Wednesday, September 21, 2022

How Do Doctors Test For Hepatitis C

How Will I Be Tested For Hep C

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There are several blood tests that healthcare professionals can perform to find out if you have hep C, including:

  • The hep C antibody test, which can tell if you’ve ever been infected with the virus.
  • The hep C virus RNA test, which can tell if you have a current infection. RNA is the virus’ genetic material.

How To Find The Right Doctor

Finding the correct doctor to treat hepatitis C first involves a visit to a primary care physician . During this consultation, the PCP will recommend the type of specialist who is most qualified to treat the individual. They can also write a referral.

Gastroenterologists and hepatologists both focus on diagnosing and treating diseases that affect the liver. Due to this, they are well-placed to treat those with significant liver damage from hepatitis C.

Infectious disease specialists can also manage HCV infections. However, although they can treat the disease itself, they may not be able to treat any liver damage.

People who have severe liver damage and need a new liver will likely need treatment from a transplant surgeon.

Before choosing a specific specialist, it is advisable to check:

  • the doctors experience
  • the level of satisfaction of previous patients
  • the doctors ability to answer questions about treatment

Other things that people should consider when choosing a doctor include their insurance coverage and how easily they can travel to the clinic.

Some people might find it helpful to seek information from patient support groups, discussion boards, and social media platforms. These allow individuals to connect with others who have hepatitis C and provide a place to share advice on treatment options.

Diagnosing Hepatitis A B & C

At NYU Langone, hepatologists, or liver specialists, and infectious disease specialists use blood tests to diagnose hepatitis A, B, and C. These viral infections cause inflammation of the liver.

If the results of a blood test confirm a diagnosis of viral hepatitis, your doctor may recommend imaging tests or a liver biopsy to determine the extent of liver disease.

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Hepatitis C Testing And Diagnosis

Doctors will start by checking your blood for:

Anti-HCV antibodies: This blood test is the first — and sometimes only — one you may get. Also called the ELISA screen, it checks for antibodies that your body releases to fight the virus. These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection. Your test will be either negative or positive for antibodies. It usually takes a few days to a week to get results, though a rapid test is available in some places.

What the results mean

Negative . This is when your blood shows no signs of HCV antibodies. Most of the time, thatâs because you never came in contact with the virus and you do not have hep C.

Sometimes, your negative result can be false, meaning you have HCV. That may happen if you:

  • Took the test too soon after your exposure. This test checks for only HCV antibodies, which can take several months to appear.
  • Have HIV, a donated organ, or other conditions that weaken your immune system, which can suppress your antibodies
  • Get hemodialysis for kidney problems

If youâve been exposed in the last 6 months, youâll need to be retested.

Positive . This means youâve been infected with HCV. But false positives are surprisingly common. More than 1 in 5 people who test positive donât actually have hepatitis C. Possible reasons include:

What the results mean

Time For Processing Hcv Ab Test Results

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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.

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How Is Hepatitis C Spread Will My Loved Ones Catch It From Me

Household transmission of hepatitis C is extremely rare. Here are some ways the virus is transmitted:

  • Injecting drugs, such as heroin, even if it’s only once. The needles and other drug “works” that are used to prepare or inject the drug may have had someone else’s blood that contained HCV on them.
  • Being a health care worker with frequent contact with blood on the job, especially from accidental needlesticks.
  • Having a mother who had hepatitis C when she gave birth to you.
  • Sharing items such as razors, toothbrushes, and other personal health items that might have had blood on them.
  • Getting a tattoo with unsanitary instruments, as they might have someone else’s blood on them.
  • Having unprotected sex with multiple partners. Although hepatitis C rarely is spread through sexual contact, it can happen.
  • The number one risk factor for infection and transmission is sharing needles for intravenous drug use. Most people who use IV drugs become infected with HCV within one year of sharing needles. Learn more.

    How Does Hepatitis C Progress

    When someone is first infected with hepatitis C, most likely they have no symptoms and are unaware. Occasionally people experience fatigue, loss of appetite, weakness or sometimes having a yellow color in their skin or eyes. Although having any symptoms at all is rare, if they do occur, they usually go away within a few weeks.

    Around 15-25% of people who are infected will spontaneously fight off the virus on their own and they will not have a chronic hepatitis C infection and no long term damage occurs.

    But around 75-85% of people will develop chronic infection. Most of the time, people with chronic hepatitis C have no symptoms at the time of infection and no symptoms for years or even decades of chronic infection. The virus will be with them until they are successfully treated with hepatitis C medications.

    Around 10-20% of people with chronic infection will slowly have gradual damage in the liver over years and will eventually develop cirrhosis . This can take 20 years or more from the time of the initial infection.

