Who Should Get A Hepatitis C Screening
If youre under 18, you may or may not need a parents or guardians consent to get tested. State laws on minor consent for medical care vary. If youve been exposed to hepatitis C or feel that you need a test for any reason, dont let your age stop you from getting the medical help you need.
If left untreated, hepatitis C can have serious consequences for your health. If you test positive, you can also pass the virus onto others.
The recommends universal hepatitis C screening for:
- all adults aged 18 and over
- pregnant people
How Do I Tell Someone I Have Hepatitis C
Informing someone that you have hepatitis C can be hard. Most people know little about this disease. You can start with how you found out about your diagnosis. It helps to be prepared with educational materials on HCV, and to be aware of the ways that people can and cannot be infected. For example, it is very rare for HCV to be transmitted during sex. Be sure to tell anyone who may be directly affected, such as:
You may want to encourage others to be tested for HCV if they have similar risk factors.
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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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.
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.
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Is It Necessary To Do Genotyping When Managing A Person With Chronic Hepatitis C
Yes, as there are 6 known genotypes and more than 50 subtypes of HCV, and genotype information is helpful in defining the epidemiology of hepatitis C. Knowing the genotype or serotype of HCV is helpful in making recommendations and counseling regarding therapy. Based on your genotype, the length of treatment, as well as the combination of medication will be determined. The good new now, is that the current HCV therapies are “pan-genotypic”, meaning they work equally well with all of the genotypes. This is great news.27. What is the risk for HCV infection from a needle-stick exposure to HCV contaminated blood?
After needle stick or sharps exposure to HCV positive blood , about 2 healthcare workers out of 100 will get infected with HCV.
Reflexive Hcv Rna Testing With Positive Initial Hcv Eia
The CDC encourages setting up a procedure whereby samples that test positive with a laboratory-conducted HCV antibody assay would then undergo reflexive HCV RNA testing, using the same patient blood sample. Many laboratories now offer reflexive HCV RNA testing on HCV antibody-positive samples. The reflexive testing approach is more efficient than other approaches for follow-up HCV RNA testing that include collecting two separate venipuncture samples at the initial blood draw , or having the patient return for another venipuncture after receiving a positive antibody test result. From a practical standpoint, it is clearly preferable to have the laboratory reflexively perform the HCV RNA testing for positive HCV EIA tests utilizing the same blood sample.
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What Are The Side Effects Of Treatment
The direct acting antiviral regimens used to treat hepatitis C today are extremely well tolerated. You may experience mild side effects like headache or fatigue. For details on the side effects, review the handout specific to medication you take.
In rare instances, providers may recommend the addition of the medication ribavirin for more difficult cases of hepatitis C. Ribavirin may cause additional side effects such as fatigue, shortness of breath, cough, anemia, or rash. Patients who receive ribavirin may need more frequent monitoring for side effects as well as adjustment of the dose if side effects are experienced. For detailed information on ribavirin, patients should review the ribavirin handout.
Can The Results Of Liver Panel Tests Point To The Presence Of Hepatitis C
A “liver panel” usually includes tests called AST, ALT, bilirubin, alkaline phosphatase, and some others. Abnormal results could show up in many different conditions, not just hepatitis C. And even if the results of a liver panel are normal, you might still have hepatitis C. So, the liver panel alone cannot tell your provider the answer.
Hepatitis C can be diagnosed only by blood tests that are specific to hepatitis C:
In short, if the results of one or more tests on a liver panel are abnormal, generally speaking, the tests should be repeated and confirmed. If the results remain abnormal, your provider should be prompted to look for the cause.
More important than using the liver panel, if you have risks of having been infected with hepatitis C then you should have the specific hepatitis C antibody test to determine if you have hepatitis C infection.
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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.
What Is The Risk That Hcv Infected Women Will Spread Hcv To Their Newborn Infants
About 5 out of every 100 infants born to HCV infected women become infected. This occurs at the time of birth, and there is no treatment that can prevent this from happening. Most infants infected with HCV at the time of birth have no symptoms and do well during childhood. More studies are needed to find out if these children will have problems from the infection as they grow older. There are no treatments or guidelines for the treatment of infants or children infected with HCV. Children with elevated ALT levels should be referred for evaluation to a specialist familiar with the management of children with HCV-related disease.
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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.
