Who Should Get Tested For Hepatitis C
The CDC recommends that you get tested at least once no matter what. Definitely get screened if any of these things apply to you:
- You were born between 1945 and 1965.
- You use or inject drugs.
- You have ever injected drugs — even if it was just once or a long time ago.
- Youâre on kidney dialysis.
- You have abnormal alanine aminotransferase levels .
- You had a blood transfusion, blood components, or an organ transplant before July 1992.
- Youâve ever gotten clotting factor concentrates made before 1987.
- You received blood from a donor who later tested positive for hepatitis C virus.
- Youâre a health care worker, first responder, or have another job that exposes you to HCV-infected needles.
- You were born to a mother with HCV.
Hepatitis C Antibody Positive Donors
Hepatitis C antibody positive donor organs are offered to hepatitis C positive recipients. If a donor tests positive for antibody to hepatitis C, additional testing is done to check for actual virus in the blood. Unlike hepatitis B, it is very likely that these donors will have virus in the blood, however these organs are only offered to recipients who also have circulating virus in the blood. There are many different strains of hepatitis C virus, and it is possible that the donor had a different strain than the recipient has. Patients who receive organs from a hepatitis C positive donor have a superior survival when compared to remaining on dialysis.
Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
More rarely, HCV RNA is used when either very acute HCV infection is suspected or a false HCV Ab is suspected.
It would not be appropriate to repeatedly order HCV RNA viral load screening for a patient who is not on or was recently on HCV treatment, or to use the HCV viral load to determine the severity of the patient’s infection or the patient’s risk of developing significant liver disease.
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I Have Hepatitis C And Im 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 sexit does not affect a womans ovarian or uterine function, or a mans 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.
What Can Persons With Hcv Infection Do To Protect Their Liver
Stop using alcohol.
- Keep your weight in the normal weight. Fatty liver, related to obesity, diabetes, and metabolic syndrom increases your risk of liver damage and cirrhosis in hepatitis C.
See your doctor regularly.
Don’t start any new medicines or use over-the-counter, herbal, and other medicines without a physician’s knowledge.
Get vaccinated against hepatitis A and B
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Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDCs National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
Submission And Collection Notes
Detailed instructions for ordering Hepatitis C testing are available to assist you with completing the Hepatitis Serology boxes in section 3 of the General Test Requisition.
Public Health Ontario prefers centrifuged SST for serological assays. Instructions for using SST tubes are found in the document titled: LAB-SD-008 Blood Collection Using Serum Separator Tubes.
If testing for a combination of hepatitis virus markers, HIV, HTLV, syphilis, and rubella, you are only required to submit one FULL 6 8.5 mL SST. If a full tube cannot be drawn, submit two tubes.
Do not submit glass tubes.
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Are Test Results Accurate
Although no test is perfect, hepatitis C testing is an important and accepted method of testing for HCV. In order to reduce the risk of inaccurate results, doctors take steps to verify a patients diagnosis. For example, a positive test result for hepatitis C antibody requires confirmation with HCV RNA testing.
What Is The Difference Between Hepatitis B Surface Antibody And Antigen
An antigen is a substance that induces antibody production. Hepatitis B surface antigen is a protein on the surface of hepatitis B virus.
Hepatitis B surface antibodies are produced by the bodys immune system in response to HBsAg. The presence of adequate hepatitis B surface antibodies in the blood indicates protection against hepatitis B virus infection.
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Staying Healthy With Hepatitis
Not everyone needs treatment right away, but its important to be monitored regularly by an experienced doctor and discuss treatment options of the best way to keep you healthy.
- Get vaccinated against Hepatitis A and Hepatitis B
- Avoid alcohol and drugs
- Eat a healthy & balanced diet. Include a lot of vegetables and fruits try to stay away from too much salt, sugar and fat.
- Exercise regularly. Walking is one of the best exercises, and it helps to make you feel less tired.
- Check with a health professional before taking any prescription pills, supplements, or over-the-counter medications.
- Do not share razors, nail clippers, needles or other items that come in contact with blood with other people.
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What Other Information Should Patients With Hepatitis C Be Aware Of
Sneezing, hugging, coughing, food or water does not spread HCV nor does sharing eating utensils or drinking glasses, or casual contact.
Persons should not be excluded from work, school, play, child-care or other settings on the basis of their HCV infection status.
Involvement with a support group may help patients cope with hepatitis C.
