Hepatitis C: diagnostic challenges, viral markers and testing algorithm

Bulgarian Medical Journal, 2024, 18(4), 7-11.

A. Gotseva

Laboratory of Virology, Military Medical Academy ‒ Sofia

Abstract. Hepatitis C virus (HCV) is described as the „silent killer“ owing to the specifics in the clinical course of infection. The acute phase usually remains undiagnosed, as the mild and anicteric forms predominate. Chronic HCV infection is asymptomatic or subclinical over a long course with nonspecific complaints and progression to fibrosis, cirrhosis and hepatocellular carcinoma. In most cases, diagnosis is made late, when complications have already occurred. Diagnosis of infected individuals is most often incidental, as part of prophylactic testing due to abnormal liver enzyme levels, during hospitalization for another disease, or in the presence of suggestive medical history (drug use, blood transfusion prior to mandatory donor blood screening, or other medical history). Laboratory diagnosis of hepatitis C relies on two groups of methods, serological tests for the detection of specific virus markers (anti-HCV antibodies and HCV Core antigen) and molecular assays (PCR) for the detection and quantification of HCV RNA (viral load).

Key words: hepatitis C, viral markers, detection methods, testing algorithm

Address for correspondence: Anelia Gotseva, MD, e-mail: anelialg@abv.bg