Hepatitis c virus

RNA virus. Belongs taxonomically to the Flaviviruses(Flaviviridae) like Hepacivirus, West Nile Virus, Dengue Virus and Yellow Fever Virus. There are 7 genotypes and >80 subtypes.

• Genotype 1a and 1b (USA and Western Europe)
• Genotype 1b,1a and 2b: Japan and Taiwan
• Genotype 3: Thailand, Northern Europe, Australia
• Genotype 4: Middle East, Africa
• Genotype 5: South Africa
• Genotype 6: Southeast Asia
• Genotype 7: Central Africa

Transmission of the virus occurs through blood or blood products (10-30% of all post-transfusion hepatitis; risk today 1:15 million blood units); increased prevalence in drug-addicted homosexual men, after organ transplantation, during hemodialysis, after tattoos and needlestick injuries, vertical transmission from HCV-positive mothers to the child (<10%).

The virus occurs worldwide. Incubation period (ICT): 5-12 weeks.

CD81 acts as a receptor for HCV in hepatocytes. Association with CLDN1 and the CLDN1-CD81 receptor complex is essential for HCV entry into the host cell. CD 81 is specifically required for the infectivity of hepatocytes by Plasmodium falciparum, which controls the entry of sporozoites into hepatocytes via the parasitophorous vacuoles and the subsequent differentiation of the parasites into exoerythrocytic forms.

Test material: Serology: 1-2ml serum

Microbiological diagnostics:

Direct detection:

• PCR for amplification of HCV DNA after prior reverse transcription of HCV RNA. Detects active HCV infection. Becomes positive 20 days after infection.
• Quantification of HCV-RNA by PCR to assess the effect of therapy and determine the duration of therapy.
• HCV genotyping (serological or by PCR): Determination for the prognosis of a therapeutic effect and determination of the duration of therapy.

Serological detection of AK:

• IgG-AK: are detectable by ELISA from the 4th-6th week after infection. Lifelong pesistance in chronic hepatitis.
• IgM-AK: narrows the diagnostic window only slightly.
• Confirmation reaction: by recombinant immunoblot assay (RIBA)

Supplementary laboratory parameters: liver enzymes (GPT>GOT) ↑, Bilirubin↑, AP, GGT increased only initially and decreased in the case of cholestasis, serum ants ↑, gamma-Globuline↑, liver synthesis parameters (CHE, albumin, quick value) only in the case of fulminant course.

1. Neumeister B (2018) Hepatitis viruses. In: Neumeister B et al. (Eds) Clinical guide to laboratory diagnostics. Elsevier GmbH S. 657-659