curable just like HIV infection! You can live with it for years! But cirrhosis of the liver can come sooner or later. Look who you work for. whether your diagnosis will affect work is unknown. but it’s better not to tell your colleagues this diagnosis

Kostarev konstantin

It is worth noting that only about 20% of people once infected with hepatitis C clear the infection on their own. Therefore, unfortunately, in most cases, the presence of antibodies to HCV indicates chronic viral hepatitis C (CVHC).

Olga

To all of the above, I will add that after the detection of antibodies, it is necessary to take an analysis for the presence of the virus itself in the blood. This analysis is called HCV RNA by the PCR method, if it is positive, then it is necessary to do genotyping, that is, to identify the genotype of the virus (the duration and cost of treatment depend on this). If negative, then you may have become one of the lucky 15-20% who have self-healed. But in this case, you need to control the situation and at least once a year you need to take an analysis by PCR.
If you still have hepatitis, then you should not be upset. He is successfully treated. The treatment is difficult, but you can work if the work is not among the dangerous ones that require special concentration. It's definitely not worth flying into space)))

Hepatitis C is a serious disease characterized by severe liver damage. The virus that causes the disease is referred to as the so-called pathogens that have RNA in their composition. To detect this disease, an HCV analysis is used. This is a blood test based on the detection of specific antibodies.

HCV analysis refers to studies that are carried out in laboratory conditions and help diagnose the presence of antibodies. These include Ig G and Ig M. They are produced in the patient's blood after the virus enters the bloodstream. These antibodies are pathogenic microorganisms that occur a couple of weeks or months after infection.

Hepatitis C first appeared in the late 1980s. The disease spread in several ways:

• parenteral;
• sexual;
• vertical.

With the parenteral type of infection, infection occurs if a person uses non-sterile medical instruments, needles, and manicure devices. During sexual transmission of the virus, it enters the human body through unprotected sexual contact, when one of the partners is infected. The vertical route of hepatitis C infection involves mother-to-child transmission of the virus.

A test for the presence of antibodies to hepatitis C in the blood is not always carried out, since this type of test is not mandatory and standard for medical research. But such a test is recommended in the following cases:

• planned hospitalization before operations;
• pregnancy planning or pregnancy;
• an increase in the concentration of bilirubin, ALT or AST in the general blood test;
• donation;
• the appearance of a symptomatic picture characteristic of hepatitis C;
• frequent change of sexual partners;
• sexual intercourse without the use of barrier contraceptives;
• taking drugs;
• work in medical, preschool institutions.

In the latter case, a study on the content of antigens to the hepatitis virus in human blood is carried out annually.

Decryption

HCV analysis is based on the study of the genome of the same name. It includes one gene, which contains information about nine different proteins.

Three of them contribute to the entry of the virus into the cell, the other three allow it to form its own particle, and the last three proteins begin to transform the natural functions of the cell to suit their own needs. The last three proteins are classified as special structural proteins, and the rest are non-structural.

The HCV genome is a single strand of RNA, which is located in its own capsule - a capsid formed by a nucleocapsid protein. The capsule is enveloped in a shell based on protein and lipids, which allows the virus itself to contact a healthy cell and destroy it.

The virus, penetrating into the blood, passes throughout the body with its current. When it enters the liver, it begins to activate and join the healthy cells of this organ. After joining, he penetrates them. These cells are called hepatocytes. And after the virus enters them, they cannot function as they should.

Their task now is to provide the virus, that is, to synthesize the proteins of the virus and RNA. It should be noted that the longer the genome stays in the cell, the more cells he strikes. With large volumes of such cells, a malignant neoplasm can form.

The HCV genome has several different genotypes or strains, each of them has its own subspecies. They are designated by numbering from 1 to 6. The location of the genotype varies within all continents. The virus genotype 1,2,3 is ubiquitous, 4 is located mainly in the Middle East and Africa, genotype 5 is more common in South Africa, and 6 in Southeast Asia.

