Getting A Hepatitis C Test From Your Doctor
Ideally, you should talk with a doctor about hepatitis C screening. Theyll ask you about any potential exposures or risk factors and will probably order a blood test to check for HCV antibodies. You can get your blood tested anywhere that does routine blood work.
Its the same procedure as getting a routine blood test.
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Treatments For Hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.
Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .
Tablet-only treatments are now available.
These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.
They include sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But itâs important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.
Meaning Of Hcv Viral Load
The number of HCV RNA international units per milliliter of blood must be measured before treatment and during the course of treatment, to assess response. Before treatment, however, the HCV viral load is not related to the patient’s liver disease severity or HCV prognosis. This is important for patients and providers to understand.
Note: In hepatitis B, unlike hepatitis C, a higher HBV DNA viral load does correlate with increased disease severity and increased likelihood of outcomes such as hepatocellular carcinoma.
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What To Do If The Hcv Antibody Test Is Reactive
If the antibody test is reactive or positive, you need an additional test to see if you currently have hepatitis C. This test is called a nucleic acid test for HCV RNA. Another name used for this test is a PCR test.
If the NAT for HCV RNA is:
- Negative you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
- Positive you now have the virus in your blood.
If you have a reactive antibody test and a positive NAT for HCV RNA, you will need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8 to 12 weeks.
Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
More rarely, HCV RNA is used when either very acute HCV infection is suspected or a false HCV Ab is suspected.
It would not be appropriate to repeatedly order HCV RNA viral load screening for a patient who is not on or was recently on HCV treatment, or to use the HCV viral load to determine the severity of the patient’s infection or the patient’s risk of developing significant liver disease.
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Possible Complications Of Hepatitis C
Theres one main complication of acute hepatitis C: It could become chronic.
- Cirrhosis. With cirrhosis, scar tissue gradually replaces healthy tissue in your liver, blocking blood flow and disrupting liver function. Cirrhosis can eventually lead to liver failure.
- Liver cancer. Having chronic hepatitis C raises your risk for eventually developing liver cancer. If you develop cirrhosis or your liver is very damaged before treatment, youll still have a higher risk for cancer after getting treated.
- Liver failure. It takes a long time for your liver to fail. Liver failure, or end-stage liver disease, happens slowly over months, often years. When your liver becomes unable to function properly, youll need a transplant.
If you believe you contracted the hepatitis C virus, a good next step involves reaching out to a healthcare professional. Getting timely treatment can lower your risk for experiencing serious complications.
The sooner you get a diagnosis, the sooner your healthcare professional can start a treatment plan.
Currently, the best way to protect yourself from the hepatitis C virus is to avoid using any items that may have come into contact with someone elses blood.
You can do this by:
How Do You Get Tested For Hepatitis C
Several testing procedures are available to accurately diagnose hepatitis C infection.
Hepatitis C, an inflammation of the liver caused by the hepatitis C virus , often goes undiagnosed until serious liver problems develop decades after contracting the virus. This is because the illness is asymptomatic for most people, according to the Centers for Disease Control and Prevention .
For these asymptomatic people, hepatitis C is generally detected when blood screenings show they are HCV-positive, or routine examinations show they have elevated levels of the liver enzyme alanine aminotransferase , an indication of liver cell damage.
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Can You Have Hep C And Not Know It
We said this illness is sneaky, and in fact, most people with hepatitis C dont have any symptoms at the time they are diagnosed, says Dr. Goff. That makes it difficult to trace exactly where and when someone contracted the virus. Unfortunately, it also gives the virus time to wreak havoc on the liver before you feel sick enough to seek treatment.
Until we started actively screening the population, patients could be infected with hepatitis C and have absolutely no idea they had it, Dr. Fox says. Weve had to change our screening recommendations over time so that were not only testing people who self-report a history of a risk factor.
Currently, the CDC recommends all adults get screened for hepatitis C at least once in their lifetime, and pregnant women should be screened during each pregnancy. For people with ongoing risk factorsfor example, for people who regularly inject drugs or share needlesmore frequent testing is recommended.
This Hepatitis C Screening Test Checks Whether You Test Positive For Hepatitis C
In the event that your test results are positive, an associate from our physician network will contact you directly to discuss your particular case as well as provide information on how to take the next steps to get treatment. We take customer privacy very seriously and will never share your information with a third-party with the exception of the lab we use to test your sample and our physician network.
