Hepatitis
Viral hepatitis is a group of infectious diseases in which a virus attacks liver cells. The most common are hepatitis A, B, and C, which have different transmission routes, clinical presentations, and prevention approaches.
Hepatitis A is usually acute and does not become chronic, while hepatitis B and C can become chronic and lead to cirrhosis and liver cancer if left untreated.
The primary diagnostic method is laboratory blood tests for specific viral markers, antibodies, and viral load.
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Hepatitis A (HAV) tests
Hepatitis A is most often transmitted through water and food; the incubation period is usually 2–6 weeks.
Key markers:
- Anti-HAV IgM — antibodies of acute infection; appear at the onset of the disease, indicating current or recent hepatitis A
- Anti-HAV IgG — antibodies indicating a previous infection or developed immunity (including after vaccination)
When the test is prescribed:
- Symptoms of acute hepatitis (weakness, nausea, dark urine, jaundice)
- Contact with someone with hepatitis A
- When preparing for travel to high-risk regions and deciding on vaccination
Hepatitis B (HBV) tests
Hepatitis B is transmitted through blood and other bodily fluids (sexually, from mother to child, by sharing needles and instruments).
Main HBV markers:
- HBsAg — the surface antigen of the hepatitis B virus; the main marker of current infection.
- Anti-HBs — antibodies to HBsAg; appear after recovery or vaccination, indicating the development of immunity.
- Anti-HBc IgM — antibodies to the nuclear antigen (HBcAg) of the IgM class; Sign of acute infection
- Anti-HBc IgG (total) — antibodies indicating exposure to the virus (past infection, chronic form)
- If necessary: HBeAg, Anti-HBe, quantitative HBV DNA PCR to assess viral load
Hepatitis B tests are important for screening pregnant women, donors, healthcare workers, and pre-operative patients.
Hepatitis C (HCV) tests
Hepatitis C, like B, is transmitted through blood, can be asymptomatic for a long time, and often becomes chronic.
Main tests:
- Anti-HCV (total antibodies) – a screening test that indicates exposure to the virus (acute, chronic, or past infection)
- If positive: PCR for HCV RNA (qualitative and quantitative) to confirm active infection and assess viral load.
- If necessary, determine the HCV genotype to select a treatment regimen.
Other viral hepatitis: D, E and G
In addition to the hepatitis A, B, and C types described above, there are other viral hepatitis types—D, E, and so-called hepatitis G (GBV-C/HGV). In routine clinical practice, these are tested less frequently, primarily when indicated and in risk groups.
Hepatitis D (HDV)
Hepatitis D is caused by the HDV virus, which cannot replicate without the hepatitis B virus (HBV). It occurs only in people with HBsAg-positive status and is considered a "satellite" infection.
Infection types:
- Coinfection – simultaneous infection with HBV and HDV
- Superinfection – the addition of HDV to a patient with chronic hepatitis B; More often results in a severe course and a high risk of chronicity.
Main markers of HDV:
- Anti-HDV (antibodies to the D virus)
- HDV-RNA (PCR) — confirms active infection.
As a rule, testing for hepatitis D is performed on patients with chronic hepatitis B who are suspected of having a more severe course or deteriorating liver function tests.
Hepatitis E (HEV)
Hepatitis E is transmitted primarily through water and food. It is similar to hepatitis A, but can be more severe, especially in pregnant women.
Characteristics:
- In most cases, it causes acute hepatitis, which resolves on its own.
- In pregnant women, especially in the second and third trimesters, a fulminant course with high maternal and perinatal mortality (mortality can reach 20-25%) is possible.
Key tests: Anti-HEV IgM, IgG, and, if necessary, HEV RNA (PCR).
Testing for hepatitis E is especially important:
- For acute hepatitis in pregnant women
- In regions/situations with unsafe drinking water and HEV outbreaks
Hepatitis G (GBV‑C/HGV)
Hepatitis G refers to the GBV-C/HGV virus, which is transmitted primarily through blood, sexual contact, and vertical contact and is often found in people with other parenteral infections (e.g., HIV).
Features:
- The question of whether GBV-C/HGV independently causes severe liver disease remains controversial.
- Cases of acute and chronic hepatitis G have been described, but severe liver damage in monoinfection is rare.
- Several studies have demonstrated a possible slowing of HIV infection progression in GBV-C coinfection (observational data)
Tests (Anti-HGV, HGV-RNA) are administered on a case-by-case basis—primarily in specialized centers and for research purposes, rather than for routine screening.
Explanation of key markers (simplified table)
| Virus | Marker | What it could mean |
|---|---|---|
| HAV | Anti-HAV IgM "+" | Acute or recent infection |
| HAV | Anti-HAV IgG "+" | Past infection or immunity after vaccination |
| HBV | HBsAg "+" | Current infection (acute or chronic) |
| HBV | Anti-HBs "+" | Immunity (after illness or vaccination) |
| HBV | Anti-HBc IgM "+" | Acute infection |
| HCV | Anti-HCV "+" | Contact with the virus (PCR required for clarification) |
| HCV | HCV-RNA "+" (PCR) | Active infection, virus present in the blood |
Who and when should be tested for hepatitis?
Testing for hepatitis A, B, C, D, and E is recommended:
- For hepatitis symptoms (weakness, nausea, loss of appetite, jaundice, dark urine, light-colored stool)
- Pregnant women (usually early in pregnancy)
- People who have ever received a blood transfusion or undergone surgery
- Patients with chronic hepatitis B and worsening liver function – to rule out superinfection with the hepatitis D virus
- Healthcare workers and laboratory staff
- People with elevated liver enzymes (ALT, AST)
- Having unprotected sex or changing partners
- Pregnant women with signs of acute hepatitis should undergo a targeted evaluation for hepatitis E, especially if infected in regions with an unfavorable HEV epidemic.
- Having a history of injection drug use (past or present)
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General information
Preparing for testing
Most serological tests and PCR tests do not require any strict preparation, but the following is generally recommended:
- Donate blood in the morning on an empty stomach (8-12 hours without food; you can drink water)
- Avoid alcohol and very fatty foods 1-2 days beforehand.
- Tell your doctor about any medications you are taking, especially those that affect the immune system and liver.
It is also important to bring previous test results (if any) to monitor progress.
FAQ
Is it possible to cure hepatitis C?
If I have a negative HBsAg, does that mean I don't have hepatitis B?
Are there any hepatitis vaccinations?
Can you become infected with hepatitis through household contact?
Should I get tested if I have no symptoms?
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What tests are taken for hepatitis?
To diagnose viral hepatitis A, B, C, and, if necessary, D and E, several groups of tests are used:
The specific set of markers depends on the suspected type of hepatitis (A, B, or C) and the clinical situation.