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.
Tests For Hiv Hepatitis A And B
These are tests to determine if you have been exposed to other viruses that can cause or worsen liver disease. Vaccines for hepatitis A and B are recommended for all unvaccinated patients with hepatitis C. A positive test result for hepatitis A and B may indicate you were previously exposed or vaccinated and the results should be interpreted by your provider.
A positive test result for HIV indicates exposure to the HIV virus and requires referral to an infectious disease specialist. HIV is treatable and should be treated before HCV treatment can be provided. Hepatitis C treatments are as effective in patients with HIV as they are in patients without HIV.
How Hepatitis C Is Diagnosed
To determine a hepatitis C diagnosis, your doctor will:
- Get your medical history .
- Perform a physical exam, especially checking for changes in skin color, swelling in your lower extremities, and tenderness in your abdomen.
- Order certain diagnostic blood tests.
The first diagnostic tool in the screening process is a blood test that screens for HCV antibodies proteins the body produces in response to the virus. An enzyme immunoassay is used to perform this test.
A negative result for the antibody test means that youve never had HCV in your blood, while a positive result means you were exposed to the virus at some point in your life. Up to a quarter of people spontaneously clear the virus from their blood within six months of contracting it.
Because EIA sometimes produces false-positive results, a test called recombinant immunoblot assay may be used to confirm that you have the HCV antibody. This test is not necessary for most patients, and it is more commonly performed by blood banks to check for the virus in donated blood.
A negative EIA result may just mean that your body has not yet produced the HCV antibody , and you may need to be tested again in a few months.
If you have a positive antibody test, your doctor will then use another blood sample to conduct a qualitative polymerase chain reaction test or a process called transcription-mediated amplification , which looks for the presence or absence of RNA of HCV in your blood.
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Hcv Rna Detection And Quantification From Dbs
All DBS were tested for HCV RNA using 2 quantitative real-time PCR assays, the CAP/CTM and the m2000 platform. None of the individuals from group A had detectable HCV RNA in whole-blood specimens from DBS. Specificity was thus 100% . HCV RNA was also undetectable in patients from group B.
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A, Individual differences between hepatitis C virus RNA levels measured in whole-blood specimens from dried blood spots stored at 80°C and those from DBS stored at room temperature for a mean duration of 19 ± 1 months, using the m2000 platform, ranked in increasing order for the 25 samples. B, Difference in HCV core antigen levels between whole-blood specimens from DBS and stored for a mean duration of 19 ± 1 months at 80°C or at room temperature .
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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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?
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.
Antibody 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.
PCR test
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Screening Strategies In A Low
Our study was integrated in an established population-based survey with repeated health surveys since 1974. The attendance rate was 64.3% and the estimated cost per newly detected chronic HCV infection was approximately NOK 90000 . HCV-screening of the general population outside such an established population survey would have been more laborious and at an expected considerably higher costs, thus making it less feasible. As discussed above, it is likely that persons belonging to risk groups for HCV infection attended the study to a lesser degree than the general population, reducing the efficiency of such an approach. On the other hand, the study has unmasked several individuals with chronic HCV infection that did not define themselves as belonging to known risk groups. A recent Spanish pilot study for an eventual population-based screening program included the adult population in a small health area with a participation rate of 46.2% . HCV RNA was detected in 13 persons , of whom five were unaware of the disease.
In low-prevalence countries, routine screening of the entire population has not been considered to be cost-effective , and screening are limited to high-risk populations. However, the high proportion of undiagnosed HCV infection clearly underscores the limitations of the risk-based screening approach and the need to reconsider screening strategies in order to achieve the diagnosis rate of 90% promoted by the WHO.
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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How Is The Test Used
The various hepatitis C tests have different uses:
The HCV antibody test may be performed as part of an acute viral hepatitis panelto determine which of the most common hepatitis viruses is causing your symptoms.
