Everyone at risk, not just those with symptoms, should be tested for HCV. Testing for HCV is not routine. You may have to request a test from your physician.
Persons for Whom Routine HCV Testing is Recommended:
- Persons who ever injected illegal drugs, including those who injected once or a few times many years ago.
- Persons who received a blood transfusion or organ transplant before July 1992.
- Persons who received clotting factor concentrates before 1987.
- Persons who were ever on long-term dialysis.
- Children born to HCV-positive women.
Healthcare, emergency medical, and public safety workers after needlesticks, sharps, or mucosal exposures to HCV-positive blood.
- Persons with evidence of chronic liver disease.
- Anyone with elevated liver enzymes, ALT and AST, shown in their blood panels.
Tests for Hepatitis C
The FDA has approved two types of test for detecting antibodies to HCV in a person's blood, providing evidence of infection. A simple blood test EIA (enzyme immunoassay) or ELISA (enzyme-linked immunosorbent assay) can detect the antibody to HCV. If this test result is negative, no further testing is needed. But if the result is positive, an additional, more expensive test is used to rule out a "false positive." If this second test, the RIBA (recombinant immunoblot assay), yields a positive result, the person is considered to have been, or to currently be, infected. If the RIBA result is negative, the person is considered not to have been infected.
In 1999, the FDA approved an over-the-counter home test system, called Hepatitis C Check. The product allows a person to take a sample of blood at home and mail it to a designated laboratory for analysis with EIA and, when appropriate, RIBA testing. The results are available anonymously by phone through a unique identification number.
A liver biopsy to examine tissue from the liver is not necessary for diagnosing HCV infection. However, a biopsy is the only accurate way to check the severity and stage of liver disease.
Before 1990 doctors could diagnose HCV only by ruling out other possibilities (thus the old name for HCV "non-A, non-B hepatitis).
Hepatitis C patients, whether they decide to get treated or not, should be monitored regularly by their doctors. Patients not in treatment should have a blood test approximately every six months to check liver functioning. A baseline liver biopsy is recommended to establish the severity of HCV infection, and the biopsy should be repeated in three to five years. Patients on treatment will have additional and more frequent tests.
A qualitative PCR (polymerase chain reaction) test is used as a confirmatory test. A PCR test detects RNA genetic material of the virus in the blood serum. PCR is extremely sensitive and can detect as few as 10 viral copies per milliliter of blood serum. Qualitative PCR results are measured as positive or negative for the presence of the hepatitis C virus. In 1 to 3 weeks after initial exposure, HCV RNA can be detected in blood.. A quantitative PCR test measures the number of viral copies per milliliter. Quantitative PCR testing and genotyping of HCV RNA can be used as a predictor of response to therapy.
A liver enzyme test is used to measure the level of ALT (alanine aminotransferase) in the blood. An elevated ALT indicates inflammation of the liver and you should be checked further for chronic (long-term) liver disease and possible treatment. It is common for persons with chronic hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some persons have a liver enzyme level that is normal for over a year but they still have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6 to 12 month period. If the liver enzyme level remains normal, your doctor may check it less frequently, such as once a year.
Hepatitis virus can be found in 7 out of 10 persons when symptoms begin and in about 9 out of 10 persons within 3 months after symptoms begin. However, it is important to note that many persons who have hepatitis C have no symptoms. It is possible to find HCV within 1 to 2 weeks after being infected with the virus.
If you Test Positive for Hepatitis C, it is very likely that you have chronic (long term) liver disease. You will need to see a doctor to:
- Determine if you have liver disease and how severe it is.
- Determine if you should be treated for your liver disease.
- Learn how you can protect your liver from further harm.
- Learn how you can prevent spreading HCV to others.
All information provided in this site is offered for educational purposes only, and it is not intended nor implied to be a substitute for professional medical advice. Always consult your own physician or healthcare provider with any questions you may have regarding a medical condition.