How To Test For Hep C
If you suspect you may have a hepatitis C infection, taking a hepatitis C test can be a great start in addition to consulting your healthcare provider for next steps. Our at-home hepatitis C test is a convenient way to check for this virus. To check for hepatitis C with this test, you just collect a small sample of blood with a simple finger prick, then ship the sample to a lab for testing with the prepaid shipping label that comes with the kit.
If your results from our hepatitis C test indicate that you do have this viral infection, share your results with your healthcare provider right away so you can take the next steps they recommend.
Can I Take The Test At Home
At-home hepatitis C tests are available that allow patients to collect a blood sample at home and mail it to a laboratory for testing. Test samples are collected through pricking a finger with a sharp object, called a lancet, thats included in the test kit.
At-home HCV testing is a form of hepatitis C antibody testing and does not test for hepatitis C RNA or the strains genotype. Testing for hepatitis C at home is not a substitute for testing performed by a health care professional, and positive test results may need to be confirmed by laboratory-based testing.
Poor Infection Control For Tattooing And Piercing
The notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.
Commercially licensed tattooing and piercing businesses are generally thought to be safe.
More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a of HCV transmission
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How Do My Healthcare Professional And I Decide On Treatment
Your healthcare professional will look at your health history and decide if treatment is right for you. The treatment you receive and the length of treatment may depend on:
- how much virus is in your body
- your genotype of hep C
- whether you have liver damage
- whether or not youve been treated previously
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
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Is There Anything Else I Should Know
Hepatitis A vaccines are effective even when administered up to 15 days after exposure to the virus. Infants, immunocompromised people, people with chronic liver disease, or adults over 40 may be given an injection of immune globulin instead of the vaccine for post-exposure protection.
Although hepatitis A IgM antibodies are considered diagnostic for acute infection with hepatitis A, there has been increasing use of the test in people who do not have signs and symptoms of acute hepatitis. The Centers for Disease Control and Prevention have recommended that the test only be used for persons who clinically have acute hepatitis to decrease the possibility of falsely positive results.
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.
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Is There A Hepatitis C Vaccine
Prevention truly is your best medicine for hepatitis C because unlike its cousins, hepatitis A and B, hepatitis C has no vaccine. Thats not for lack of trying: There are currently clinical trials underway to find a vaccine, and in a study published last year in Science Advances, scientists at the Scripps Research Institute in La Jolla, California, showed proof of concept for the development of a vaccine. But despite this progress, not every expert is convinced a vaccine is in the near offing. There are people who have tried to make a hepatitis C vaccine for 20 years and couldnt do it, says Dr. Dieterich. This is a virus that mutates a lot.
In other words, going on the offense with a commitment to healthy behaviors is going to be your best defense against hepatitis C. You can set yourself up for a healthy future, too, by taking advantage of the May 19 National Hepatitis Testing Day and getting yourself checked. Remember, the disease is curablebut only if you know you have it. Go get tested for free today: You literally have nothing to lose.
Lagging on important health checkups? Let this Checklist of Annual Physical Exams for Women be your cheat sheet.
Can This Test Be Done At My Healthcare Practitioners Office
Maybe. There are rapid HCV antibody tests available that can be done at the point of care , in settings such as your healthcare practitioners office, community health clinics, and emergency rooms. They provide results in about 20 minutes. However, a positive result requires confirmation of active disease with an HCV RNA test, which is performed in a laboratory.
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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.
Recommended Method For Monitoring Of Treatment Efficacy
The optimal and standard approach to monitoring for treatment efficacy consists of repeated measurement of quantitative HCV RNA levels. Monitoring requires use of a highly sensitive quantitative HCV RNA assay, typically with a lower limit of quantification in the range of 12 to 25 IU/mL. In addition, to minimize interassay and interlaboratory variation, monitoring should ideally utilize the same HCV RNA assay performed by the same laboratory. Three commercially available HCV RNA assays are widely used in the United States: Roche COBAS TaqMan Version 1.0, Roche COBAS TaqMan Version 2.0, and the Abbott RealTime HCV assay. The following definitions related to HCV RNA assay results are used in clinical practice and in research studies :
- Lower Limit of Quantification : This is the lowest HCV RNA concentration that is within the validated range the assay can accurately quantify. If HCV RNA is not quantifiable, the result is either HCV RNA detected but below the LLOQ or HCV RNA not detected. Note that the lower limit of quantification is not the same as the lower limit of detection.
- Limit of Detection : This value is the concentration of HCV RNA detectable at a rate of at least 95%. The ability of the assay to detect HCV RNA gradually decreases as the actual amount of HCV RNA in the sample approaches 0 IU/mL. The result below the limit of detection is referred to as undetectable.
- Target Detected : The HCV RNA is detected.
- Target Not Detected : The HCV RNA is not detected.
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Other Tests For Diagnosing Hepatitis C
Before recommending a treatment plan, your doctor will likely conduct other tests. The six major strains, or genotypes, of HCV respond differently to different treatments, so your doctor will conduct another blood test that determines your HCV genotype.
You can be infected with more than one genotype at a time. Genotypes 1, 2, and 3 are the most common in the United States.
