Diagnostics - Treatment of Hepatitis C in Moldova

Diagnostics

Сomplete blood count (CBC)

A fast, affordable and reliable method of diagnosis. It is necessary for the primary detection of most diseases. If the liver is damaged by viral hepatitis, the following indicators should be considered:
  • Hemoglobin
  • Leukocytes
  • Platelets
  • ESR (Erythrocyte sedimentation rate)
  • Leukocyte formula (leukogram)

Blood Chemistry Test

A method of laboratory diagnosis, which allows to evaluate the internal organs function, metabolism and the content of trace elements in the blood. Most important indicators of biochemical blood analysis in the diagnosis of viral hepatitis C are:
  • Alanine aminotransferase (ALT)
  • Aspartate Aminotransferase (AST)
  • Bilirubin
  • Gamma-Glutamyl Transpeptidase (GGT)
  • Alkaline Phosphatase (APF)
  • Glucose
  • Ferritin
  • Albumin

FibroScan

A relatively new, non-invasive method used to determine the liver fibrosis stage. This procedure has a number of advantages - high diagnostic accuracy, painlessness, low cost.

The liver fibrosis staging is a prerequisite for the selection of the drugs and the calculation of the of antiviral therapy duration.

Analysis of IL28B

Determination of the interleukin 28B gene is an important prognosis factor in the hepatitis C treatment.Interleukin 28B gene polymorphisms were studied because of their association with stable virologic responses. In certain genotypes, a sustained virologic response is achieved 2 times more often. That is why the determination the interleukin 28B genotype serves as a prognosis for the antiviral therapy effectiveness and allows to find more ways to increase it before the beginning of therapy.

PCR (Polymerase Chain Reaction)

A method of molecular diagnostics, which allows to identify the genetic material of the hepatitis C virus. The test consist in the investigation of a unique nucleotides sequence presence, which is characteristic only for the hepatitis C virus. In the diagnosis of viral hepatitis C, the following types of PCR are used:
  • 1) Qualitative PCR analysis — is the first step in diagnosing the disease. It detects the presence of viral RNA particles in the blood. The results of this analysis can be "detectable" or "undetectable".
  • 2) Quantitative PCR analysis — viral load measurement, i.e. viral RNA concentration in 1 ml of blood. This analysis is mandatory before starting the therapy as it plays a major role in treatment effectiveness monitoring.
  • 3) Genotyping - analysis aimed to determine the viral genotype. There are 6 major genotypes of the hepatitis C virus, the most common are the first and third. Genotyping is one of the main tests needed to select the appropriate treatment strategy.

Ultrasound scan

A highly informative diagnostic method. Its main advantage is non-invasiveness. Ultrasound scan is widely used in diagnosing liver pathology. This diagnostic method allows to determine diffuse liver changes, including: fibrosis, hypertrophy, sclerosis, lung parenchyma or its dystrophy.

FibroTest

A laboratory method based on determination of fibrosis biomarkers in patient's blood. There are several varieties of this test: Fibro/Acti Test and Fibro Max.
Fibro/Acti Test includes:
  • FibroTest: determines the presence and degree of liver fibrosis.
  • Acti Test: determines the activity of necroinflammatory process in the liver tissue.
FibroMax includes:
  • FibroTest: determines the presence and degree of liver fibrosis.
  • Acti Test: determines the activity of necroinflammatory process in the liver tissue.
  • Steato Test: diagnoses the presence and the degree of hepatic steatosis.
  • Ash Test: determines alcoholic steatohepatitis in alcohol abusers.
  • Nash Test: determines non-alcoholic steatohepatitis in patients with overweight, insulin resistance, hyperlipidemia and diabetes mellitus.
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