As is the case with all STD testing – whether through EverlyWell or your doctor â we may be required by law to report positive test results to certain state health departments. This is only done to track infection prevalence. In rare cases you may not receive a definitive result because of early infection or inadequate sampling and repeat testing is suggested. Know where you stand with our at-home Hepatitis C test.
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How Is Liver Damage Assessed
If you have hepatitis C, doctors can gauge the level of liver damage you’ve experienced. One useful diagnostic tool is called a hepatic function panel, a group of blood tests performed together that examine the levels of certain liver enzymes, bilirubin , and proteins circulating in the blood.
Higher-than-normal levels of the liver enzymes, indicate that your liver is damaged, possibly from cirrhosis or liver cancer.
Albumin may be low, and your total bilirubin levels may also be elevated.
Along with the hepatic function panel, your doctor may also order two other tests: one test to determine the levels of the liver enzyme gamma-glutamyl transpeptidase in your blood, and a prothrombin time test that measures how well your blood clots.
A liver biopsy, in which a liver tissue sample is removed with a thin needle inserted through your skin and into your liver, can provide more details about the amount of scarring and damage HCV has caused.
Your doctor may also order an imaging test, such as a computerized tomography scan, magnetic resonance imaging , or ultrasound, to see if your hepatitis C has caused liver cancer, a possible complication of hepatitis C.
Additional reporting by Deborah Shapiro.
Why It Is Done
Hepatitis C virus testing is done to:
- Find out if a hepatitis C infection is the cause of abnormal liver function tests.
- Screen people who have an increased chance of getting or spreading a hepatitis C infection.
- Screen potential blood donors and donor organs to prevent the spread of hepatitis C.
- Screen people born from 1945 to 1975. People in this age group are more likely to have hepatitis C and not know it.
- Identify the type of hepatitis C virus causing the infection.
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Testing For Hepatitis C
Two tests need to be done to discover if you have hepatitis C:
- Antibody test: Which establishes whether you have ever been exposed to the hepatitis C virus.
- PCR test: Which establishes whether the virus is still active and needs treating.
The two tests can often be done from one sample of blood which means you may only need to provide the sample once. Both tests can then be done on your sample at the laboratory. However, some services will perform one test and then call you back for a further blood sample to perform the second test.
A hepatitis C antibody test is the first test undertaken. This is to determine whether you have ever been exposed to the hepatitis C virus. It works by testing for the presence of antibodies to the virus generated by your immune system. If you receive a negative hepatitis C antibody test but have been experiencing symptoms or have been recently exposed to hepatitis C, then you are likely to be advised to have a second test.
It is important to remember that there is a ‘window period’. This is the short period of time when your immune system may not have had time to produce antibodies. It usually takes between six and twelve weeks for these antibodies to develop. However, in a few people it can take up to six months. So if you have the test within this window period and the result is negative, it does not necessarily mean that you don’t have the virus.
Specific Hcv Rna Assays And Range Of Detectable Virus
HCV RNA tests use target amplification techniques. Several assays exist for HCV RNA testing. Methods include polymerase chain reaction , transcription mediated amplification , and branched chain DNA tests. Results are expressed as international units/mL . The different methods and different commercial assays each have a lower limit of quantification and lower limit of detection , therefore a patient’s results could be reported differently depending on the assay used. HCV RNA tests must have an LLOQ of 25 IU/mL or lower when used to assess treatment response with DAAs.
LLOQ = the lowest HCV RNA level that is within the linear and analytically acceptable range of the assay.
LLOD = the lowest level of HCV RNA that is detected 95% of the time.
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Hepatitis C Testing Types
Testing for hep C starts off with a hep C antibody test. This test looks for human antibodies something that your body produces to fight the virus. If your hep C antibody test result is positive, then it means you have been exposed to the hep C virus at some point.
If you get a positive antibody result, then your sample of blood is tested again using a PCR test. This test looks for parts of the actual hep C virus. If the PCR test result is positive it means that you have hep C. Have a look at our Hep C Testing chart for more info on hep C tests.
