What Is A Biopsy
A biopsy is a medical procedure. A tiny piece of liver is removed and examined to find out the extent of damage. It involves a large needle and local anesthetic, as well as some risk of bleeding. A pathologist looks at the piece of liver under microscopes to determine how much damage has occurred in the liver. This is a very useful test and used to be done very commonly. However, the procedure is done much less frequently than in the past. For most patients with hepatitis B and C, liver biopsy is not required. Today, other tests can be used to try to estimate the fibrosis in the liver.
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Interpreting Hcv Rna Test Results
It is essential that the provider understands how to interpret HCV RNA test results, especially during the course of HCV treatment.
|Result of HCV RNA Test||Interpretation|
|A quantified viral load — any exact number||Ongoing HCV infection|
|“Detected”||The HCV RNA is detectable but the number of international units is so low that it cannot be quantified accurately. This indicates extremely low level of virus is present.|
|“< 12 IU/mL” or “< 15 IU/mL” or “< 25 IU/mL” All of these are “less than the LLOQ”||HCV RNA is undetectable. No virus is detected at all in the patient’s serum specimen.|
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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Is It Possible To Prevent Hepatitis
Hepatitis prevention is very much a possibility with the right strategies. A vaccine is available for hepatitis A. Healthcare providers recommend this vaccine for all people who are at high risk of exposure to the virus. Children- one year and above, should take this vaccine. Prevention of hepatitis A is possible with good hygiene and sanitation. Washing hands especially after using the toilet and before consumption of food can help with cutting hepatitis A transmission. Hepatitis B vaccine has become the norm in developed nations and most new-borns are given these shots. The hepatitis B shots are recommended for children and adolescents as well as adults in high-risk groups. Hepatitis C vaccine is not developed yet, and efforts are in the process to have a vaccine for this infection. Prevention of hepatitis C is possible by avoiding contact or exposure to blood and bodily fluids. Further, avoiding the sharing of needles or other instruments to inject drugs can cut the rate of transmission of this disease.
Viral Load Testing After A Positive Antibody Test
It is very important to wait after possible exposure to have the antibody test. The Centers for Disease Control says that antibodies may show in the blood between 6-7 weeks after exposure. If the test is negative at that time, it should be repeated at 6 months as some people take a longer time to develop the antibody. The HCV/RNA by PCR test is definitive earlier after exposure if there is a need to know sooner.
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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.
Viral Loads During Treatment
Checking your virus count before, during, and after treatment tells your doctor if and how well your drugs are working. A rising viral load doesnât always mean youâre getting sicker, and a drop in the virus count isnât a sign that youâre on your way to being cured.
Unlike with HIV, where lower viral counts usually mean longer, healthier life, HCV viral loads donât say much about how fast your hep C is progressing or how your disease might turn out. For that, your doctor will need to check your liver enzymes and your liver tissues and run other tests.
Usually, your hep C treatment will be the same no matter how high or low your viral load is. Your doctor will use your virus levels to monitor how you respond to the medication. The drugs youâre prescribed will depend less on your viral count than on your overall health, genetic makeup of your HCV, and other things.
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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.
What Is Hepatitis C Test
Hepatitis C Test is a blood test that is used for the detection of the Hepatitis C virus. There are several types of Hepatitis C test that is used by doctors for the diagnosis of Hepatitis C. The varied Hepatitis C tests are
Hepatitis C Antibody Test : Hepatitis C antibody test is used by doctors to ascertain whether or not a person has been affected by the HCV at any point of his/her life by detecting Hepatitis C antibodies in the blood.
Hepatitis C RNA Qualitative Test : Also referred to as PCR test, this test screens for current infection of the virus.
Hepatitis C RNA Quantitative Test: As the name suggests it is a quantitative test and measures the amount of Hepatitis C virus in the body. The Hepatitis C RNA Quantitative Test is also referred to as viral load test.
