title: [The diagnosis of hepatitis C virus infection].
abstract: The successful therapy of hepatitis C viral infection requires that the illness is diagnosed before the development of structural changes of the liver. Testing is stepwise consisting of screening, diagnosis, and anti-viral therapy follow-up. For these steps there are different biochemical, serological, histological and molecular biological methods available. For screening, alanine aminotransferase and anti-HCV tests are used. The diagnosis of infection is confirmed using real-time polymerase chain reaction of the viral nucleic acid. Before initiation of the therapy liver biopsy is recommended to determine the level of structural changes in the liver. Alternatively, transient elastography or blood biomarkers may be also used for this purpose. Differential diagnosis should exclude the co-existence of other viral infections and chronic hepatitis due to other origin, with special attention to the presence of autoantibodies. The outcome of the antiviral therapy and the length of treatment are mainly determined by the viral genotype. In Hungary, most patients are infected with genotype 1, subtype b. The polymorphism type that occurs in the single nucleotide located next to the interleukin 28B region in chromosome 19 and the viral polymorphism type Q80K for infection with HCV 1a serve as predictive therapeutic markers. The follow-up of therapy is based on the quantitative determination of viral nucleic acid according to national and international protocols and should use the same method and laboratory throughout the treatment of an individual patient.
authors: Fejér Megyei Szent György Egyetemi Oktató Kórház I. Belgyógyászat Hepato-Pancreatologia és Molekuláris Diagnosztikai Egyetemi Oktató Laboratórium Székesfehérvár Seregélyesi u. 3. 8000.
authors: Judit
authors: J
authors: Gervain
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000302:isolation & purification; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005838:Genotype; D005973:Glutamine; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000302:isolation & purification; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008099:Liver / Q000201:enzymology / Q000821:virology; D008239:Lysine; D008403:Mass Screening / Q000379:methods; D020641:Polymorphism, Single Nucleotide; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D000095022:Interferon Lambda
chemical_list: D000410:Alanine Transaminase; D000998:Antiviral Agents; D001323:Autoantibodies; D015415:Biomarkers; D004279:DNA, Viral; D005973:Glutamine; D018937:Hepatitis C Antibodies; D007372:Interferons; D007378:Interleukins; D008239:Lysine; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda
keywords: genotype; genotípus; hepatitis C; nucleotide polymorphism; nukleotidpolimorfizmus; real-time polimeráz láncreakció; real-time polymerase chain reaction; viral load; vírustiter