Hepatitis C Diagnosis and Tests

You can be infected with the hepatitis C virus and have no symptoms. Your doctor could find it when he checks your blood and sees that your level of certain liver enzymes is high. If that happens, he'll follow up with other tests to confirm you have the disease.

Who Should Get Screened for Hepatitis C?

Some doctors say you should get tested at least once no matter what. Definitely get screened if any of these things apply to you:

  • Were born between 1945 and 1965
  • Currently using or injecting drugs
  • Ever injected drugs -- even if it was just once or a long time ago
  • Have HIV
  • Are on kidney dialysis
  • Have abnormal alanine aminotransferase levels (ALT)
  • Had a blood transfusion, blood components, or an organ transplant before July 1992
  • Got clotting factor concentrates made before 1987
  • Received blood from a donor who later tested positive for hepatitis C virus (HCV)
  • Health care workers, first responders, and other whose work exposes them to HCV-infected needles
  • Children born to women with HCV

Why Should You Get Tested?

  • You can have hep C with no symptoms.
  • The test is quick and easy.
  • You’ll protect family and friends.
  • Treatment can suppress the virus and maybe even cure you.
  • Early treatment prevents cirrhosis and liver failure.

Hepatitis C Testing and Diagnosis

Doctors will start by checking your blood for:

Anti-HCV antibodies: These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection.

  • How long does it take to get results? It usually takes a few days to a week to get results, though a rapid test is available in some places.
  • What do the results mean?
    • Non-Reactive or negative:
      • You don’t have hep C.
      • If you’ve been exposed in the last 6 months, you’ll need to be retested.
    • Reactive or positive:
      • You have hep C antibodies, and you’ve been infected at some point.
      • You’ll need another test to make sure.

If your antibody test is positive, you’ll get this test:

Continued

RNA: It measures the number of viral RNA (genetic material from the hepatitis virus) particles in your blood. Your doctor might refer to this as your viral load. They usually show up 1-2 weeks after you’re infected.

  • What do the results mean?
    • Negative: You don’t have hep C.
    • Positive: You have hep C.

As part of the diagnosis process, you might also get:

Liver function tests: They measure proteins and enzymes levels, which usually rise 7 to 8 weeks after you’re infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C.

Tests After the Diagnosis

Once the doctor knows you have hep C, he’ll do tests to find out more about your condition. They could include:

  • Genotype tests to find out which of the six kinds (genotypes) of hepatitis C you have.
  • Tests to check for liver damage. You might get:
    • Elastography: Doctors use a special ultrasound machine to feel how stiff your liver is.
    • Liver biopsy: The doctor inserts a needle into your liver to take a tiny piece to examine in the lab.
    • Imaging tests: These use various methods to take pictures or show images of your insides. They include:
      • CT scan
      • Magnetic resonance imaging (MRI)
      • Magnetic resonance elastography (MRE)
      • Ultrasound
  • Liver function tests (LFTs) or liver enzyme tests: These blood tests help the doctor know how well your liver is working

These test results will help the doctor decide which treatment is right for you. They also may play a role in decisions made by your insurance company, Medicaid, or other sources of help with your payment.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on December 11, 2018

Sources

SOURCES:

Younossi ZM. Cleveland Clinic Journal of Medicine, May 1997.

De Medina M, Schiff ER. Semin Liver Dis 1995.

Friedman LS: Chronic Hepatitis, In: Tierney LM, McPhee SJ, Papadakis MA (eds): Current Medical Diagnosis and Treatment, 36th edition, Appleton & Lange, Stamford CT, 1997.

National Center for Biotechnology Information: "FibroSURE and FibroScan in relation to treatment response in chronic hepatitis C virus."

CDC: "Testing for HCV Infection: An Update of Guidance for Clinicians and Laboratorians," “Hepatitis C: General Information,” “Hepatitis C: Information on Testing & Diagnosis,” “Hepatitis C: What to Expect When Getting Tested,” “Testing Recommendations for Hepatitis C Virus Infection,” “Viral Hepatitis.”

UpToDate: "Diagnosis and Evaluation of Chronic Hepatitis C Virus Infection," “Clinical manifestations, diagnosis, and treatment of acute hepatitis C virus infection in adults.”

American Liver Foundation: “Diagnosing Hepatitis C.”

Lab Tests Online: “RNA.”

The Hepatitis C Trust: “The acute phase of hepatitis C.”

U.S. Department of Veterans Affairs: “Viral Hepatitis.”

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