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What Is Being Tested
Hepatitis C is a virus that causes an infection of the liver that is marked by liver inflammation and damage. Hepatitis C tests are a group of tests that are performed to diagnose hepatitis C infection and to guide and monitor treatment of the infection.
Hepatitis C tests include:
Hepatitis C is one of five viruses identified so far, including A, B, D, and E, that are known to cause hepatitis.
HCV is spread when contaminated blood enters the body, primarily though sharing needles and syringes during IV drug use. HCV is spread less commonly by sharing personal items contaminated with blood , through sex with an infected person, needlestick injuries to healthcare workers, unregulated tattooing, and from mother to baby during pregnancy and childbirth. Before tests for HCV became available in the 1990s, HCV was often transmitted by blood transfusions. Currently, there is no vaccine to prevent hepatitis C.
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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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What Is Hepatitis B Surface Antibody
When you are exposed to hepatitis B, your body mounts an immune reaction against it as an invader. This happens whether you are exposed due to blood or sexual contact or if you are vaccinated with the hepatitis B vaccine.
The hepatitis B virus has proteins on its surface that cause your immune system to produce antibodies. With the vaccine, the sample contains the protein only and not the virus itself.
The first response your body will make when exposed to hepatitis B is to manufacture hepatitis B IgM antibodies. These early antibodies are produced to fight against several parts of the virus including its core. These antibodies are seen in the initial response, but they eventually fade away.
Your immune system then begins to produce IgG antibodies. It continues to produce these antibodies for the rest of your life. In this way, your immune system is always ready to attack hepatitis B virus when it is exposed to it.
How Is Hepatitis C Diagnosed
Hepatitis C infection is diagnosed with several blood tests. The hepatitis C antibody test checks for antibodies that fight the virus. A non-reactive result means that antibodies to the virus are not detected. A reactive result means antibodies to the virus are present, but the test is unable to indicate whether the infection is current or in the past. Another blood test assessing the presence of hepatitis C genetic material is available. The results of this test can help doctors determine whether hepatitis C infection is current or not. Additional blood tests can be used to determine the amount of virus in the body, known as a titer.
When someone has confirmed hepatitis C infection, the doctor will order more tests to assess the degree of liver damage. A liver biopsy may be performed. There are several different strains of hepatitis C virus that respond to different treatments. For this reason, the doctor will order a test to determine the genotype of the hepatitis C infection to help determine the course of treatment.
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Can I Take The Test At Home
At-home hepatitis C tests are available that allow patients to collect a blood sample at home and mail it to a laboratory for testing. Test samples are collected through pricking a finger with a sharp object, called a lancet, thats included in the test kit.
At-home HCV testing is a form of hepatitis C antibody testing and does not test for hepatitis C RNA or the strains genotype. Testing for hepatitis C at home is not a substitute for testing performed by a health care professional, and positive test results may need to be confirmed by laboratory-based testing.
What Does High/low Viral Load Mean
Viral load is the amount of virus present in the bloodstream. It is expressed as the amount of viral genetic material per milliliter of blood. The amount of virus does not predict how severe the liver disease is or will become. The level of the viral load does not tell us anything about the risk of liver damage or how sick someone is. In hepatitis C, it matters if virus is present or absent. Some treatment regimens can be shortened if the patient has a low viral load to start with, but most often, treatment regimens are the same for people with high hepatitis C viral loads or low viral loads.
The RNA test is essential for making the diagnosis of hepatitis C infectionhaving a positive RNA test is the definition of having infection. After the diagnosis is made, the RNA level does not need to be checked over and over unless it is checked during the time that the patient is undergoing treatment. During treatment, regular RNA tests are done to follow the dropping virus level until it reaches an undetectable state. But before treatment and after treatment, repeated RNA testing is not necessary.
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Question 2 Why Are Hcv Rna Results Being Reported In Iu/ml
Results are reported in international units per milliliter to facilitate comparisons between results generated by different test methods. This is important because the various methods used by different laboratories are not standardized against each other. Use of IU/mL reporting units helps to make the comparison of viral load results across different methods more reliable.
