Author/Editor		Poljak, Mario; Seme, Katja; Meško, Karmen M; Fujs, Kristina; Močilnik, Tina; Babič, Dunja Z
Title		Microbiological diagnosis of viral hepatitis
Type		članek
Source		In: Ferlan-Marolt V, Luzar B, editors. Viral hepatitis. Proceedings of the 35th memorial meeting to professor Janez Plečnik with international participation; 2004 Dec 2-3; Ljubljana. Ljubljana: Faculty of medicine, Institute of pathology,
Publication year		2004
Volume		str. 72-86
Language		eng
Abstract		Viral hepatitis is mainly caused by five viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis E virus (HEV). All five hepatitis viruses can cause acute hepatitis, whereas HBV, HCV and HDV can also cause chronic hepatitis. The presence of anti-HAV IgM antibodies confirms the diagnosis of acute hepatitis A. The presence of total anti-HAV antibodies, in the absence of anti-HAV IgM, indicates previous infection with HAV or successful immunization. Six serological HBV markers are routinely determined, namely two viral proteins (HBsAg and HBeAg) and four anti-HBV antibodies (anti-HBs antibodies, total anti-HBc antibodies, anti-HBc IgM antibodies and anti-HBe antibodies). The detection of HBV DNA has recently become indispensable for resolving diagnostic uncertainties following serological testing for HBV markers. The diagnosis of hepatitis C begins with the detection of anti-HCV antibodies. In an immunocompetent subject, a negative result of anti-HCV screening test excludes chronic HCV infection. Individuals with repeated reactivity of anti-HCV screening test are tested for the presence of HCV RNA in order to distinguish those who have resolved HCV infection (HCV RNA negative) from the patients with active/ongoing HCV infection (HCV RNA positive). Three serological markers of HDV infection are routinely determined, namely total antiHDV antibodies, anti-HDV IgM antibodies, and hepatitis D antigen. The detection of anti-HEV IgM usually indicates an acute or recent infection with HEV. The presence of anti-HEV IgG antibodies alone, in the absence of anti-HEV IgM antibodies, indicates the recovery from hepatitis E or late phase of acute hepatitis E. Due to a low positive predictive value of testing for hepatitis E, the results of serological tests in Slovenian individuals with no history of recent travel to hepatitis-E-endemic areas should be interpreted with caution.
Descriptors		HEPATITIS, VIRAL, HUMAN HEPATITIS A HEPATITIS B HEPATITIS B ANTIBODIES HEPATITIS B SURFACE ANTIGENS HEPATITIS B CORE ANTIGENS HEPATITIS B E ANTIGENS DNA, VIRAL HEPATITIS C HEPATITIS C ANTIBODIES RNA, VIRAL HEPATITIS C ANTIGENS HEPATITIS E IGG IGM