Asking questions about your medical history and doing a physical exam will help your doctor determine your chances of having hepatitis C. Often, people find out by accident that they have hepatitis C, such as when donating blood or having a routine physical exam. High liver enzymes in your blood may be the first sign of the virus.

To check how well your liver is working, you may have liver function tests. These are blood tests that can help your doctor find out if you have liver damage.

If your doctor thinks that you may have hepatitis C, he or she will order a hepatitis C virus test. This is a blood test that looks for antibodies against the hepatitis C virus. If you have hepatitis C antibodies, you will have another blood test that looks for the genetic material (RNA) of the hepatitis C virus. The antibody test shows whether you have been exposed to the virus, and the RNA test shows whether you are infected with the virus now. Before having these tests, your doctor should talk to you about the pros and cons of testing for hepatitis C so that you understand what having the virus means.

If your test results are positive, your doctor may order a liver biopsy to see whether the virus has caused scarring or damage to your liver. During a liver biopsy, a doctor will insert a needle between your ribs to collect a small sample of liver tissue to be examined under a microscope. See a picture of the placement of the needle for a liver biopsy.

Your doctor also may order some imaging tests such as a CT scan, MRI, or ultrasound to make sure that you do not have liver cancer. You also may have a blood test to determine the kind of hepatitis C virus (genotype) you have. Knowing your genotype and the extent of your liver damage will help you and your doctor decide if and how you should be treated.

Early Detection

You should be tested for hepatitis C if you:

• Have signs or symptoms of liver disease, such as abnormal liver tests.
• Received blood from a donor who was found to have hepatitis C.
• Have ever shared needles while using drugs, even if you only experimented many years ago.
• Are a health care worker who may have been exposed to hepatitis C through a needle stick or other contact with blood or body fluids.
• Have a sex partner who has a chronic hepatitis C infection.
• Have had your blood filtered by a machine (hemodialysis) because your kidneys cannot filter your blood.
• Received blood, blood products, or a solid organ from a donor before 1992. Since 1992, all donated blood and organs are screened for hepatitis C, so it is now rare to get the virus this way.
• Received blood-clotting factor concentrates (used to treat blood disorders such as hemophilia) before 1987. In 1987, screening of clotting factor concentrates for hepatitis C became a requirement.