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When Is It Ordered
The CDC, the Infectious Diseases Society of America , the American Association of the Study of Liver Diseases , and the U.S. Preventive Services Task Force recommend screening with an HCV antibody test at least once in your lifetime when you are 18 years old or older . The CDC also recommends HCV screening for women with each pregnancy or for anyone who requests it.
One-time screening is recommended regardless of age if you:
- Have ever injected illegal drugs
- Received a blood transfusion or organ transplant before July 1992*
- Have received clotting factor concentrates produced before 1987
- Were ever on long-term dialysis
- Are a child born to HCV-positive women
- Have been exposed to the blood of someone with hepatitis C
- Are a healthcare, emergency medicine, or public safety worker who had needlesticks, sharps, or mucosal exposure to HCV-positive blood
- Have evidence of chronic liver disease
- Have HIVabout 21% of those with HIV are also infected with HCV .
*The blood supply has been monitored in the U.S. since 1992, and any units of blood that test positive for HCV are rejected for use in another person. The current risk of HCV infection from transfused blood is about one case per two million transfused units.
Screening at regular intervals is recommended if you have ongoing risk of HCV infection, such as current injection drug use and sharing needles or syringes.
- Yellowing of eyes and skin
An HCV RNA test is ordered when:
All Adults Pregnant Women And People With Risk Factors Should Get Tested For Hepatitis C
Most people who get infected with hepatitis C virus develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
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Prevalence Of Hepatitis C
Figure shows a flowchart of the study with associated results. The anti-HCV screening test was positive in 217 of 20,946 individuals. The follow-up test was negative for anti-HCV and/or RIBA in 83 samples. Thus, the prevalence of confirmed anti-HCV was 0.6% , with a sex distribution of 71 men and 63 women. HCV RNA was detected in 33 of 20,946 participants, 18 male . Of these viraemic cases, 13 were not aware of their infection. Two of the 33 persons with current positive HCV RNA reported that they had received antiviral treatment earlier, one of whom had interrupted the treatment before scheduled treatment-end and was considered to be a treatment failure. The second person did not meet for clinical follow up, rendering it unclear whether the vireaemia represents reinfection or treatment failure. Overall, current or treatment-recovered HCV infection was found in 85 of 20,946 individuals, 48 men and 37 women. Of those, 52 had previously received antiviral treatment with achieved SVR.
Fig. 1
The Quantitative Hcv Rna Test Is Checked Before A Patient Starts Treatment
For each patient, the result can be described as either a “high” viral load, which is usually > 800,000 IU/L, or a “low” viral load, which is usually < 800,000 IU/L. It’s not uncommon to have a viral load in the millions. Today’s hepatitis C treatments are very effective with both high and low viral loads. An undetectable HCV viral load 10-12 weeks after hepatitis C is completed is associated with a cure.
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Hepatitis C Reflex Testing
To ensure complete and timely diagnosis of HCV, HCV reflex testing is recommended following a reactive hepatitis C antibody screening test. Reflex testing means the laboratory will perform the hepatitis C antibody test, and if the result is positive, the laboratory will immediately perform an HCV RNA test on the same specimen. If the subsequent HCV RNA test is negative, HCV infection is effectively ruled out for most patients. If the reflex HCV RNA test is positive, a diagnosis of active HCV infection has been confirmed, and the individual should be referred directly for HCV care and treatment.
Reflex testing obviates the need for the patient to return for follow-up testing should the initially HCV antibody test be reactive. If the RNA test is negative, the work-up is done, and the patient may be reassured.
- Rationale for reflex testing:
What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
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Clinical Features And Natural History
Persons with acute HCV infection are typically either asymptomatic or have a mild clinical illness like that of other types of viral hepatitis . Jaundice might occur in 20%30% of persons, and nonspecific symptoms might be present in 10%20% of persons. Fulminant hepatic failure following acute hepatitis C is rare. The average time from exposure to symptom onset is 212 weeks . HCV antibodies can be detected 410 weeks after infection and are present in approximately 97% of persons by 6 months after exposure. HCV RNA can be detected as early as 12 weeks after exposure. The presence of HCV RNA indicates current infection .