The Cost Of Hepatitis C Treatment
Though all of these drugs have been hailed as major medical breakthroughs, much of the discussion around them has focused on their exorbitant price tags. When sofosbuvir was released, it made news because a 12-week round of treatment came in at a total of $84,000. Harvoni cost even more $94,500 for a 12-week course, though some patients may be cured after only eight weeks, or $63,000. Gileads newer offering, Epclusa, goes for just over $74,000. The gamechanger in the market may be Mavyret, which costs $26,500 for treatment. As of January 2019, there are also of some of these drugs available at lower prices.
There have been many arguments about whether these prices may be justified if they actually do provide a permanent cure. Patients with hep C who are not cured often go on to need far more expensive care. One study estimated that yearly care for an HCV patient without liver damage is approximately $5,800. This goes up to over $27,000 each year for an HCV patient with decompensated cirrhosis of the liver, over $43,000 a year for an HCV patient with liver cancer, and over $93,000 a year for a patient who has had a liver transplant.
In the long term, it is likely cheaper for insurers to pay for treatment with a DAA than to wait and pay for ongoing care once the patient gets sicker. Moreover, curing those who have been diagnosed would also prevent the virus from spreading further, which could in turn keep future costs down.
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Contaminated Needles And Infected Blood
You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.
Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.
You can prevent hepatitis C by:
- never sharing needles and syringes or other items that may be contaminated with infected blood
- only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
- following the standard infection control precautions, if youre working in a healthcare setting.
How To Get Tested
Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.
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How Do You Get Tested For Hepatitis C
Several testing procedures are available to accurately diagnose hepatitis C infection.
Hepatitis C, an inflammation of the liver caused by the hepatitis C virus , often goes undiagnosed until serious liver problems develop decades after contracting the virus. This is because the illness is asymptomatic for most people, according to the Centers for Disease Control and Prevention .
For these asymptomatic people, hepatitis C is generally detected when blood screenings show they are HCV-positive, or routine examinations show they have elevated levels of the liver enzyme alanine aminotransferase , an indication of liver cell damage.
What Do You Do If You Become Ill
Talk to your health care provider about getting tested if you think you:
- are at risk
- may have hepatitis C
If you have hepatitis C, tell those who may have been exposed to your blood or bodily fluids. They should get tested and be treated if necessary. Bodily fluids, like semen and vaginal fluid, are a concern because they could be carrying small amounts of infected blood.
Some adults with hepatitis C will recover from the disease on their own within 6 months. Until your health care provider confirms your recovery status, you are still contagious and can spread the disease.
After recovery, you are no longer contagious because you will not have the disease anymore. But you can get hepatitis C again.
Unfortunately, most adults with hepatitis C:
- cannot recover on their own
- develop a more serious form of the disease if they are sick for longer than 6 months
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Testing Procedures And Costs
The test for HCV antibodies, as well as follow-up blood tests, can be done in most labs that perform routine blood work.
A regular blood sample will be taken and analyzed. No special steps, such as fasting, are needed on your part.
Many insurance companies cover hepatitis C testing, but check with your insurer first to be sure.
Many communities offer free or low-cost testing, too. Check with your doctors office or local hospital to find out whats available near you.
Testing for hepatitis C is simple and no more painful than any other blood test.
But if youre at risk for the disease or think you may have been exposed to the virus, getting tested and starting treatment if necessary can help prevent serious health problems for years to come.
CDC recommends that all adults ages 18 years and older should be screened for hepatitis C except in settings where the prevalence of HCV infection is less than 0.1%.
Also, all pregnant women should be screened during each pregnancy, except in setting where the prevalence of HCV infection is less than 0.1%.
Hepatitis C is often associated with sharing needles . But there are other methods of transmission.
For example, healthcare workers who are regularly exposed to other peoples blood are at higher risk for contracting the virus.
Getting a tattoo from an unlicensed tattoo artist or facility where needles may not be properly sterilized also increases the risk of transmission.
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 you’ve 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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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.
What Your Hepatitis C Diagnosis Means
Hepatitis C is a viral infection that results in chronicinflammation of the liver. Its spread when blood from an infected personenters the bloodstream of an uninfected person. But, it doesnt always resultin symptoms right away.
Doctors use a blood test called the hepatitis C antibody test to screen for the infection. If your results come back positive on this test, thats not a diagnosis. That just means youve been exposed to the virus at some point.
A follow up test, called the hepatitis C virus RNA PCR test,can confirm whether the infection is active.
In some people, the infection goes away on its own. In otherpeople, it progresses and scar tissue develops on the liver a process calledfibrosis.
Scarring, of course, is not good. It makes it difficult for the liver to do its many jobs, which include metabolizing proteins filtering the blood and breaking down, storing and releasing carbohydrates into the bloodstream.
Over time, scarring can lead to cirrhosis, liver cancer or the development of enlarged veins in the esophagus, called portal hypertension.
Only a subset of patients will develop scarring orcirrhosis, Dr. Lindenmeyer says. Theres another subset of patients who willcontinue to have the infection but will never develop the scar tissue in theirliver.
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