Thursday, May 19, 2022

How Often Should You Be Tested For Hepatitis C

What The Cdc Recommends

Hepatitis C: Should You Be Tested?

Were you born between 1945 and 1965? If so, then youre a member of the Hepatitis C generation. The CDC recently recommended that all people born between during this time have a 1-time screening test for Hepatitis C. We now have new drugs that can treat and cure Hepatitis C so you should go get tested today.

The life you save may be your own! Please contact your local healthcare provider.

What Does The Test Measure

Hepatitis C testing identifies antibodies to the hepatitis C virus, detects viral RNA, and/or determines the strain of hepatitis C. Hepatitis C testing may involve several different tests:

  • Hepatitis C antibody test: Antibodies are a part of the bodys response to an infection. Testing for hepatitis C antibodies determines whether or not a patient has been exposed to the hepatitis C virus at some point in their life. If this test is positive, the next step is to test for hepatitis C RNA which can tell you if you have a current infection.
  • Hepatitis C RNA test: RNA is a type of genetic material from the hepatitis C virus that can be detected in the blood. If test results are positive after a hepatitis C antibody test, doctors use a hepatitis C RNA test to look for and/or measure the amount of the virus in the blood. Qualitative HCV RNA tests can detect the presence of HCV RNA, while quantitative HCV RNA tests measure the amount of HCV RNA. Understanding the amount of HCV in the blood helps to monitor response to treatment.
  • Genotype test: There are at least six types of hepatitis C, which are also called strains or genotypes. Treatment for hepatitis C depends on the strain, so genotype testing to guide treatment is performed in patients who are diagnosed with an HCV infection.

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.

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If I Have Hepatitis C Infection Does This Mean I Am Going To Have Other Health Problems

Hepatitis C can cause scarring of the liver leading to cirrhosis and liver cancer. Other conditions have also been linked to hepatitis C and are known as extra-hepatic manifestations of hepatitis C. They include diabetes mellitus, arthritis, hypothyroid, and aplastic anemia among other conditions. Talk to your provider for more information.

Baby Boomers Are Especially Vulnerable

How Long Should You Follow

“The hepatitis C virus didn’t have a name or a screening test until in 1989,” Reau says. “That means people born between 1945 and 1965, the group referred to as ‘baby boomers,’ are at highest risk of infection. They grew up before health care facilities started taking standard precautions, like not sharing vials of medicine among patients and requiring staff to wear gloves.”

The CDC reports that baby boomers are five times more likely to have Hepatitis C than other adults, accounting for 75% of those living with the disease.

These are some other reasons you may be at risk:

  • You have engaged in high-risk behaviors like IV drug use or unprotected sex
  • Your biological mother has/had hepatitis C
  • You received blood transfusions, an organ transplant or dialysis before 1989
  • You were or are currently incarcerated

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What Are The Tests For Hepatitis C

There are two blood tests needed to diagnose hepatitis C:

The antibody test–called HCV antibody, HCV Ab, or anti-HCV–is done first. If this test is positive, it means that you have been infected with hepatitis C at some point in the past. If your antibody test is negative, then you have never been infected with hepatitis C if you were infected within the past month or so, the test may not be accurate you may needed to be retested at a later date.

However, a positive antibody test does not tell you if you still have hepatitis C. For that, you need to have a HCV RNA test, which determines whether the virus itself is in the bloodstream.

If any RNA is present in the blood after 6 months from time of infection, then you have chronic hepatitis C.

If no RNA is detected in the blood after 6 months, you no longer have hepatitis C.

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?

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Testing For Hepatitis C

To diagnose a hepatitis C infection, doctors use a hepatitis C antibody test, which is a blood test. The test must have the approval of the Food and Drug Administration .

The hepatitis C antibody can show if a persons body has made any antibodies to HCV. If they have, this indicates that they have had the infection at some point in their lives.

Some people have the infection at some time, but their immune system eliminates the virus after a few months. In others, the body is unable to fight off the virus, leading to chronic hepatitis C infection. Many people will not experience any symptoms until the disease has progressed significantly.

A non-reactive or negative test result will generally indicate that a person does not have HCV. However, if the person has the test during the window period, they could receive inaccurate results.

If the person knows when exposure occurred, a doctor may recommend waiting a few weeks before repeating the test.