When conducting a blood test for HCV, hepatitis treatment is prescribed only after confirming the presence of the HCV genome, as well as one of the genotypes, that is, the disease is diagnosed if the blood contains:

• anti-HCV Ig M;
• Anti-HCV Ig G;
• Ag HCV;
• HCV RNA.

The first position indicates the presence of a marker of active virus replication in the blood, the second indicates the probability of the presence of blood viruses, the third position allows you to accurately diagnose the presence of the virus, and the fourth indicates the exact presence of the virus in the patient’s blood and its active progression.

Norm

The presence of virus RNA in the blood already indicates problems in the body. However, when deciphering the study, an indicator above the norm is considered to be a volume of up to 8 by 10 to the 5th degree IU / ml (the number of RNA per milliliter of blood). However, these data may vary from laboratory to laboratory.

With a low content of the virus in the blood, the presence in the blood of 600 to 3 to 10 to the 4th degree IU / ml is allowed. With an average viremia, the indicator can reach from 3 to 10 to the 4th degree IU / ml to 8 to 10 to the 5th degree IU / ml. Indicators above the norm, that is, more than 8 to 10 to the 5th degree IU / ml, indicate the development of type C hepatitis.

Positive

A positive result occurs not only in the presence of the hepatitis C virus in the blood. Quite often, during tests, it can be diagnosed false positive result research. This phenomenon is quite rare, but still occurs. Usually this problem occurs in pregnant women as well as in people suffering from other infectious diseases.

There is also the problem of diagnosing a positive result in people who take immunosuppressants or have a malfunctioning immune system. But, a positive result, which can be diagnosed as false, also occurs in people who have recently become infected with viral hepatitis C, when the disease is in its early stages.

If there is any doubt about the correctness of the test, you can use additional research, that is, conduct a PCR test. If the result of the test is positive, then it can be confirmed by passing a test for virus genotype determination.

It should be noted that the results of the study may be affected by the conditions of storage and processing of the biomaterial, especially this should be paid attention to when conducting the study in two different laboratories. If the patient received a positive result, then after some time he should undergo a second one in another laboratory, since the blood during the first study could be contaminated with chemicals, protein compounds, was not taken as it should be, or the analysis itself was carried out erroneously.

In response to the introduction of a foreign agent, the human immune system produces immunoglobulins (Ig). These specific substances are designed to bind to a foreign agent and render it harmless. Determination of antiviral antibodies has great importance for the diagnosis of chronic viral hepatitis C (CVHC).

How to detect antibodies?

Antibodies to the virus in human blood are detected by the ELISA method (enzymatic immunoassay). This technique is based on the reaction between an antigen (virus) and immunoglobulins (antiHVC). The essence of the method is that pure viral antigens are introduced into special tablets, antibodies to which are searched for in the blood. Then the patient's blood is added to each well. If it contains antibodies to the hepatitis C virus of a certain genotype, the formation of antigen-antibody immune complexes occurs in the wells.

After a certain amount of time, a special dye is added to the wells, which enters into a color enzymatic reaction with the immune complex. The color density is used to quantify the antibody titer. The method has high sensitivity– up to 90%.

The advantages of the ELISA method include:

• high sensitivity;
• simplicity and speed of analysis;
• the possibility of conducting research with a small amount of biological material;
• low cost;
• possibility early diagnosis;
• suitability for screening a large number of people;
• the ability to track indicators in dynamics.

The only drawback of ELISA is that it does not determine the pathogen itself, but only the reaction of the immune system to it. Therefore, with all the advantages of the method for making a diagnosis of CVHC, it is not enough: additional tests are required to identify the genetic material of the pathogen.

Total antibodies to hepatitis C

Modern diagnostics using the ELISA method allows you to detect in the patient's blood both individual fractions of antibodies (IgM and IgG), and their total amount - antiHVC total. These immunoglobulins are diagnostic markers of CVHC. What does their discovery mean? Class M immunoglobulins are determined in an acute process. They can be detected as early as 4-6 weeks after infection. G-immunoglobulins are a sign of a chronic process. They can be detected in the blood 11-12 weeks after infection, and after treatment they can persist for up to 8 years or more. At the same time, their titer gradually decreases.

