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Molecular Genetics

HCV RNA Real Time PCR

The virus that causes hepatitis C is the Hepatitis C virus (HCV), a member of the Flaviviridae family. The genetic material of HCV, a sheathed virus, consists of a single-strand ribonucleic acid (RNA) of 9.6 kilobase length. HCV has six genotypes and more than 100 subtypes.

Epidemiology

It is estimated that approximately 180 million people (approximately 3% of the world's population) carry hepatitis C infection worldwide. The majority of infected people (70-90%) develop chronic infections. Although chronic infection may be asymptomatic, it causes cirrhosis or liver cancer in 20-50% of patients. Depending on the therapies administered, the treatment may be effective in 10-50% of individuals.

 Transmission

The primary route of transmission of HCV is contact with human blood. The most common forms of transmission for HCV infection are transfusion of un-screened blood, re-use of non-sterilized medical equipment, and needle sharing among drug users. Sexual transmission and transmission from mother to baby is also possible, although less common. HCV can also be transmitted during dialysis, colonoscopy or surgery. There is no evidence that HCV is contaminated during daily living activities (sneezing, coughing, cuddling, sharing kitchen utensils, etc.).

Diagnosis

Diagnosis and monitoring of HCV infections; Enzyme-linked ImmunosorbentAssay (ELISA) based mainly on the detection of specific antibodies to HCV in human serum, Recombinantimmunoblotassay (RIBA) and AlaninAminotransferase (ALT) in serum, which identify antibodies that react with HCV antigens based on conventional Western and dotblotting techniques. Of these techniques, the ELISA technique can give false negative results in the early stage of infection, ie between about 7-8 weeks between the occurrence of HCV infection and the detection of the patient's antibodies. Recombinantimmunoblotassay (RIBA), used to confirm the ELISA result, cannot be routinely administered because it requires liver biopsy. Alanine-aminotransferase (ALT) level detection is not sensitive enough and is insufficient alone to determine the severity of the disease.

In cases where these techniques are inadequate, HCV-RNA real time PCR tests, a more specific and / or more sensitive, cost-effective, practical test method, can be used, in which the presence and quantification of serum HCV RNA is detected and quantified.