How To Diagnose Hepatitis C

Testing For Hcv Infection

The recommendations for testing are derived from published evidence and expert opinions.22,23 There are many options for HCV testing and, as newer diagnostic technologies are introduced, HCV testing should become more streamlined. Also, some providers will have limited choices for testing because of laboratory testing protocols and reimbursement issues. Providers are advised to consult with their laboratories for information regarding available tests and testing protocols.

Recommendations

All patients suspected of having infection with HCV should be tested for antibody to HCV using an EIA screening test. In low-risk patients with a positive EIA test, confirmatory testing with the recombinant immunoblot assay should be performed. For patients at low risk with a positive EIA and RIBA, confirmatory testing with a qualitative PCR test for detection of HCV RNA should be performed.

For patients at moderate or high risk and/ or unexplained elevated serum alanine aminotransferase value, a positive EIA should be followed by a qualitative test for HCV RNA in the blood.

For immunocompromised patients at high risk with unexplained elevated ALT value and a negative screening EIA, a qualitative test for detection of HCV RNA should be performed to diagnose HCV infection.

How Do You Get Hepatitis C

Hepatitis C spreads when blood or body fluids contaminated with the hepatitis C virus get into your bloodstream through contact with an infected person.

You can be exposed to the virus from:

• Sharing injection drugs and needles
• Having sex, especially if you have HIV, another STD, several partners, or have rough sex
• Being stuck by infected needles
• Birth — a mother can pass it to a child
• Sharing personal care items like toothbrushes, razor blades, and nail clippers
• Getting a tattoo or piercing with unclean equipment

You canât catch hepatitis C through:

• Breastfeeding
• Casual contact

• Have been on long-term kidney dialysis
• Have abnormal liver tests or liver disease
• Have HIV
• Were born to a mother with hepatitis C

Since July 1992, all blood and organ donations in the U.S. are tested for the hepatitis C virus. The CDC says it is now rare that someone getting blood products or an organ would get hepatitis C. That said, The CDC recommends that anyone over the age of 18 get tested for Hepatitis C. If you haven’t been screened, you should consider having it done.

Learn more about the risk factors for hepatitis C.

Contaminated Strawberries Linked To Hepatitis Outbreak Fda Says

Contaminated strawberries are the likely cause of a hepatitis A outbreak in the U.S. and Canada, the U.S. Food and Drug Administration announced Saturday .

The potentially tainted strawberries were sold under the brands FreshKampo and HEB and were purchased between March 5 and April 25, 2022, in the U.S. .)

U.S. stores that sold the berries included Aldi, HEB, Kroger, Safeway, Trader Joe’s and Walmart, among others. The potentially affected berries are now past their shelf life, but if any consumers froze the berries for later consumption, they should not eat them, the FDA warns. “If you are unsure of what brand you purchased, when you purchased your strawberries, or where you purchased them from prior to freezing them, the strawberries should be thrown away,” the agency advised.

The FDA has teamed up with the Centers for Disease Control and Prevention , the Public Health Agency of Canada and the Canadian Food Inspection Agency to investigate the hepatitis cases further and determine if any other contaminated products may have contributed to the outbreak.

Related: How do you die from hepatitis A?

Hepatitis infections cause inflammation of the liver, and in the most severe cases, this inflammation can result in liver failure and death, according to the FDA . Hepatitis A is specifically caused by the hepatitis A virus, which can spread through close person-to-person contact or via contaminated food and water, according to the CDC .

Originally published on Live Science.

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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 patientâs 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.

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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What To Do If You Have Hepatitis A Symptoms

If you have been exposed to hepatitis A and show the symptoms above, you need to contact your doctor and/or your local health department as soon as you can, according to the CDC. Once you get to see your doctor, they will run a blood test to confirm the infection diagnosis. Typically, health professionals want to see a patient within two weeks of viral exposure.

The two-week window is important because doctors can help treat hepatitis A with a single dose of the viral vaccine. But treatment only works within the first two weeks of exposure/infection.

