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Hepatitis C (HCV) and Viral Load

If you're being treated for hepatitis C virus infection -- also called HCV-- your doctor is keeping track of your viral load.

What is HCV viral load? Why does it matter? WebMD got answers to your most frequently asked questions about hepatitis C and viral load from two experts:

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Could I Get Hepatitis C?

More than 3 million Americans have a long-term infection from the hepatitis C virus (HCV). Anyone who has this disease can give it to someone else through blood and other bodily fluids. Once you've learned what situations make you likely to catch it, though, you can take steps to protect yourself or get diagnosed and treated.

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  • Frank Anania, MD, associate professor of medicine and director of hepatology at Emory University School of Medicine in Atlanta.
  • Brian L. Pearlman, MD, medical director of the center for hepatitis C at the Atlanta Medical Center, Atlanta; and associate professor, Medical College of Georgia in Augusta.

What Is HCV Viral Load?

Dr. Pearlman: Viral load is [the number of] viral particles floating in the blood. These are copies of the genetic material of the virus circulating through the body.

Dr. Anania: Viral load is based on technology that lets us measure extremely small quantities of hepatitis C virus RNA, the building block of the virus.

Can I Be Positive for Hepatitis C if I Don't Have any Measurable Viral Load?

Dr. Pearlman: Being "hepatitis C positive" means you have anti-HCV antibodies in your blood. Having HCV antibodies just means you've been exposed to the hepatitis C virus. You can certainly be antibody positive and not have any measurable viral load. One lucky thing this might mean is that you are one of the nearly 20% of people who naturally clear the virus from their bodies. The other possibility is that the virus, during the time blood is drawn, was only temporarily undetectable. HCV viral load in the blood goes up and down, and the test might have caught it on a downswing. So before we tell someone they are negative, we ask them to have the test repeated.

Dr. Anania: After hepatitis C treatment, people still have antibodies to HCV. But if they have no detectable HCV viral load, that indicates recovery from infection -- that is, response to treatment and sustained remission. Over a period of time, if a later viral load test comes back undetectable, that patient is in remission.

What Is a High Viral Load and Low Viral Load?

Dr. Pearlman: Anything over 800,000 IU/mL is usually considered high. Anything under that is low viral load ... Those with low viral load have a better chance of responding to treatment.

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