Hepatitis C Viral Load Labcorp

What Other Laboratory Tests Might My Healthcare Practitioner Perform

In addition to tests for hepatitis viruses, your healthcare practitioner may choose to run tests to see how your liver has been affected. These may include a liver panel or individual liver enzyme tests such as aspartate aminotransferase , alanine aminotransferase , and alkaline phosphatase . Your healthcare practitioner may also run a test for bilirubin and a prothrombin time , which can help determine if there is liver damage.

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.

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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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.

• Fatigue
• Loss of appetite, nausea, vomiting
• Dark urine
• Yellowing of eyes and skin

An HCV RNA test is ordered when:

Are These Tests Always Run As A Panel

No. Sometimes, if the particular hepatitis virus a person was exposed to is known, tests specific for that virus may be performed. Also, some of these tests are used for other purposes, such as monitoring the progression of disease or determining if treatment is working, and they may be run singly or in different combinations in those cases. For more about other tests used in viral hepatitis infections, see the individual articles on Hepatitis A Testing, Hepatitis B Testing, and Hepatitis C Testing.

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How Is The Test Used

The various hepatitis C tests have different uses:

If I Have Viral Hepatitis Am I Contagious

You may be contagious it depends on which hepatitis virus you were infected with and the stage of your infection. Often, people with viral hepatitis can spread the infection even though they don’t have symptoms. With hepatitis A, you may be contagious from the time you are infected and continue to be contagious, but less so, for several weeks after symptoms, such as jaundice, develop. A person with hepatitis B is contagious as long as the virus is present in their blood. Anyone who tests positive for the presence of hepatitis C virus should be considered contagious. The HCV RNA test may be performed as follow up to a positive result for anti-HCV.

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Hepatitis C Viral Load / Hcv Rna Quantitative Testing

Hepatitis C

The viral load of hepatitis C refers to the amount of virus present in the bloodstream. The quantitative HCV RNA tests measure the amount of hepatitis C virus in the blood. The result will be an exact number, such as “1,215,422 IU/L.” Many people refer to the quantitative measurement as the hepatitis C “viral load.”

Viral load tests are used to confirm active hepatitis C infection and are used during treatment to help determine response. If you have lower levels of virus in your blood when you start treatment, you may have a better chance of getting rid of the virus.

Hepatitis C Testing For Pharma

Pharmaceutical companies are using our HCV resistance assays to support all phases of research and clinical development for several new HCV compounds. Our phenotypic and genotypic sequencing assays offered to pharmaceutical companies target all the major steps in the HCV replication cycle, including the NS3 protease, NS5A, and the NS5B polymerase. As more compounds reach the clinic, our assays will continue to provide useful information for the incorporation of DAAs into patient management.

For more information about Monograms full line of HIV, HCV, or pharmaceutical services, visit our Pharma Collaborations page.

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Once I Have Been Treated And/or Recovered From Hepatitis C Can I Get Infected Again

Yes. A prior infection with HCV does not protect you from another infectionit does not make you immune to HCV. Most people do not have an effective immune response to the virus. Changes that the virus undergoes as it replicates during an infection make it difficult for the body to fight against the initial or subsequent infections.

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.

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The Results Of My Hepatitis Panel Came Back Negative What Other Conditions Can Cause Similar Symptoms

Hepatitis can be caused by several different factors and conditions such as alcohol, drugs like acetaminophen, or inherited disorders. There are a few other viral infections that may cause similar symptoms, such as cytomegalovirus and Epstein-Barr virus . An autoimmune disease is another possibility your healthcare provider may need to consider if your hepatitis panel is negative. Typically, additional tests will be performed to help determine the cause of your condition.

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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Is There A Way To Prevent Viral Hepatitis

Yes. There is a vaccine available for hepatitis A. It is recommended for all children at age one year and for people who are at an increased risk of exposure to the virus. Hepatitis A can also be prevented with good hygiene. This includes washing hands well after using the bathroom, after changing diapers, and before eating or starting any food preparation.

Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, healthcare practitioners in the U.S. began vaccinating all newborns. Children and adolescents who were not vaccinated at birth are routinely given the series of shots. The Centers for Disease Control and Prevention also recommends that adults in high risk groups get vaccinated. Unless there is something in your medical history to the contrary, it is prudent to get the series of vaccinations.

Currently, there is no vaccine available for hepatitis C, although efforts are ongoing to develop one. Spread of hepatitis C can be prevented by avoiding exposure to blood and body fluids and the sharing of needles or other equipment to inject drugs.

What Is The Treatment For Hcv

There are several drugs that can be used to treat HCV infection. Most commonly, a combination of drugs is used, and new drugs are under development. Before 2000, chronic HCV was curable in only 10% of cases. Now, treatments for HCV can cure over 90% of people with hepatitis C before late complications occur, but even those with advanced liver disease often respond to treatment. This increases the opportunity to intervene early and prevent HCV-associated deaths.

• According to the CDC, recent treatment guidelines recommend monitoring people with acute HCV but only considering treatment if the infection persists longer than 6 months.
• Chronic HCV is usually treated with a combination of drugs.

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Other Tests That May Be Performed To Find Out How Severely Your Liver Has Been Damaged Include:

• Liver biopsy. This surgical procedure may be performed to obtain a sample of liver tissue that can be examined under a microscope.
• Liver fibrosis assay. This is a blood test that can provide information about the extent of liver damage caused by chronic hepatitis C. It can be used to establish a baseline measurement of the health of your liver before you start drug therapy and to monitor the health of your liver after you have completed drug therapy. For people who are at increased risk for complications from a liver biopsy, the liver fibrosis assay is another way to measure the health of the liver.
• Ultrasound exam. This exam may be used to screen for liver cancer.2,3

• How is the hepatitis C virus spread?

  The hepatitis C virus is spread when the blood of an infected person enters the body of a person who is not infected. The most common ways HCV is spread include1,2:

• Injecting drugs, especially if it involves sharing needles or works used to inject illegal drugs. This is the main way HCV is transmitted in the United States.
• Being stuck with a needle or sharp that has HCV-infected blood on it. This is an on-the-job hazard for many health care workers.
• Sharing household items that could have an infected persons blood on them .
• Having sexual contact with a partner who is infected with HCV. This does not happen very often.

A newborn baby also can become infected with HCV if the babys mother has hepatitis C when she gives birth.1,2

What Does The Test Result Mean

Screening and diagnosis

An HCV antibody test is typically reported as “positive” or “negative.”

Results of HCV viral load testing are reported as a number of virus copies present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as “negative” or “not detected.”

Interpretation of the HCV screening and follow-up tests is shown in the table below.

• In general, if your HCV antibody test is positive, then you have likely been infected at some time with hepatitis C.
• If the laboratory reports results as weakly positive, most of these results are false positive and some laboratories will retest your sample with another test before reporting it as positive.
• If your HCV RNA test is positive, then you have a current infection.
• If no HCV viral RNA is detected, then you either do not have an active infection or the virus is present in very low numbers.

Guiding and monitoring treatment

The result of your HCV genotype test identifies which strain of HCV you have and helps guide the selection and the length of your treatment. Treatments may differ depending on a variety of factors, including HCV genotype and the health of your liver.

An HCV viral load can indicate whether or not treatment is effective.

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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.

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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Time For Processing Hcv Ab Test Results

The turnaround time for 3rd-generation EIAs is at least 1 day. Many labs do not perform the tests on site and must send specimens to another lab for processing, which may further increase the turnaround time.

A point-of-care test is also available. The OraQuick® HCV Rapid Antibody Test is an FDA-approved test that can be performed with a fingerstick . It is also a CLIA-waived test and therefore can be used in clinic offices and outreach facilities. Results are reported as reactive or nonreactive within 20 minutes. Just as for the standard HCV Ab test done in the lab, a positive OraQuick® test must be confirmed by an HCV RNA test. The sensitivity and specificity of the test is similar to that of the laboratory-based assays.

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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