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Early Diagnosis Prevents Disease Spread

The longer you wait before treatment, the greater the odds of permanent liver damage. If liver damage goes unchecked for too long , it can lead to serious problems throughout the body, including bleeding in the digestive tract, trouble absorbing nutrients from food, memory problems, and even type 2 diabetes.

Also, the longer you live with hepatitis C before being diagnosed, the greater the chance you may unknowingly spread it to other people. HCV is transmitted through the blood, so while its not as easy to catch as, say, the flu, it can be spread from person to person in a household.

If you share toothbrushes or razors, for example, you could inadvertently transfer it and not know, Dr. Fontana says. Sexual transmission is also possible, so you would want to use some form of barrier contraceptionlike condoms , diaphragms, cervical caps, and contraceptive spongesor wait until youve been treated.

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Strategies For Improving Linkage To Care

Attempts at the public health level to implement an HCV testing and linkage-to-care program have shown that additional funds can be used to leverage existing program and provider networks. The CDC and other organizations are actively working to explore strategies, such as the Hepatitis Testing and Linkage to Care initiative, to enhance linkage to care for persons infected with HCV. It should also be noted that patients who have been previously diagnosed many years ago in the interferon era may have been counseled to not seek treatment given the relatively poor efficacy, long duration, and high rate of adverse effects associated with interferon-based therapy. These patients may require more intensive outreach efforts to educate and update on new greatly improved medications that are now available.

Hepatitis C Symptoms & Treatment

FAST FACTS:

• Hepatitis C is found in infected blood. It is also rarely found in semen and vaginal fluids.

• Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present.

• You can prevent hepatitis C by never sharing needles and syringes, practising safer sex, and avoiding unlicensed tattoo parlours and acupuncturists.

• Hepatitis C will often not have any noticeable symptoms, but a simple blood test carried out by a healthcare professional will show whether you have hepatitis C.

• In the early stages, some peoples bodies can clear a hepatitis C infection on their own, others may develop chronic hepatitis C and will need to take antiviral treatment to cure the infection.

• Without treatment, chronic hepatitis C can lead to permanent liver damage.

Hepatitis C is part of a group of hepatitis viruses that attack the liver.

Its mainly passed on through contaminated needles, either from injecting drugs or from needle stick injuries in healthcare settings. It can also be transmitted sexually, especially during anal sex or other types of sex that may involve blood.

Some groups are more at risk of getting hepatitis C than others, including people who use drugs, people in prisons, men who have sex with men, health workers and people living with HIV.

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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.

Why It Is Done

Hepatitis C virus testing is done to:

• Find out if a hepatitis C infection is the cause of abnormal liver function tests.
• Screen people who have an increased chance of getting or spreading a hepatitis C infection.
• Screen potential blood donors and donor organs to prevent the spread of hepatitis C.
• Screen people born from 1945 to 1975. People in this age group are more likely to have hepatitis C and not know it.
• Identify the type of hepatitis C virus causing the infection.

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Who Is More Likely To Get Hepatitis C

People more likely to get hepatitis C are those who

• have injected drugs
• had a blood transfusion or organ transplant before July 1992
• have hemophilia and received clotting factor before 1987
• have been on kidney dialysis
• have been in contact with blood or infected needles at work
• have had tattoos or body piercings
• have worked or lived in a prison
• were born to a mother with hepatitis C
• are infected with HIV
• have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
• are men who have or had sex with men

In the United States, injecting drugs is the most common way that people get hepatitis C.13

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.

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Symptoms Of A Chronic Infection

If the hepatitis C infection progresses to a chronic infection , it can take years before symptoms develop. Symptoms of advanced liver disease caused by long-term chronic infection can include: jaundice fluid build-up and blood in stool or vomit. Sleep disturbances, depression, weight loss, dry or itchy skin, and brain fog also occur in people with chronic hepatitis C but the cause of these symptoms remains uncertain.