There are cases when antiviral antibodies are found in a healthy person during an ELISA for antiHVC total. This can be both a sign of a chronic pathology, and a consequence of a spontaneous cure of the patient. Such doubts do not allow the doctor to establish the diagnosis of CVHC, guided only by ELISA.

There are antibodies to structural (nuclear, core) and non-structural (nonstructural, NS) proteins of the virus. The purpose of their quantitative determination is to establish:

• virus activity;
• viral load;
• probabilities of process chronization;
• degree of liver damage.

AntiHVC core IgG are antibodies that appear when the process is chronic, therefore, CVHC is not used to determine the acute phase. These immunoglobulins reach their maximum concentration by the fifth or sixth month of illness, and in long-term ill and untreated patients, they are determined throughout life.

AntiHVC IgM are antibodies acute period and talk about the level of viremia. Their concentration increases during the first 4-6 weeks of the disease, and after the process becomes chronic, it decreases until it disappears. Repeatedly in the patient's blood, class M immunoglobulins can appear during an exacerbation of the disease.

Antibodies to non-structural proteins (AntiHVC NS) are detected at different stages of the disease. Diagnostically significant of them are NS3, NS4 and NS5. AntiHVC NS3 is the earliest antibody to the CVHC virus. They are markers of the acute period of the disease. The titer (quantity) of these antibodies determines the viral load on the patient's body.

AntiHVC NS4 and NS5 are chronic phase antibodies. It is believed that their appearance is associated with damage to the liver tissue. A high titer of AntiHVC NS5 indicates the presence of viral RNA in the blood, and its gradual decrease indicates the beginning of the remission phase. These antibodies are present in the body for a long time after recovery.

Deciphering the analysis for antibodies to hepatitis C

Depending on the clinical symptoms and the results of the analysis for hepatitis C virus RNA, the data obtained after ELISA can be interpreted in different ways:

• positive results for AntiHVC IgM, AntiHVC IgG and viral RNA indicate an acute process or an exacerbation of a chronic one;
• if only class G antibodies without virus genes are found in the blood, this indicates a past but cured disease. At the same time, there is no RNA of the virus in the blood;
• the absence of both AntiHVC and virus RNA in the blood is considered normal, or a negative antibody test.

If specific antibodies are detected, but the virus itself is not in the blood, this does not mean that the person is sick, but does not deny it either. Such an analysis is considered doubtful and requires a re-examination in 2-3 weeks. Thus, if immunoglobulins to the CVHC virus are found in the blood, complex diagnostics is necessary: ​​clinical, instrumental, serological and biochemical studies.

For diagnosis, not only a positive ELISA is important, which means the presence of a virus in the blood at the present time or earlier, but also the detection of viral genetic material.

PCR: detection of hepatitis C antigens

The viral antigen, or rather its RNA, is determined by the polymerase chain reaction (PCR) method. This method, along with ELISA, is one of the key laboratory tests allowing the doctor to make a diagnosis of CVHC. It is prescribed when a positive antibody test result is obtained.

The antibody test is cheaper than PCR, which is why it is used to screen certain categories of the population (pregnant women, donors, doctors, children at risk). Together with a study on hepatitis C, the determination of the Australian antigen (hepatitis B) is most often carried out.

Carrier of antibodies to hepatitis C virus

If AntiHVC to the virus is detected in the patient's blood by ELISA, but no clinical signs there is no hepatitis C, this can be interpreted as a carriage of the pathogen. The virus carrier may not get sick himself, but at the same time actively infect people in contact with him, for example, through the blood of the carrier. In this case, differential diagnosis is needed: advanced antibody analysis and PCR. If the PCR test turns out to be negative, the person may have had the disease latently, that is, asymptomatically, and self-healed. With a positive PCR, the probability of carriage is very high. What if there are antibodies to hepatitis C, but PCR is negative?

