Screening For Hcv Infection
HCV screening has several potential benefits. By detecting HCV infection early, antiviral treatment can be offered earlier in the course of the disease which is more effective than starting at a later stage. Further, early detection together with counseling and lifestyle modifications may reduce the risk of transmission of HCV infection to other people. The optimal approach to screen for HCV is to test the individuals having risk factors for exposure to the virus. The American Association for the Study of Liver Diseases recommends screening for HCV for the following individuals:
Recipient of blood or blood components .
Recipient of blood from a HCV-positive donor.
Injection drug user .
Persons with following associated conditions
persons with HIV infection,
persons who have ever been on hemodialysis, and
persons with unexplained abnormal aminotransferase levels.
Children born to HCV-infected mothers.
Healthcare workers after a needle stick injury or mucosal exposure to HCV-positive blood.
Current sexual partners of HCV-infected persons.
Noninvasive Testing To Assess Liver Fibrosis
The use of non-invasive tests to assess liver fibrosis is not yet recommended.
Various non-invasive tests are being investigated for staging degree of liver fibrosis. These tests may be used in decisions regarding whether or not to initiate antiviral therapy and to monitor the effects of such therapy. 44 An array of such tests would be highly desirable if adequately validated, since liver biopsy may not be readily available in view of the large number of affected patients with hepatitis C, the risks involved in performing liver biopsies, and the problem of sampling error on biopsy that can underestimate cirrhosis in 10-30% of cases.
Standard liver biochemical tests, measures of liver function such as coagulation studies, and radiological imaging of the liver may be sufficiently sensitive to diagnose advanced cirrhosis but have not been accurate in defining evolving hepatic fibrosis and early stages of cirrhosis.44 A number of studies have been published employing a variety of indirect markers of liver fibrosis including standard liver chemistries, platelet count, prothrombin index, and lipoprotein A1 concentrations. These tests have gained acceptance in Europe as alternatives to liver biopsy.45, 46 However, the utility of these tests requires further validation in prospective studies.
What To Think About
- There is no vaccine to prevent infections with the hepatitis C virus.
- All donated blood and organs are tested for hepatitis C before being used.
- Other tests that show how well the liver is working are usually done if your doctor thinks you may have hepatitis C. These may include blood tests for bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase.
- Aspartate Aminotransferase
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Hepatitis C Is Often Asymptomatic
Offer testing to anyone with a risk factor or clinical indication.
- shared drug-use equipment, even once
- received personal services , with nonsterile equipment
- exposed to blood during sexual activity
- received blood, blood products, or organ transplant before 1992
- received medical care where non-sterile equipment may have been used
- born, travelled, or lived in a region where hepatitis C is common
- born to a mother with hepatitis C
- diagnosis of HIV or hepatitis B
- clinical clues or symptoms of liver disease
- occupational exposure
Antiviral Medication For Hepatitis C
For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease.
Your doctor decides which antiviral medicationor combination of medicationsto prescribe based on the results of a blood test called a genotype test. There are six genotypes, or strains, of the hepatitis C virus, and people with certain genotypes respond more quickly to medical treatment.
For many years, the standard treatment for chronic hepatitis C consisted of the antiviral medications pegylated interferon and ribavirin. Ribavirin is taken by mouth every day, and interferon is an injection that you or a caregiver can administer once a week at home.
In 2013 and 2014, the U.S. Food and Drug Administration approved a group of new medications for the treatment of hepatitis C. These medications, which include sofosbuvir, are very effective and have fewer side effects than older medications, particularly interferon.
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Discussing Screening Results With Clients
The medical personnel who ordered or arranged the screening test, not counselors, usually explain the results. Hepatitis screening should be part of the intake physical examination in an opioid treatment program, and medical personnel may report the results. However, the client may want to discuss the results with the counselor or ask the counselor questions.
Anxiety might interfere with some clients ability to comprehend or retain information, which might need to be repeated.
Suggestions for conversations with clients when the test results are negative include the following:
- Explain results clearly and simply: So the HCV screening result was negative? This means that, as of 6 months ago, you did not have .
- Emphasize that a negative result to an HCV test does not indicate to and that the client should take precautions to avoid . If a relapse to drug use occurs, advise clients to avoid sharing any drug paraphernalia or equipment. Specify that this includes cookers, cotton, water, needles, syringes, pipes, and straws.
- Emphasize the importance of getting HAV and HBV vaccinations. Provide information about the availability of low- or no-cost vaccinations.
Clients whose screening test results are positive for will need additional tests and examinationsusually with doctors who specialize in diseases of the liver to get accurate diagnoses and to determine their health status and the extent of liver damage. These tests are described in .
Interpretation Of Hcv Test Results And Recommended Action
Prior to discussing the HCV test results with the individual who has undergone testing, it is important to interpret the test results and have a plan for communicating the test results and your recommended further action . Individuals who engage in activities, such as injection drug use, that place them at higher risk of acquiring HCV should undergo regular screening for HCV infection.
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Explanation Of Test Results:
If this test result is positive, it means your body was exposed to the hepatitis C virus and made antibodies . However, it does not tell you whether you are still infected with hepatitis C. If the antibody test result is positive, you should be tested for hepatitis C RNA , which determines whether you are chronically infected. The lab will perform this RNA test automatically if your hepatitis C antibody test is positive.
If the antibody test result is negative, it means you have not been infected with the hepatitis C virus, and further testing for hepatitis C usually is not needed.
The Test Is Quick And Easy
A simple blood test can tell if you’ve ever had the virus. The results usually come back in a few days, but some clinics have rapid versions that can be read in as little as 20 minutes. If it comes back negative, but there’s a chance you were exposed in the last 6 months, get tested again.
