Diagnosis Dilemma of Chronic Hepatitis

Abstract

One of the most frequent reasons of hepatitis is HCV virus infection. There are two methods of infection detection: immunological and genetic ones. The study was made on 361 patients with the features of liver pathology admitted to the Clinic during the years of 2000–2004. Besides standard methods aimed to determine disease aetiology and the level of liver damage, the blood serum tests were made simultaneously. There were as follows: detection of anti-HCV antibodies by the quality method Architekt System; Innogenetics test as the confirmation test, and detection of RNA-virus by PCR method, Cobas Amplicor 2.0 test. The tested population underwent outpatient observation for at least six months. The anti-HCV antibodies were detected among 256 patients, RNA-virus was detected among 212 patients. The results of both of these tests were negative for 102 patients and positive for 209 patients. The RNA-virus was not detected among 47 patients with presence of the anti-HCV antibodies. The RNA-virus was detected for three patients without presence of the anti-HCV antibodies. The following observation and performing the tests such as liver biopsy led to diagnose hepatitis virus infection among all the patients with detected at least single infection marker. Four patients were diagnosed as the acute infection cases and 255 as chronic infection cases. The following next months’ observation did not led to detect any changes for the infection status of patients without infection markers. The detection of the anti-HCV antibodies in the blood serum with the third-generation tests should be treated as the standard procedure in the liver infection diagnosis. The detection of HCV RNA can be reasonable in the following cases: suspected acute HCV infection, unclear clinical picture; particularly when the possibility of infection related claims occur, drug addicts and patients suspected for taking drugs, review of antiviral therapy effectiveness.