It is important to correctly interpret the tests not only for diagnosing chronic hepatitis C, but also to monitor the effectiveness of its treatment:

• if antibodies to hepatitis C do not disappear during the treatment, this indicates its ineffectiveness;
• if, after antiviral therapy, AntiHVC IgM is again detected, this means that the process has been activated again.

In any case, if the virus is not detected by the results of RNA tests, but antibodies to it are detected, a second examination should be carried out to ensure the accuracy of the result.

After treatment for hepatitis C, antibodies remain

Do antibodies remain in the blood after a course of treatment and why? After effective antiviral therapy, only IgG can normally be detected. The time of their circulation in the body of an ill person can be several years. The main sign of cured CVHC is a gradual decrease in IgG titer in the absence of viral RNA and IgM. If the patient has cured hepatitis C for a long time, and he still has total antibodies, it is necessary to identify antibodies: residual IgG titers are the norm, but IgM is an unfavorable sign.

Do not forget that there are false results of antibody tests: both positive and negative. So, for example, if there is virus RNA in the blood (qualitative or quantitative PCR), but there are no antibodies to it, this can be interpreted as a false negative or dubious analysis.

Reasons for the appearance false results several:

• autoimmune diseases;
• benign and malignant tumors in organism;
• severe infectious processes; after vaccination (from hepatitis A and B, influenza, tetanus);
• treatment with interferon-alpha or immunosuppressants;
• a significant increase in liver parameters (AST, ALT);
• pregnancy;
• improper preparation for the test (drinking alcohol, drinking fatty foods the day before).

During pregnancy, the percentage of false tests reaches 10-15%, which is associated with a significant change in the reactivity of the woman's body and the physiological suppression of her immune system. It is also impossible to ignore the human factor and violation of the conditions for the analysis. Analyzes are carried out "in vitro", that is, outside living organisms, so laboratory errors take place. TO individual characteristics organisms that may affect the results of the study include hyper- or hyporeactivity of the organism.

An antibody test, despite all its advantages, is not a 100% reason for making a diagnosis. There is always a risk of error, so to avoid possible errors, necessary comprehensive examination patient.

An analysis is carried out for the presence of specific antibodies to the structural proteins of HCV (Anti-HCV-total). This analysis performed for liver disease, donation, preoperative preparation, pregnancy or suspected hepatitis. This test lasts a very short time (1-2 days). A positive result of this test indicates infection with the hepatitis virus.

What to do if antibodies are found?

How many antibodies should be normal? Normally, the amount of antibodies should be zero. Total antibodies are a complex of antibodies to the structural and non-structural proteins of the virus that are produced in the body in response to infection.

What to do if antibodies to the hepatitis C virus are detected? First of all, don't panic! The detected total antibodies do not always indicate a chronic course.

One fifth of all patients with viral hepatitis C recover from this disease on their own, without even knowing that they were infected.

But specific immunoglobulins continue to be synthesized for a long time. This natural reaction to the appearance of the pathogen in the body. In addition, a positive test for specific antibodies to hepatitis is found in people who have undergone drug therapy.

The initial test in the diagnosis of hepatitis C is the detection of specific immunoglobulins produced against the structural proteins of HCV. To confirm the diagnosis, a polymerase chain reaction method is used to search for viral particles in the blood serum.

The chronic form of the course can be said in the case when HCV RNA was detected in the blood serum. However, liver dysfunction does not occur immediately, but over many years.

In this case, it is required not to hesitate, but to start treatment as early as possible, until the consequences become irreparable.

It is required to know some restrictions aimed at protecting others and loved ones. HCV is transmitted from person to person parenterally, that is, through contact through the blood.

The pathogen is not spread by kissing, talking, coughing, or eating utensils. During sex, the virus can enter the body through damaged mucous membranes, although the likelihood of sexual transmission of the virus is very small. During sexual intercourse, it is recommended to use a condom.

It is important to give up bad habits. Use drugs and liquor speeds up pathological processes in the liver parenchyma. In addition, you should not forget about the diet.

It is necessary to limit yourself from heavy, fatty and hard to digest food. Food should be full of vitamins and all essential trace elements. Colds may also have a negative effect on the healing of hepatic tissue.