What Are The Symptoms Of Hepatitis C

Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

• vomiting
• yellowish eyes and skin, called jaundice

If you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

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Testing For Chronic Hcv Infection

The initial screening test to be used in all circumstances is a test for antibody to hepatitis C viral proteins . These tests become positive as early as 8-10 weeks after infection, will be positive in 97% of patients by 6 months after infection, and probably will persist for life. Presence of anti-HCV does not define activity of infection. Up to 25% of patients will resolve infection spontaneously, but will still have detectable anti-HCV. Antibody tests currently recommended for anti-HCV screening include the EIA test and the more specific RIBA the latter being used to confirm a positive EIA test in some situations . These antibody tests are highly reliable for determining HCV infection at some time in the past.

Detection of HCV RNA in blood is the currently accepted “gold standard” for diagnosis of active HCV infection. Tests for HCV RNA are both qualitative and quantitative, vary in technical aspects, and report values differently.

The Latest Screening Recommendations

Because the vast majority of people with hepatitis C do not have symptoms, diagnosing the disease requires screeningbasically, a proactive testing method for a disease before someone is showing indications of illness. The latest recommendation from the Centers for Disease Control and Prevention , updated in 2020, is that all adults over the age of 18 should be screened at least once in their lifetime, Dr. Fontana says. If you have ongoing risk factorsyoure currently using injection drugs or are on dialysis, for examplethen routine screening once per year is recommended. Pregnant women should also be screened for hepatitis C during each pregnancy.

If you dont know if youve ever been screened or if you have any of the known risk factors of hepatitis C, ask your primary care doctor about being tested. Some of the big risk factors include:

• Sharing needles or other equipment to prepare or inject drugs

• Getting tattooed or pierced with an unsterile needle

• Living with HIV

• Having a blood transfusion or organ transplant before 1992, when pre-screening blood for infections like HCV was poor

The test for hepatitis C should be covered by insurance, and should be given to anyone who asks, even if you dont feel comfortable disclosing exactly why you want it.

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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 â 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.

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How Is Hepatitis C Spread

Hepatitis C spreads through contact with the blood of someone who has HCV. This contact may be through:

• Sharing drug needles or other drug materials with someone who has HCV. In the United States, this is the most common way that people get hepatitis C.
• Getting an accidental stick with a needle that was used on someone who has HCV. This can happen in health care settings.
• Being tattooed or pierced with tools or inks that were not sterilized after being used on someone who has HCV
• Having contact with the blood or open sores of someone who has HCV
• Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
• Being born to a mother with HCV
• Having unprotected sex with someone who has HCV

Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. Since then, there has been routine testing of the U.S. blood supply for HCV. It is now very rare for someone to get HCV this way.

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Additional Tests You Might Need

Once youve been diagnosed with Hepatitis C, your doctor will likely order a number of tests to find out about the health of your liver and decide on a treatment plan thats most appropriate for you.

Hepatitis C genotype

The Hepatitis C genotype refers to a specific strain or type of the Hepatitis C virus. There are six major types of Hepatitis C around the world: genotypes 1, 2, 3, 4, 5 and 6. In the United States, genotypes 1, 2, and 3 are common:

• Genotype 1: Most Americans with Hepatitis C have this type
• Genotype 2: About 10% of Americans with Hepatitis C have this type
• Genotype 3: About 6% of Americans with Hepatitis C have this type

The genotype of Hepatitis C does not change over time, so you only need to get tested once.

Genotype tests are done before a person starts treatment. Hepatitis C treatment works differently for different genotypes, so knowing your genotype helps your doctor choose the best treatment for you.

Testing for Hepatitis A and Hepatitis B

Your doctor may test to see if your body is immune to Hepatitis A and Hepatitis B. If these tests show no prior exposure or protection, he or she will recommend that you be vaccinated against these two viruses to eliminate the chance of becoming infected.

Liver function tests or liver enzymes

• ALT
• AST

Liver function tests also include ALP and total bilirubin, among other things.

Tests to measure liver scarring or fibrosis

• Liver Biopsy

• Elastography

• Serum markers

Imaging tests

• The Body