Treatment For Hcv Infection
Treatment for HCV infection is available. The role of treatment in acute infection is being evaluated and currently the existing data shows that response to 6 months of standard therapy with interferon in terms of absence of HCV RNA from serum is excellent and progression to chronicity is reduced. The recommended treatment for chronic HCV infection is a combination of a pegylated IFN alpha and ribavirin. The treatment duration depends on the genotype of the virus and it has two goals. The first is to achieve sustained eradication of HCV, that is, sustained virologic response , which is defined as the persistent absence of HCV RNA in serum for 6 months or more after completing antiviral treatment. The second goal is to prevent progression to cirrhosis, HCC, and decompensated liver disease requiring liver transplantation.
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Test Frequency And Turnaround Time
Hepatitis C Serology testing is performed daily Monday to Friday.
Turnaround time is up to 3 days from receipt by PHO laboratory for Non-reactive antibody results. Reactive and Indeterminate HCV antibody results are available and reported within 6 days.
Repeat testing may be indicated in those with ongoing risk factors for the acquisition of HCV.
Once a patient tests positive for HCV antibodies, other than in cases of maternal antibody transfer, there is no value in repeating the test as they will remain antibody positive for life regardless of whether they have cleared the virus or are chronic carriers.
Blood Transfusion Issues And Donor Counseling
Guidelines for donor notification for donors positive for transfusion transmissible infections are outlined in An Action Plan for Blood Safety by National AIDS Control Organization 2004. A blood donor is offered an option to know his TTI status at the time of registration for blood donation after due counseling and give consent for the same.
Notifying donors regarding a single positive screening test is fraught with the risk of causing undue anxiety and stress to a donor. If a screening test is positive, the blood unit should be immediately discarded. Presently there are no guidelines regarding confirming the test results before informing the donor. In case of samples with low S/CO and grey zone samples, a retesting of the donor samples using a different assay would be imperative before notifying the donor. There are clear cut guidelines regarding donor notification and referral for HIV positive blood donors with integrated counseling and testing centers available for the same. Donors who are positive for viral hepatitis markers have to be counseled by blood bank staff. An algorithm for donor counseling for HCV positive donors is outlined in .
Algorithm for donor counseling for HCV positive donors
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Here Are Our Top Five Reasons To Get Tested For Hepatitis:
1. You can have hepatitis and not know it
Signs and symptoms of viral hepatitis are not always easy to see or feel. Sometimes there can be no symptoms at all. Someone who has hepatitis can live for many years symptom-free until liver damage is severe or liver cancer is found.
2. It helps prevent liver damage and liver cancer
Getting tested for hepatitis is important because knowing your status early allows your health-care team to monitor your liver health regularly and treat it as required.
3. It helps protect your family and friends
Many people dont know the facts about how hepatitis is transmitted. Some people think that transmission can only happen through sharing needles. Here are some facts to consider:
- Hepatitis A is transmitted through contaminated water or food.
- Hepatitis B is transmitted through contact with body fluid .
- Hepatitis C is transmitted through blood-to-blood contact .
Baby boomers and people with other risk factors should get tested for hepatitis.
Hepatitis is NOT spread by
- hugging your loved ones
Dried Blood Spot Testing
Dried Blood Spot testing uses drops of blood from the end of your finger. It doesnt use a needle and syringe and you can do it free of charge in the privacy of your home. Your details and the results are kept private. If your test result shows you have hep C, the people who give your results can help you access hep C treatment and cure.
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There Is No Vaccine For Hepatitis C
But, did you know?
- Hepatitis C can be treated with medication that has cure rates > 90%.
- Earlier diagnosis and treatment lead to better health outcomes.
- Early treatment may even prevent liver disease, liver cancer, or cirrhosis.
Testing is quick and simple with a blood test.
Ask your health care provider for a test if you think you could have hepatitis C.
The best way to know is to get tested.
To learn about how to protect yourself and where you can get tested, visit Canada.ca and search ‘hepatitis C.’
Tests After The Diagnosis
Once the doctor knows you have hep C, theyâll do tests to find out more about your condition. This will help determine your treatment. They could include:
- Genotype tests to find out which of the six kinds of hepatitis C you have.
- Liver function tests. They measure proteins and enzymes levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C.
- 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:
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