A reactive or positive result tells a doctor that the person has had an HCV infection at some point in their lives. The result indicates that their body has created antibodies to fight the virus.

However, this does not mean that a person still has active HCV. Even if their immune system has eliminated the virus, they will still have the antibodies.

How Do I Tell Someone I Have Hepatitis C

What is Hepatitis C and Why Should You Care?

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.

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    Are There Other Reasons For The New Recs

    Yes. A big reason for the re-think is that the number of hep C cases has risen dramatically in recent years, in part due to the opioid epidemic. Public health experts estimate that about one in three people who inject drugs under the age of 30 are infected with hep C, while the majority of older injection drug users are also likely to be infected. These factors convinced infectious disease experts that screening should be widespread and reach a broad age demographic.

    Why Did Screening Recommendations Change

    A lot of it has to do with the treatment for hep C itself. Only a decade ago, treatment options for the disease werent that effective and caused significant side effects. Now, with the development of medications called direct-acting antiviral regimens, treatments for hep C destroy the virus in more than nine out of 10 people. These meds are also easier to tolerate and typically require only 8 to 12 weeks of therapy. Thats been a really remarkable change, Dr. Chou says.

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    Requisitions And Kit Ordering

    < 1.50E+01 IU/mL< 1.00E+03 IU/mLHCV RNA detected below the lower limit of quantitation. Unable to quantify. or 1000 IU/mL .)
    1.50 E+01 to 1.00 E+08 IU/mL1.00 E+03 to 1.00 E+08 IU/mLViral load will be reported in IU/mL.
    > 1.00E+08 IU/mL> 1.00E+08 IU/mLHCV RNA detected above the upper limit of quantitation. Unable to quantify.

    1Based on internal validation studies performed at PHO Laboratory, HCV RNA testing conducted on DBS is less sensitive than venous-collected samples. The lower limit of detection of HCV RNA using two DBS per test is approximately 1.6 to 2.0 logs higher than a concomitantly tested EDTA plasma or serum sample thus, DBS samples should NOT be used to rule out active HCV infection or to determine whether a patient on treatment has achieved an undetectable HCV RNA level.

    No additional sample is usually required for HCV genotyping, provided there is sufficient volume. The first pre-treatment sample submitted for HCV RNA viral load testing will be used to automatically perform HCV genotyping if the HCV viral load is 500 IU/mL. Below this level, HCV genotyping cannot be performed.

    How Does Hepatitis C Progress

    From a Hep C Advocate: My Advice to Anyone Struggling with ...

    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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    Can I Drink Alcohol Once In A While If I Have Hepatitis C

    Alcohol can clearly contribute to worsening liver disease. You must discuss with your health care provider if any amount of alcohol is safe for you.

    Alcohol can cause inflammation and scarring in the liver. If you have any underlying liver condition, such as hepatitis C or hepatitis B or damage from long-term alcohol use, your liver will be more sensitive to alcohol. When you have hepatitis C virus, alcohol on top of the hepatitis C can cause the inflammation and scarring to be worse, and overall damage to the liver may happen much faster when you drink alcohol.

    Here is some helpful information about alcohol and hepatitis:

  • No one knows exactly what amount of alcohol is “safe” when you have hepatitis C. Some small amounts of alcohol may be safe while you have hepatitis C and have mild damage in the liver, but if you have cirrhosis, then no amount of alcohol is safe and you should not drink at all.
  • All forms of alcohol can be damaging. In other words, beer and wine are not “safer” than whiskey.
  • If you have severe scarring , then you should not drink any alcohol at all.
  • If you are awaiting a transplant, you also cannot drink any alcohol at all.
  • What Is Hepatitis C And How Common Is It In The United States

    Hepatitis refers to inflammation of the liver. There are a handful of viral hepatitis types , but hepatitis C is the cause of the majority of serious liver disease in the United States. The hepatitis C virus is spread when blood from a person infected with the virus enters the body of someone whos not infected. There is no vaccine to prevent hepatitis C, which makes early detection so important.

    In the United States, its estimated that between 3 and 5 million people have chronic hepatitis C, and most of those people dont know theyre infected. The majority of people with chronic hepatitis C are from the baby boom generation.

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    How Likely Am I To Become Infected With Hepatitis C From A Family Member Living In The Same House

    Household transmission of hepatitis C is extremely rare. Fewer than 1 in 1,000 family members or close acquaintances becomes infected each year through common, nonsexual contact with hepatitis C-infected persons.