If the first results are positive, you had hepatitis C at some point. A second test will check to see if the original case cleared up or became chronic . If it’s chronic, you’ll need to see a doctor who specializes in treating the disease.
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Evaluation Of Individuals With Positive Screening Test
Patients with a positive screening test for anti-HCV antibody should be tested for serum HCV RNA. Serum HCV RNA quantifies the amount of viral RNA in serum and indicates ongoing infection. If HCV RNA is detectable, tests should be performed to determine the extent of hepatic fibrosis. These tests typically include liver biopsy or noninvasive measures, such as biochemical markers of fibrosis or transient elastography., An ultrasound of the abdomen should also be performed to identify the possible presence of cirrhosis and focal lesions in the liver suspicious for hepatic malignancy.
Patients who have a positive anti-HCV on a screening test but have no detectable HCV RNA should have a confirmatory HCV RNA test a few months later. If HCV RNA remains undetectable, these individuals should be reassured that they do not have hepatitis C infection and that the anti-HCV may remain persistently positive. Such individuals have either cleared the virus or the true specificity of the test is lower than the reported 100%, and the test result was a false positive.
Identifying Patterns Of Risky Behavior
Screening is an opportunity to draw attention to the clients behaviors that put him or her at risk for contracting :
- Ask for the clients perception of his or her risk for having contracted : How likely do you think it is that the test will be positive?
- Listen for and identify behaviors that put the client at risk for contracting , B, and C and HIV, especially unprotected sex and sharing injection drug paraphernalia.
- Assess the clients alcohol consumption.
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Risk Factors For Hepatitis C
You are at a greater risk of having the hepatitis C virus if you:
- Are a current or former injection drug user
- Received a blood transfusion or organ donation before 1992, or clotting factor replacement therapy before 1987
- Are on dialysis for kidney failure
- Are HIV positive
- Have a mother with hepatitis C
- Have undergone body modification without the use of sterile instruments
- Were born between 1945 and 1965
The Centers for Disease Control and Prevention recommends that anyone born between 1945 and 1965 take a hepatitis C antibody test at least once. If you have never done testing for the hepatitis C virus, our at-home hep C test makes it easy to collect a small sample of blood from the convenience of home and send it to a lab for testing. Our HCV antibody test, sometimes called an anti-HCV test, checks if the infection is present in your body by looking for antibodies released by the immune system in response to the hepatitis C virus.
Who Should Get Tested
You should consider getting tested for hepatitis C if you’re worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
The following groups of people are at an increased risk of hepatitis C:
- ex-drug users and current drug users, particularly users of injected drugs
- people in the UK who received blood transfusions before September 1991
- UK recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high-risk areas include north Africa, the Middle East and central and east Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
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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.
Other Things To Know:
- After a successful course of treatment for hepatitis C, the hepatitis C antibody remains detectable, but the hepatitis C RNA will be undetectable.
- If you plan to donate blood, you will be tested for the hepatitis C antibody and will be turned away even if you do not have an active infection.
- Any patient with a positive test result for the hepatitis C antibody should have additional tests to determine whether or not the virus is still active.
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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.
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.
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.
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This Hepatitis C Screening Test Checks Whether You Test Positive For Hepatitis C
In the event that your test results are positive, an associate from our physician network will contact you directly to discuss your particular case as well as provide information on how to take the next steps to get treatment. We take customer privacy very seriously and will never share your information with a third-party with the exception of the lab we use to test your sample and our physician network.
As is the case with all STD testing – whether through EverlyWell or your doctor â we may be required by law to report positive test results to certain state health departments. This is only done to track infection prevalence. In rare cases you may not receive a definitive result because of early infection or inadequate sampling and repeat testing is suggested. Know where you stand with our at-home Hepatitis C test.
When Should I Test For Hep C
Many people dont feel sick when they first get hep C. If you are exposed to hep C, your body will try and fight the virus for 6 months. 1 in 4 people will clear hep C in those first 6 months.
People who dont clear their hep C will have whats called chronic hep C. You can get tested for hep C straight after you think you have been exposed, but you will need to go back for another test after 12 weeks and possibly again at 6 months.
You might be able to access testing and healthcare via your computer or phone.
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Letsgetchecked Hepatitis B And C Test
- Price: $$
- Pros: tests for both hepatitis B and C, includes option to speak with a nurse if you test positive
- Cons: no option to test for hepatitis C only
If you want to buy a hepatitis C test from LetsGetChecked, you have to buy the hepatitis B and C testing bundle.
The hepatitis B surface antigen test checks for hepatitis B specific antigens and antibodies in the blood. A positive test means you can transmit the virus, but it cant tell you if you have a chronic or acute infection.
Additionally, a negative test will only tell you that youre not currently contagious. You can test negative and still have hepatitis B. LetsGetChecked doesnt include this info on the product page.
Testing for hepatitis C involves an HCV antibody test. Youll need additional testing if you test positive for HCV antibodies.
Tests from LetsGetChecked should be safe and accurate when used as directed. Still, you should talk with your doctor about your results.
Both the hepatitis B and C tests involve taking a finger prick sample. You can take the sample in the morning and send it back the same day.
Results should arrive within 2 to 5 business days. If either test returns a positive result, a nurse will get in touch to go over what this means. However, we recommend also going over your results with your doctor.
- Pros: includes comprehensive STI testing
- Cons: not available in all states, some customer service complaints
You can use an FSA or HSA account to pay for the test, or pay out of pocket.