Skip to content
My WebMD Sign In, Sign Up

Hepatitis Health Center

Font Size

Hepatitis C Tests

Chronic hepatitis C infection often has no symptoms. It is usually first suspected when a blood test shows an elevation in liver enzymes.

One liver enzyme called alanine aminotransferase (ALT) can indicate hepatitis C infection when elevated. Many infections, toxins, and diseases can cause elevations in ALT. Your doctor must perform specific hepatitis C tests to confirm the diagnosis.

Recommended Related to Hepatitis

Understanding Hepatitis C -- Prevention

Hepatitis C virus can only be transmitted through blood transfer. But exposure to tiny amounts of blood is enough to cause infection. There is no vaccine to prevent hepatitis C infection. Here are some steps you can take to prevent becoming infected with hepatitis C. Never share needles. Intravenous drug users are at greatest risk of becoming infected with hepatitis C because many share needles. In addition to needles, the virus may be present in other equipment used with illicit drugs...

Read the Understanding Hepatitis C -- Prevention article > >

The first test for hepatitis C infection is a blood test for hepatitis C antibody. Your body produces this antibody when it is infected with the hepatitis C virus. The name of this blood test is the enzyme-linked immunosorbant assay (ELISA).

The ELISA test is not perfect. It may indicate a hepatitis C infection when you do not actually have one. If the ELISA is positive, your doctor may do a recombinant immunoblot assay (RIBA) test to help confirm a hepatitis C infection.

When the RIBA test indicates a hepatitis C infection, the results are compared to the ALT levels. If the ALT levels are elevated, and the ELISA and RIBA tests are positive, it’s likely you have a chronic hepatitis C infection. Another test called a polymerase chain reaction (PCR) may be done to determine current activity of the virus. 

Before treatment starts, the patient may have a liver biopsy. A biopsy determines the amount of liver damage caused by the virus. In this procedure, the doctor inserts a special biopsy needle through the skin and into the liver. A small sample of liver tissue is removed.  Another test used for determining damage to the liver is called a Fibrosure blood test. 

Hepatitis C tests may be positive in someone who was previously infected with the hepatitis C virus but whose immune system was able to clear the infection. Liver enzyme levels are usually normal in these people. The PCR test provides more information.

The PCR detects the genetic material of the hepatitis C virus living in your body. If you have a positive ELISA, RIBA, and PCR, and normal liver enzymes, you may be a hepatitis C carrier. This means the hepatitis C virus is in your body, but you do not have any major liver damage. In general, these people do not need immediate treatment. The doctor will monitor the liver enzymes. If an elevation in ALT were to occur, treatment would then be considered.

Someone with positive ELISA and RIBA, negative PCR, and normal ALT would be considered to have recovered from a hepatitis C infection. However, a single negative PCR could mean that amount of virus in the body has temporarily fallen below the detection limits of the test. Your doctor may repeat the PCR test to confirm that the infection is gone.


WebMD Medical Reference

Reviewed by Debbie Bridges, MD on August 25, 2012

Today on WebMD

Hepatitus C virus
young couple
Hepatitis Basics
Hepatitis Prevent 10
Hepatitis C Treatment
Syringes and graph illustration
liver illustration
passport, pills and vaccine
Scientist looking in microscope
Fatty Liver Disease
Digestive Diseases Liver Transplantation
Picture Of The Liver
Image Collection

WebMD Special Sections