    There are many possible ways by which hepatitis C could be passed from one person to another. Because the virus is carried in the blood, it could be transmitted between household members if a mucous membrane were to come in contact with blood or body fluids containing hepatitis C. Family members sometimes share razors, toothbrushes, or toothpicks, perhaps unknowingly. If an item were contaminated with hepatitis C-infected blood from one person, the virus could be passed to a second person if it were to tear the lining of the mouth or break through the skin.

    Although these sorts of possibilities are often discussed as potential ways for hepatitis C to infect family members, such events occur very rarely.

    If you aren’t sure of your hepatitis C status, get tested. If you test negative and have lived in a household with an infected family member or close acquaintance, you shouldn’t worry that any more contact will put you at risk.

    Management Of Abnormal Alt During Therapy

    Should you be tested for hepatitis?

    Clinically significant hepatotoxicity has been reported with DAA therapy, specifically NS3 protease inhibitors, particularly for patients with advanced liver disease. The AASLD-IDSA HCV Guidance advises against the use of NS3 protease inhibitors in patients with a Child-Turcotte-Pugh score of 7 or greater. Elevations in ALT to greater than 5 times the upper limit of normal occurs in up to 1% of all persons taking elbasvir-grazoprevir therefore, hepatic panel monitoring for persons taking elbasvir-grazoprevir has been recommended by the manufacturer at week 8 and as clinically indicated during therapy . Due to increased risk of hepatotoxicity, coadministration of ethinyl estradiol with glecaprevir-pibrentasvir is not recommended. For individuals who have on-treatment increases in ALT levels at week 4, the AASLD-IDSA HCV Guidance provides the following recommendations based on the severity of the ALT elevation and whether symptoms are present.

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    I Have Hepatitis C And I’m Thinking About Having Children What Should I Know

    Hepatitis C does not prevent a man or woman from having children.

    The hepatitis C virus infection does not cause infertility in either sex–it does not affect a woman’s ovarian or uterine function, or a man’s sperm production or sperm characteristics.

    If you are a woman with hepatitis C, talk to your provider about treatment before pregnancy. Treatment before pregnancy can help reduce the risk of hepatitis C transmission to your baby. If you are already pregnant, treatment will usually take place after pregnancy and you may need to be tested for hepatitis C again prior to starting treatment.

    If you are a man with hepatitis C, talk to your provider about being treated prior to conceiving. Although the risk of transmission during sex is low, it is still important to treat hepatitis C for your personal health.

    Where Can I Get More Information About Hepatitis C

    When ready, you can learn more about hepatitis C from booklets or websites, support groups for people with hepatitis C, or a doctor or nurse.

    For free booklets and other information about hepatitis C,

    For information about services for hepatitis C in Canada,

    • visit the website hcv411.ca
    • visit the Canadian Liver Foundation website liver.ca or call 1-800-563-5483

    For information about dealing with serious problems when people do not respect your rights, visit the website of the Canadian Human Rights Tribunal at chrt-tcdp.gc.ca

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    Whos Most At Risk Of Infection

    The hep C virus is transmitted through blood consequently, one of the most significant risk factors in the U.S. is actively injecting drugs with shared needles or syringes. Even if you dont use drugs anymore, just one shared needle, many years ago, is enough to cause infection. The exposure might have been ancient history, says Michael Barry, M.D., a professor of medicine at Harvard Medical School in Cambridge, MA, and a member of the U.S. Preventive Services Task Force.

    Preparation Prior To Transport

    Hepatitis C

    Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.Place specimen in a biohazard bag and seal. It is recommended to ship specimens for testing to PHO Laboratory immediately after collection or processing to avoid delays in testing. Whole blood that has not been centrifuged must be received at PHO Laboratory within 6 hours of collection, before 2:00 p.m. Monday – Friday. Serum stored at 2°C – 8°C must be shipped with ice packs within 6 days of separation. Frozen serum must be shipped on dry ice.Filter cards containing DBS specimens should be shipped to the PHO Laboratory in individual resealable bags containing a desiccant sachet. When the sample is appropriately prepared, it will be stable at room temperature for 30 days. Do not refrigerate samples. Do not ship on weekends.Shipping of specimens shall be done by TDG certified individuals in accordance with TDG regulations.

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