Hepatitis C virus infection and disease. Diagnostic problems

Area of Science:

• Virology
• Hepatology
• Immunology

Background:

• Hepatitis C virus (HCV) is a lipid-enveloped RNA virus causing chronic infections in 40-60% of individuals.
• Chronic HCV infection is linked to liver diseases, including cirrhosis and hepatocellular carcinoma.
• The physical structure of HCV remains largely unknown, hindering a complete understanding of its pathogenesis.

Purpose of the Study:

• To review the diagnostic approaches for Hepatitis C virus infection.
• To evaluate the utility of antibody detection and RNA quantification in diagnosing and monitoring HCV.
• To discuss the limitations in current diagnostic markers for HCV-induced liver disease.

Main Methods:

• Review of diagnostic methods including anti-HCV antibody detection and HCV-RNA quantification.
• Analysis of serological markers like anti-C-22 and anti-C-100 for monitoring treatment response.
• Discussion of limitations of current diagnostic assays, such as distinguishing past from present infections.

Main Results:

• Second-generation assays achieve ~95% diagnostic sensitivity for HCV.
• HCV-RNA detection by RT-PCR is a valid alternative for anti-HCV negative infections and early acute hepatitis.
• Anti-C-100 is an early disappearing antibody in responders and associated with liver disease, suggesting it as an indirect marker.

Conclusions:

• Current diagnostic tools for HCV infection have improved but do not fully distinguish past from present infections.
• Monitoring anti-HCV titres and HCV-RNA levels are crucial for managing interferon therapy.
• There is an ongoing need for specific markers to accurately assess HCV-induced liver disease.