Nat: Detection Of Hcv Rna
Molecular virological techniques play a key role in diagnosis and monitoring of treatment for HCV. Because it is difficult to cultivate the virus in cell culture, molecular techniques were instrumental in first identifying HCV, making it one of the first pathogens to be identified by purely molecular methods. NAT is considered the gold standard for detecting active HCV replication. HCV NAT is extremely useful in establishing the diagnosis of acute HCV infection, since RNA is detectable as early as 1 week after exposure via needle-stick or blood transfusion, and at least 4-6 weeks prior to seroconversion as demonstrated in a number of transmission settings. The diagnosis of HCV infection is established with antibody screening followed by NAT for HCV RNA for confirmation as well as for follow-up of patients on treatment. Viral load assessment at baseline is also critical for determining response kinetics during therapy. enumerates the role of NAT in HCV diagnosis.
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How Can A Person Protect Themselves From Getting Hepatitis C And Other Diseases Spread By Contact With Human Blood
Don’t ever shoot drugs. Intranasal is also a risk factor. If you shoot or inhale drugs, stop and get into a treatment program. If you can’t stop, never reuse or share syringes, water, or drug works, and get vaccinated against hepatitis A and hepatitis B.
Do not share toothbrushes, razors, or other personal care articles. They might have blood on them.
If you are a healthcare worker, always follow routine barrier precautions and safely handle needles and other sharps. Get vaccinated against hepatitis B
Consider the health risks if you are thinking about getting a tattoo or body piercing: You can get infected if:
the tools that are used have someone else’s blood on them.
the artist or piercer doesn’t follow good health practices, such as washing hands and using disposable gloves.
HCV can be spread by sex, but this does not occur very often. If you are having sex, but not with one steady partner:
You and your partners can get other diseases spread by having sex .
You should use latex condoms correctly and every time. The efficacy of latex condoms in preventing infection with HCV is unknown, but their proper use may reduce transmission.
You should get vaccinated against hepatitis B.
When Should I Get Hepatitis C Testing
When used for early detection in patients without symptoms of hepatitis C, screening is recommended at least once for all adults aged 18 years or older, except in locations with very low prevalence of HCV. Screening is also recommended during pregnancy and for patients of any age with risk factors for HCV infection. In patients with risk factors, periodic screening is recommended for as long as risk factors persist.
Risk factors for HCV include:
- Current or past injectable drug use
- Having a blood transfusion or organ transplant before July 1992
- Receiving kidney dialysis
- Pain in the abdomen or joints
- Nausea, vomiting, or loss of appetite
- Jaundice or yellowish skin and eyes
Hepatitis C testing may also be performed when liver tests are abnormal or when diagnosing the cause of existing liver damage.
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Are There Supplements That Are Good For My Liver
If a person eats a balanced diet, they will normally get enough vitamins and minerals. People with liver disease should avoid taking large amounts of supplements or mega-vitamins. This is because the liver has to do extra work to process them. Your provider may put you on a general multivitamin without iron.
Who Can Be Treated For Hepatitis C
Treatment decisions should be made by both you and your provider. Current treatments for hepatitis C are very successful and can cure most people of the virus.
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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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Who Should Get Tested For Hepatitis C
The CDC recommends that you get tested at least once no matter what. Definitely get screened if any of these things apply to you:
- You were born between 1945 and 1965.
- You use or inject drugs.
- You have ever injected drugs — even if it was just once or a long time ago.
- Youâre on kidney dialysis.
- You have abnormal alanine aminotransferase levels .
- You had a blood transfusion, blood components, or an organ transplant before July 1992.
- Youâve ever gotten clotting factor concentrates made before 1987.
- You received blood from a donor who later tested positive for hepatitis C virus.
- Youâre a health care worker, first responder, or have another job that exposes you to HCV-infected needles.
- You were born to a mother with HCV.
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How Much Does The Test Cost
The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.
For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.
At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.
What Other Information Should Patients With Hepatitis C Be Aware Of
Sneezing, hugging, coughing, food or water does not spread HCV nor does sharing eating utensils or drinking glasses, or casual contact.
Persons should not be excluded from work, school, play, child-care or other settings on the basis of their HCV infection status.
Involvement with a support group may help patients cope with hepatitis C.
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What Are The Recommendations For Follow
Anti-viral agents or immune globulin should not be used for postexposure prophylaxis.
For the source, baseline testing for anti-HCV.
For the person exposed to an HCV-positive source, baseline and follow-up testing including baseline testing for anti-HCV and ALT activity and follow-up testing for anti-HCV and ALT activity.
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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