Why does the liver hurt and how to recognize the hidden symptoms of hepatitis in time
When it comes to liver health, viral hepatitis remains one of the most insidious challenges. The main problem is the long asymptomatic course, due to which organ damage is often detected at a late stage. Accurate laboratory testing allows not only to establish the presence of the virus, but also to analyze its profile in detail: determine the genotype, reproduction activity and predict the response to future treatment.
Today, qualitative diagnostics are based on a combination of two different but complementary methods — enzyme-linked immunosorbent assay (ELISA) and molecular genetic testing (PCR). Using only one of them can lead to errors, as they look for different structures of the virus.
ELISA and PCR - why one method does not replace the other
Diagnosis of viral hepatitis is a step-by-step process, where each test performs its own specific function.
- Enzyme-linked immunosorbent assay (ELISA)
Allows you to detect antigens (proteins of the virus itself) and antibodies, i.e. the body's immune response. This method is a basic test. It helps to determine the stage of the process, distinguish the acute phase from the chronic, identify periods of exacerbations or confirm the presence of protection after vaccination. - Polymerase chain reaction (PCR)
It directly detects the genetic material of the pathogen (DNA or RNA). Qualitative analysis confirms the fact of active reproduction of the virus in the blood. Quantitative PCR analysis determines the level of viral load. This is critically important for the doctor, because a high level indicates the activity of the infection, and a decrease in indicators in dynamics is the main marker of the effectiveness of antiviral therapy.
A positive ELISA result for antibodies does not always mean that a person is sick right now - it may be a trace of a past infection that the body has dealt with. Conversely, PCR is able to detect the virus at the earliest stages, when antibodies have simply not had time to be produced.
Classification of viral hepatitis - transmission routes and risks
Today, hepatitis A, B, C, D, G, and other types are clearly distinguished. According to the specifics of their spread and consequences for the body, they are divided into two large groups.
1. Enteric hepatitis (A, E)
They are transmitted mainly through dirty water, food and household contacts. They are acute, have clear symptoms and do not become chronic. However, such viruses can significantly aggravate the patient's condition if they are superimposed on already existing chronic liver problems.
2. Parenteral hepatitis (B, C, D, G)
Transmitted through blood during manicures, tattoos, medical or other procedures, as well as sexually and from mother to child. These viruses are prone to persistent chronic course. For example, Hepatitis C becomes chronic form in over 70-80% cases.
Comparative characteristics of viral hepatitis
Below are the main markers of viruses that are subject to regular laboratory testing in practice.
| Type of hepatitis | Transmission route | Risk of chronicity | Key laboratory markers (ELISA/PCR) |
|---|---|---|---|
| Hepatitis A (HAV) | Through water and food | Missing (0%) | Anti-HAV IgM (acute phase), Anti-HAV IgG (immunity) |
| Hepatitis B (HBV) | Through blood and sexual contact | Moderate (5-10% in adults) | HBsAg (basic screening), Anti-HBs (immunity), HBV DNA (PCR) |
| Hepatitis C (HCV) | Through blood and sexual contact | High (70–80%) | Anti-HCV total antibodies, HCV RNA (qualitative, quantitative PCR, genotyping) |
| Hepatitis D (HDV) | Through blood | Develops only with HBV | Anti-HDV total, HDV RNA (PCR). It reproduces only in the presence of hepatitis B. |
| Hepatitis G (HGV) | Through blood | Weakly expressed | HGV RNA (PCR). Often occurs together with hepatitis C. |
A comprehensive approach to liver protection
The diagnostic strategy is designed to eliminate any doubts. The initial detection of markers by ELISA should always be supported by molecular genetic confirmation using PCR. Only this approach provides a complete clinical picture. The doctor learns not just about the presence of the virus, but about its behavior at a specific point in time, which allows you to stop the development of the disease in time and preserve liver function.
Head of the clinical diagnostic laboratory of Medi Lab Plus LLC, Master of Biochemistry with over 15 years of management experience. Monitors compliance of research with international EUCAST protocols and ISO 15189 standard. Acts as a medical editor of the site materials. More details…