Carrying out analyzes

You should find a competent attending physician who has experience in treating patients with hepatitis C. But it will not be superfluous to find out the opinion of other specialists about the therapy prescribed for you. You should not be treated with folk remedies without first consulting a doctor.

After contacting a doctor, tests are prescribed. This is necessary so that the doctor can fully evaluate Current state, determine the extent of hepatitis damage and clarify the stage of the disease.

The classic set will be holding:

• general blood test;
• analysis to determine the level of transaminases;
• alkaline phosphatase;
• thymol test;
• overall bilirubin level.

In addition, it will be important to analyze the viral genotype.

This will help in the appointment of antiviral therapy and will provide an opportunity to assess approximate dates treatment. HCV can have four genotype variants (1,2,3,4). The volume of therapeutic measures and the duration of therapy depends on the variant of the genotype itself.

The most difficult in terms of treatment are genotypes numbered 1 and 4. In this case, treatment is carried out for about a year. The leading drugs are Ribavirin and Ppilated interferon. When infected with genotype 2 or 3, treatment takes 6 months, financial expenses are halved and the prognosis in such patients is also favorable.

To determine the degree of fibrous degeneration of the liver, a biopsy with subsequent histological analysis will be very valuable. After advanced fibrosis antiviral therapy is ineffective.

It should be remembered that the number of people suffering from hepatitis C is very high. As practice has shown, if antibodies to hepatitis C are detected, this does not require immediate treatment. Since, after hepatitis C antibodies have been detected, the disease tends to proceed in a chronic form. However, each case is individual key factor in this question will be the number of functioning hepatocytes.

Features of therapy in pregnant women

In the treatment of pregnant women, the main factor is considered general analysis vital signs mother and child.

First of all, to evaluate normal functioning liver, it is necessary to conduct a total blood test for liver tests. In the event that the work of the liver is not disturbed, more detailed study carried out after the birth of the child.

For pregnant women infected with viral hepatitis, it is necessary to instruct and familiarize with the possible consequences for the child.

The optimal method of delivery for pregnant women with viral hepatitis has not yet been chosen. According to the results obtained from Italian scientists, the probability of birth infected child lower for caesarean section than for natural childbirth. Before giving birth, an infected woman should be made aware of these data.

For pregnant women in whom the number of viral particles in the blood exceeds 100 units / ml, C-section- the leading method of delivery. If a woman refuses and prefers to give birth naturally, it is required to carry out all necessary measures to prevent infection in the child.

Holding breastfeeding breastfeeding has a positive effect on normal development child. Therefore, it is very important to discuss this nuance with a nursing mother. This question is complex and ambiguous.

According to scientists, the RNA of the hepatitis C virus in breast milk was not found. According to other sources, signs of infection were still recorded.

This means that there are several interpretations here:

1. There are viral particles, the presence of which is not confirmed by the study data.
2. The presence of RNA in breast milk is much lower than in the blood.

Decoding the data does not provide one hundred percent evidence indicating a danger to the child.

Postpartum period and assessment of the child's condition

IN postpartum period very important Special attention to the health of children if they are born to infected mothers. This period is very important for early diagnosis and detection of infected newborns.

Deciphering the analysis of blood serum for the presence of specific antibodies should be carried out at 1.3, 6 and 12 months after birth.

Signs of destruction of maternal antibodies and the absence of viral RNA indicate that the child has not been infected. Although it should be mentioned possible development seronegative reaction.

This is a type of reaction in which, using PCR, viral RNA is detected in the blood serum after deciphering the tests, but there are no specific immunoglobulins produced against the structural proteins of the hepatitis C virus. How many particles can PCR fix? Sensitivity this method is from 600 IU / ml.

After infection in the perinatal period, children cannot be completely cured. Therefore, often in such newborns, the course of the disease passes into the chronic stage.

This means that to date there is no reliable data indicating the effectiveness of the use antiviral drugs for a child who has been in contact with contaminated material. In relation to such children, the local pediatrician should pay special attention.