Hepatitis C are you currently infected?

HCVAG - Hepatitis C Antigen - Hep C Core Antigen

What does it measure?
The HCVAG test detects specific antigens of the Hepatitis C virus in the blood. Antigens are proteins that are part of the virus and indicate active infection. This test is crucial in determining whether the Hepatitis C virus is currently present and multiplying in the body.

Indication/Significance:
A positive HCVAG test result indicates active Hepatitis C infection. This means that the virus is currently in the body and may be causing damage. The test can be used to confirm a recent infection, which is important for timely initiation of treatment to prevent further complications.

Importance of Early Detection:
Hepatitis C is a viral liver infection that often goes undetected in the early stages because it is usually symptomless. Untreated infections can lead to a chronic form of the disease in about 70% of cases. Chronic Hepatitis C can cause serious liver damage, including scarring and liver cancer. Therefore, it is essential to detect and treat the infection as early as possible. In the Netherlands, it is estimated that between 15,000 and 60,000 people are infected with the Hepatitis C virus.

Risk factors:
Hepatitis C is transmitted primarily through blood contact. The main risk factors include:

• Blood transfusions or use of blood products before 1991, when a reliable test became available.
• Use of drugs through injections, where shared syringe attributes can transmit the virus.
• Surgeries, tattoos, piercings or ritual procedures in which non-sterile material or unsafe donor blood was used.

Notifiable disease:
Hepatitis C has been a notifiable disease (group B2) since April 1, 1999. This means that a positive test result is automatically reported to the local GGD. If the result is positive, the test is automatically performed again for confirmation. If this is also positive, by ordering this test you give permission for reporting to your local GGD. The GGD then reports anonymously within 24 hours to RIVM, in accordance with the Public Health Act, and provides data for national surveillance of notifiable diseases.

Conduct Days:
This test is conducted Monday through Friday, which ensures quick processing of results.

Method:
The HCVAG test uses the CMIA (Chemiluminescence Mikroparticle Immunoassay), an advanced technique known for its high sensitivity and specificity in detecting viral antigens.

Clinical Indication:
This test is of great importance for therapy monitoring and for estimating the proportion of infected hepatocytes (liver cells) in patients with Hepatitis C.

Accreditation:
The performance of this test is accredited to ISO 15189, which stands for high quality and reliability of the test results.

For those infectious diseases for which there is a reporting requirement, we are required to report a positive result to your local GGD (more information).

Hepatitis C is a viral inflammation of the liver. This form of hepatitis was only discovered in the late 1980s. Many people are infected with the hepatitis C virus without knowing it! A hepatitis C infection is usually symptomless at first. The infection passes unnoticed into a chronic form in the majority of cases (70%). About 20-30% of people with the chronic form develop liver damage (scar tissue) and of these, about 2-5% develop liver cancer each year. Some people do not develop symptoms until 20 or 30 years after infection when the liver is already affected. It is estimated that some 15,000 to 60,000 people in the Netherlands are infected with the virus. The virus is fairly treatable, damage to the liver, however, is not. Therefore, it is important to discover and treat the infection in time. In that case, about 50-80% of patients get rid of the virus permanently.

Hepatitis C is less contagious than hepatitis A and B. Infection requires blood contact.

Risk factors include:

• The administration of blood (products). It was not until the end of 1991 that a reliable blood test became available and all donor blood in the Netherlands was tested for hepatitis C.
• Use of drugs by injection.
• Sharing spray props such as cotton balls, needles, water, etc. can transmit the virus.
• Blood transfusions, surgeries, tattoos/piercings, ritual and other invasive procedures where unsafe donor blood is used or non-sterile work is performed.

The HCVAG - Hepatitis C Antigen test can be useful as early as about 2 weeks after suspected infection. This is because the test directly detects the Hepatitis C virus itself (in the form of antigens), which is present earlier in the infection than antibodies. Because of this, the test can help make an early diagnosis even before antibodies have been produced by the body.

For a reliable diagnosis, it is usually recommended that this test be performed between 2 to 8 weeks after the suspected exposure to the virus, because at that time the antigen is present in sufficient quantities to be detected.

The "core antigen" in Hepatitis C refers to a specific protein that is part of the Hepatitis C virus (HCV). This protein is an essential structural component of the virus and is located in the nucleocapsid, the core structure that envelops the genetic material of the virus.

What is the core antigen?
"Core" literally means "nucleus" or "center," and in the context of Hepatitis C, it refers to the central component of the virus.
The core antigen is a protein that is part of the virus capsid, which protects and envelopes the RNA (genetic material) of the Hepatitis C virus.
The core antigen is produced in the body as soon as the virus is present, even before the immune system begins producing antibodies. The core antigen can be detected earlier in the infection than antibodies. This allows early detection of Hepatitis C infection, often within two weeks of infection.
The presence of the core antigen in the blood indicates an active infection. This means the virus is multiplying in the body and potentially causing damage, such as liver inflammation.
Confirmation of Infection: Measuring core antigen is used to confirm active Hepatitis C infection, especially in the early stages, when antibodies may not yet be detectable.

The Hepatitis C core antigen remains detectable as long as there is an active infection, meaning that the virus is present and multiplying in the body. Once the body has effectively fought off the infection, such as through successful treatment or by its own immune system, the core antigen disappears from the blood. This means that the core antigen is especially useful for detecting an active, persistent infection.

Comparison with Antibody Testing.
Antibodies (as detected by the HCVK test) are produced by the body in response to infection and are usually not detectable for several weeks. These tests indicate that a person has ever been in contact with the virus.
The core antigen (as detected by the HCVAG test) is a direct indicator of the presence of the virus itself and can be detected early in the infection. This makes it a valuable tool for early detection and treatment of Hepatitis C.
In summary, the core antigen is an important target when testing for Hepatitis C because it is an early and direct sign of active viral infection.

Hepatitis C infection can be detected at an even earlier stage by HCV PCR testing.

Notification requirement

If the result is positive, this search test will be automatically re-tested. If the results are also positive, then by ordering this test you give permission to report the infection to your local GGD (more information).

Hepatitis C has been a notifiable disease group B2 since 1 April 1999. Between October 1, 2003 and January 1, 2019, mandatory reporting only applied to recently acquired HCV infection. As of January 1, 2019, mandatory reporting for chronicHCV has been reinstated due to improved treatment options.

All people with a proven HCV infection in the Netherlands are reported within 24 hours by the treating doctor and the laboratory to the localGGD. In accordance with the Public Health Act, theGGD then reports anonymously within one week to theRIVM and supplies data for the national surveillance of notifiable diseases.