What This Means For You
A new combined test for hepatitis C that uses a single drop of blood on a card can test for antibodies and viral load, which will make it easier to screen at-risk people for the virus and get them treated as soon as possible.
Right now, the test is only being used in two statesâOregon and Washington. Hopefully, it will become available in other states soon.
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What Is Hepatitis C
Hepatitis C is a virus that causes inflammation of the liver. It is a member of the family of viruses that includes hepatitis A and hepatitis B. These viruses behave differently and have different modes of transmission. Hepatitis C can cause serious liver damage, liver failure, liver cancer, and even death.
What Do Antibodies Mean
Just remember that having antibodies does not always mean you have hep C – it only means you have had exposure to the virus as many as 25% or more people will clear the virus with their own immune response, and yes your antibodies do play a part in that. There is some research that looks at how immune response and treatment affect us over time, and I support more attention to discovering the connection between autoimmune disorders and chronic hep C and treatment, and how our bodys own immune response fits into these mechanisms. It is my hope that we can acquire more understanding, and through that process be able to prevent some of the issues that people are dealing with now and into the future. This has implications for other infectious disease and immunity research & understanding.
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Virological Tools For Diagnosis
Virological diagnosis of HCV infection is based on two categories of laboratory tests, namely serologic assays detecting specific antibody to HCV and assays that can detect, quantify, or characterize the components of HCV viral particles, such as HCV RNA and core antigen . Direct and indirect virological tests play a key role in the diagnosis of infection, therapeutic decision-making, and assessment of virological response to therapy.
Rna Or Viral Load Test
If you test positively for hepatitis C antibodies, you will need to get an RNA or viral load test. The RNA test is a blood test that checks to see if hepatitis C is active in your body.
- If your RNA test result is negative, you do not have hepatitis C.
Supported by an independent educational grant from Merck & Co., Inc.
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Assay Dilutional Sensitivity With Dbs Samples
The dilutional sensitivity of the ARCHITECT Anti-HCV assay with DBS samples was evaluated using dilution series created from two randomly selected plasma samples with high S/CO values. The two plasma samples were diluted in parallel in negative plasma and negative whole blood with a dilution factor ranging from 10 to 1000. The DBS S/CO results were compared to those for each plasma sample at each dilution level .
Table 1 Dilution sensitivity for 6-mm and 12-mm DBS eluted in EB and AD, tested with the standard and modified sample volume ARCHITECT anti-HCV assay.
The sensitivity of the modified assay and on-market assay with DBS as a sample was 100% and 90.97%, respectively. Specificity of the DBS assay evaluated using whole blood from 104 anti-HCV negative samples was 100% for both assays . The mean DBS S/CO value was 0.11 for the modified and 0.032 for the on-market assay. Positive predictive value was 100% for both assays. Negative predictive value was lower for the on-market assay: 88.89% vs 100% for the modified assay. Receiver operating characteristic plots were very similar for both assays , with area under the ROC curve indicating a perfect assay.
Screening For Hcv Infection
HCV screening has several potential benefits. By detecting HCV infection early, antiviral treatment can be offered earlier in the course of the disease which is more effective than starting at a later stage. Further, early detection together with counseling and lifestyle modifications may reduce the risk of transmission of HCV infection to other people. The optimal approach to screen for HCV is to test the individuals having risk factors for exposure to the virus. The American Association for the Study of Liver Diseases recommends screening for HCV for the following individuals:
Recipient of blood or blood components .
Recipient of blood from a HCV-positive donor.
Injection drug user .
Persons with following associated conditions
persons with HIV infection,
persons who have ever been on hemodialysis, and
persons with unexplained abnormal aminotransferase levels.
Children born to HCV-infected mothers.
Healthcare workers after a needle stick injury or mucosal exposure to HCV-positive blood.
Current sexual partners of HCV-infected persons.
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