Questions For Your Doctor About Test Results
Patients receiving hepatitis C testing may find it helpful to ask questions about their test results. Questions to consider include:
- What type of hepatitis C test did I receive?
- What was my test result?
- How do you interpret the results of the hepatitis C tests that I had?
- Do I need any follow-up tests based on my test result?
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Home Screening Tests For Hepatitis C
At-home screening tests provide privacy if you prefer not to go to a doctor or clinic for testing. These tests typically look for antibodies to hepatitis C, but they may not always test for active viral infection. Make sure you know what type of test youll be taking before you buy.
Many at-home tests have close to or the same reliability as blood tests received by a medical professional.
If youve recently been exposed to hepatitis C, wait several weeks before testing at home.
Addressing Hepatitis For The First Time
It is crucial that a treatment counselor or health professional use a nonjudgmental and compassionate tone. Clients need to feel comfortable disclosing information about their health and risky behaviors. The following strategies can help initiate the conversation:
- Display posters, literature, or other -related items that could help prompt the client to ask questions about hepatitis. .
- Assess clients ability to discuss , based on their degree of openness in the counseling session, the amount of detail they provide in their responses, and the length of the therapeutic relationship.
- Raise the subject in a way that avoids making clients feel defensive or afraid. Consider introducing the subject by making parallels with other conditions that have been discussed. Say, for example, You said you were tested for HIV several times. Were you ever tested for viral ? or You mentioned that your friend is sick with HIV. Have you been tested for HCV or HIV? Tell me about those tests.
- Be patient and allow time for multiple, short conversations about the subject. This might ease feelings of fear, anxiety, or shame.
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What Are Genotypes And What Do They Mean
Viruses have genes, too. The genotype of virus you have can be one of six different groups, or genotypes. Most patients with hepatitis C in the United States have genotype 1a or 1b, but in other parts of the world, other genotypes are more common.
There isnt a better or worse genotype to have. In the past , genotype 1 was the most difficult to successfully cure but this is no longer the case. All the new direct-acting antiviral medicines work extremely well in treating all genotypes. Sometimes genotype 3 is a little harder to cure, but in general, all genotypes now have extremely high likelihoods of being cured with hepatitis C treatment.
What Is This Test
A hepatitis C antibody test is used to find out if you are infected with the hepatitis C virus . When your body is infected with a virus, it produces antibodies to fight the virus. The hepatitis C antibody test looks for antibodies that the body produces in response to the presence of HCV.
HCV infects the liver, often causing inflammation and damage. It can lead to cirrhosis, liver failure, and liver cancer. It’s more common in developing nations.
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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.
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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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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Adverse Effects Of Treatment
Adherence to treatment remains a major factor influencing the rates of sustained virologic response.33,42 Discontinuation of therapy because of adverse events is common and has been reported in up to one third of patients. Approximately 50 to 60 percent of patients may exhibit self-limited influenza-like symptoms with interferon-based therapy.2 Effective management of treatment-related adverse events is essential to improve adherence to treatment therefore, patients should be monitored closely for hematologic, renal, and thyroid abnormalities. Approximately 30 percent of patients undergoing treatment for HCV infection experience depression, emotional lability, or anger, but treatment is rarely associated with suicidal ideation or hallucinations.43 Treatment for HCV infection is contraindicated in persons with uncontrolled major depression.32 A recent randomized trial found that the overall adverse effects of pegylated interferon alfa-2b plus ribavirin and pegylated interferon alfa-2a plus ribavirin were similar.40 Adverse effects of pegylated interferon and ribavirin for the treatment of HCV infection are listed in Table 8.32
Adverse Effects of Pegylated Interferon and Ribavirin for the Treatment of Hepatitis C Virus Infection
Information from reference 32.
Adverse Effects of Pegylated Interferon and Ribavirin for the Treatment of Hepatitis C Virus Infection
Information from reference 32.
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Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
Understanding Of Lab Tests Results
Please visit the site associated with The American Association for Clinical Chemistry for better understanding of tests. There you will find the most detailed and full information regarding lab tests. In common questions tab you will find answers on the most common questions.
In addition, you can use a special form to ask the question. It is useful, if there is no answer on your question on the web site. A laboratory scientist will answer your question. It is a part of voluntary service provided by the American Society for Clinical Laboratory Science.
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Ashley Flanders Bcba Clinical Director
Hi there! Im Ashley Flanders, a BCBA and Clinical Director of the South Austin clinic. Im originally from Georgia, but after learning more about ABA, we moved to Texas so I could pursue a M.Ed in Special Education at University of Texas. Ive worked with both adults and children, and in many different settings. I have a passion for working with learners with limited communication, as well as those focusing on daily living skills. When Im not at the clinic, I enjoy gardening, playing video games, reading, and spending time with my husband and 2 cats.
I firmly believe that our job is to provide learners with the tools to carve their own path with, and the support they need to help them discover who they want to be. Our team creates opportunities for learning with the use of learner led therapy and their natural interests. A learners strengths are found in what makes them unique, and we foster an environment that embraces those differences while teaching them essential skills. Im very thankful for all the insight our learners have given me, and know they will continue to touch lives.
When I look at you, and you look at me, I wonder what wonderful things you will be.