    Cirrhosis is the replacement of liver cells with permanent scar tissue. Cirrhosis can lead to problems such as bleeding from veins in the esophagus, fluid buildup in the belly, and damaged brain function.Approximately 15% of people with cirrhosis will develop liver cancer during their lifetime. Drinking excessively can double the chance of liver cancer in people infected with HCV.

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    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:

  • People you have shared needles with
  • Household members
  • Friends and family members you can count on for support. It’s okay to ask that they keep this information private.
  • You may want to encourage others to be tested for HCV if they have similar risk factors.

    What Does A Reactive Hcv Antibody Test Result Mean

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    A reactive or positive antibody test means you have been infected with the hepatitis C virus at some point in time.

    Once people have been infected, they will always have antibodies in their blood. This is true if they have cleared the virus, have been cured, or still have the virus in their blood.

    A reactive antibody test does not necessarily mean that you currently have hepatitis C and a follow-up test is needed.

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    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.

    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.

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    Can Hepatitis C Be Prevented

    There is no vaccine against hepatitis C. The only way to prevent infection is to avoid contact with infected blood.

    Hepatitis C cannot be spread by coughing, sneezing or sharing eating utensils. People should not be kept away from school, work, or other social settings because they have hepatitis C.

    Here are some precautions that may prevent the spread of hepatitis C:

    • Do not share personal care items, such as toothbrushes or razors, with others.
    • Practice safe sex by using condoms.
    • Dont share needles or syringes.
    • Wear gloves when handling another persons blood.
    • Use sterile equipment for body piercings or tattoos.
    • If you are a healthcare worker, follow recommended safety measures.

    People who are at greater risk for contracting hepatitis C should have their blood tested. The Centers for Disease Control recommends that Americans born between 1945 and 1965 be screened at least once for the disease.

    How Hepatitis C Virus Is Diagnosed

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    Hepatitis C virus is usually diagnosed with blood tests. An antibody test can detect whether your body has had to fight off HCV infection. A blood test which measures the virus in your blood confirms the diagnosis, but results take longer. Sometimes, liver function tests, imaging studies, or a biopsy can support or confirm the diagnosis as well.

    As of March 2020, the U.S. Preventive Services Task Force recommends HCV screening for all adults ages 18 to 79. The CDC also updated their guidelines in April 2020, recommending screening for all adults and pregnant women.

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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.

    How It Is Done

    A health professional uses a needle to take a blood sample, usually from the arm.

    A home test kit is available for hepatitis C . The kit contains a sharp device that you use to take a small sample of blood from your fingertip. The blood sample is then placed on a piece of collection paper and mailed in a prepaid envelope to a lab for testing. Results are ready in 10 days. You’ll get an ID number to use when calling a toll-free number to obtain confidential results. If the results of the test are positive, it’s important for you to make an appointment with your doctor to confirm the test results, find out the amount of damage to your liver, and see if antiviral therapy is an option.

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    How Do I Know If I Have Hepatitis C Virus

    Diagnosis of hepatitis C virus requires a blood test your doctor can order. Other blood tests can determine which subtype of HCV you have to better target your drug treatment, if needed. Your doctor will also want to know your viral load . In some patients, a liver biopsy is required to determine the level of damage.

    Symptoms of chronic HCV may not appear for 2 to 3 decades after infection, so the disease may develop silently in your body for many years. This is the reason you should be tested for HCV infection, to start treatment if needed and to help protect your liver from damage.

    The US Centers for Disease Control and Prevention recommends anyone 18 years or older be tested for hepatitis C virus at least once in their lifetime. Women should be tested for hepatitis C testing during each pregnancy. Some high risk groups may need more frequent testing, such as people who share drug preparation equipment and those on hemodialysis.

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    Being Treated Successfully For Hepatitis C

    How to treat hepatitis C

    I consider myself lucky. While I would be lying to say that the diagnosis didnt cause me stress, I was also aware of how far hepatitis C treatment has come since the first of the new direct-acting antivirals were introduced.

    Today, an ever-widening array of DAAs are delivering cure rates in excess of 90 percent and in as little as eight weeks, according to the CDC.

    While these successes have placed hepatitis C more firmly in the public consciousness, the cost of medications and access to specialists are barriers for many people. For example, a 2017 report by the Center for Health Law and Policy Innovation of Harvard Law School and the National Viral Hepatitis Roundtable noted that many public and private payers choose to limit access to DAAs, in part because of the cost.

    Though initially I had been denied treatment following the review of my first round of tests, I was finally approved following a subsequent ultrasound and officially started on a medication to treat hepatitis C in September 2017. I completed therapy 12 weeks later, and having experienced nothing more than a mild, short-lasting rash no longer have a detectable amount of virus in my blood. The results were maintained for 24 weeks, referred to as a sustained viral response , and Im now considered cured.

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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.

    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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