The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
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Question 4 What Do These Test Results Mean: < 15 Detected And < 15 Not Detected
A < 15 Detected viral load result means the assay detected HCV RNA in the patients specimen at a very low level , but could not measure the precise level. A < 15 Not Detected viral load result means the assay did not detect HCV RNA in the patients specimen.
This test is performed using a Taqman® assay. The lowest viral load this assay can accurately quantify is 15 IU/mL, but the qualitative limit of detection is in the 10 to 13 IU/mL range. Therefore, even when the viral load is below 15 IU/mL, we can still report qualitative detection of HCV RNA consistent with active infection in some cases.
Is It Possible To Get A False Positive
It is possible to receive a false positive result. Initially, you are likely given the ELISA test, which is looking for the antibodies that interact with the hepatitis C virus. The general belief is that this test will only be positive and the antibodies will only exist if there is a hepatitis C virus present. However, sometimes there are other reasons why the test can be positive.
Approximately 25% of people who at one point had the hepatitis C virus in their bodies will rid themselves of the virus on their own. The person might not even know that their body is doing this while the process is happening. However, if that person takes the ELISA test after this has happened, there will be antibodies present, but there will not be a hepatitis C virus anymore.
In addition, the body sometimes gets confused. As a general rule, when the body experiences an illness or foreign body , the body creates antibodies in order to fight against this foreign internal intruder. However, sometimes, the antibodies are not specific to the exact intruder. Sometimes, those non-specific antibodies can lead to an ELISA test reading that is it positive, though the antibodies that cause the positive reading are actually not battling hepatitis C, but rather another kind of illness.
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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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Immunoassays For Hcv Core Antigen
As an HCV diagnostic marker, HCV core antigen has been studied, either alone or as an HCV antibody-HCV antigen combination assay. Some experts have proposed use of an HCV core antigen test as a less expensive option than HCV RNA testing, but there are no HCV antigen assays that are FDA-approved for use in the United States at this time.
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Role Of Hcv Core Antigen In A Blood Bank/organ Donor Setting
As outlined above, the sensitivity of HCV core antigen is inferior to HCV RNA, but superior to no testing. Thus, in a resource limited setting, where HCV RNA testing might be impossible due to cost restrains at present, HCV core antigen testing would allow for a compromise.
Given the cost of organ transplantation, HCV RNA testing cost is unlikely to be a rate limiting step, and therefore not likely to be relevant to organ donation. Still if currently no HCV RNA testing is performed, HCV core antigen might be better than no testing for infectivity.
Gap In Linkage To Care
Unfortunately, many individuals diagnosed with HCV infection do not get linked to appropriate care for their HCV infection. Multiple reasons for the gap in linkage to care have been cited, including failure of the medical provider to make the referral, lack of medical insurance, and substance use or mental health disorders that interfere with making or keeping the referral appointment. Linkage to care rates have been lower among racial and ethnic minorities. Failure to link to care negatively impacts health outcomes in persons living with HCV infection. With highly effective HCV treatment now available for all HCV genotypes, referral for evaluation and management of HCV has taken on even greater importance.
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Positive Hcv Antibody And Negative Hcv Rna
Individuals with a positive HCV antibody test and a negative HCV RNA should be informed they do not have evidence of current hepatitis C infection. It should be explained to the patient that most likely they were infected at some time with HCV, but cleared the infection on their own and they do not have current infection. They do not need further follow-up HCV testing, unless they had recent exposure to HCV. A single negative HCV RNA value does not prove that a patient is not infected, given the potential fluctuations of the viral level early in HCV infection a follow-up HCV RNA level would be indicated depending on the clinical case. Patients should be reevaluated if they have exposure to HCV in the future. In addition, they should receive counseling that prior infection does not make them immune to reinfection with HCV.
Other Hepatitis C Tests
After an individual has received a reactive or positive result from a hepatitis C antibody test, they will need to have two follow-up tests.
The first test checks to see whether a person still has the virus the other measures the amount of the virus in the blood.
The first test is the hep C RNA qualitative test, also known as the PCR test. A positive result means that a person has the hepatitis C virus. A negative result means that the body has cleared the virus without treatment.
The second test is the hep C RNA quantitative test. The result of this test is given as a number rather than a positive or negative. This is because the test compares the amount of the virus in the body before, during, and after treatment.
The number given as a result of this test is known as the viral load. The lower amount of the hepatitis C virus in the blood, the better the chances that a person can eliminate the virus from their body.
After hepatitis C virus is diagnosed, other tests may be needed:
Certain behaviors, experiences, and medical procedures increase the risk of getting the hepatitis C virus, which is transmitted by contact with blood.
The following are risk factors for contracting the virus:
The Centers for Disease Control and Prevention advise all baby boomers get tested for hepatitis C. Baby boomers are people born between 1945 and 1965. They are five times more likely to have the virus than other adults.
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What The Qualitative Results Mean
The qualitative results indicate that HCV is present in your blood. The test result will be either detected or undetected.
Detected means that you do have the virus in your blood. Undetected means that you dont have the virus in your blood, or you have a tiny amount that cant be detected by this test.
The qualitative test results may still be positive even if your viral load has decreased drastically due to treatment.
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