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Search Strategy And Identification Of Studies
Search strategies were developed by a medical librarian with expertise in designing systematic review searches. Our search algorithm consisted of the following components: hepatitis C, diagnostic tests, and diagnostic accuracy. We searched MEDLINE , EMBASE , the Cochrane Central Register of Controlled Trials , Science Citation Index Expanded , Conference Proceedings Citation Index-Science , SCOPUS , Literatura Latino-Americana e do Caribe em Ciências da Saúde and WHO Global Index Medicus. The search was supplemented by searching for ongoing studies in WHOs International Clinical Trials Registry. The literature search was limited to English language and human subjects that available until April 30th, 2015. In addition to searching databases, we contacted individual researchers and authors of major trials to address whether any relevant manuscripts are in preparation or in press. The references of published articles found in the above databases were searched for additional pertinent materials.
Study selection proceeded in three stages: 1) titles/abstracts were screened by a single reviewer according to standard inclusion and exclusion criteria 2) full manuscripts were obtained and evaluated by two independent reviewers to include or not 3) two independent reviewers extracted all data. Differences were resolved by a third independent reviewer.
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Hepatitis C Viral Load / Hcv Rna Quantitative Testing
The viral load of hepatitis C refers to the amount of virus present in the bloodstream. The quantitative HCV RNA tests measure the amount of hepatitis C virus in the blood. The result will be an exact number, such as 1,215,422 IU/L. Many people refer to the quantitative measurement as the hepatitis C viral load.
Viral load tests are used to confirm active hepatitis C infection and are used during treatment to help determine response. If you have lower levels of virus in your blood when you start treatment, you may have a better chance of getting rid of the virus.
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What Is The Difference Between Relapse And Nonresponse
The goal of treating chronic hepatitis C is to completely clear the virus. This means that your viral load is zero or so low that the virus cant be detected with standard blood tests.
Without treatment, the hepatitis C virus in liver cells constantly makes copies of itself, and the virus ends up not just in liver cells but also in the bloodstream. Treatment is intended to completely stop reproduction of the virus so that it doesnt continue to enter the bloodstream or cause any more injury to liver cells.
Successful treatment results in a sustained virological response. This means the virus becomes completely undetectable before the treatment is finished, and it remains undetectable for 6 months after treatment is stopped.
A relapse means the viral load drops to an undetectable level before treatment is completed, but becomes detectable again within 6 months after treatment is stopped. Even if the virus returns at a level that is lower than it was before treatment, a relapse is still considered to have occurred. A relapse can be determined if the viral load starts to rise during treatment, or at any time after the virus becomes undetectable.
A nonresponse means the viral load never drops significantly and the virus remains detectable throughout the course of treatment.
Who Should Get Tested Or Hepatitis C
All Baby-Boomers need to be tested for hepatitis C. These are individuals born between 1945-1965. You need to get tested regardless of risk factors.
Persons who ever injected illegal drugs, including those who injected once or twice many years ago
Persons who were treated for clotting problems with a blood product made before 1992 when more advanced methods for manufacturing the products were developed
Persons who were notified that they received blood from a donor who later tested positive for hepatitis C
Persons who received a blood transfusion or solid organ transplant before July 1992 when better testing of blood donors became available
Long-term hemodialysis patients
Persons who have signs or symptoms of liver disease
Healthcare workers after exposures to HCV positive blood on the job
Children born to HCV-positive women
Homosexual men or women
- New recommendations from the Centers for Disease control state that all “Baby Boomers” get tested, regardless of their HCV risk factors. Baby Boomers were born between 1945-1965. Baby Boomers, as a group, are five times more likely to have HCV. Many have no symptoms, so they need to ask to be tested for HCV-do not assume you will be tested by your physician.
- This video by Dr. Galati outlines some of the Baby Boomer issues related to HCV.
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Time For Processing Hcv Ab Test Results
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.
Negative But Other Hepatitis Tests Are Positive
Your HBsAb test may be negative even when other hepatitis B tests are positive, showing active or chronic infection. Further testing is necessary, especially for the hepatitis B surface antigen , which shows that the virus itself is circulating in your bloodstream and that you have an active or chronic infection.
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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.
Molecular Hcv Rna Tests
Molecular diagnostic tests for hepatitis C specifically detect HCV RNA and the process is commonly referred to as a Nucleic Acid Test or Nucleic Acid Amplification Test . The HCV NAT becomes positive approximately 1 to 2 weeks after initial HCV infection. The NAT test has become the gold standard supplemental test for patients who have a positive HCV EIA screening test. The NAT can determine whether a patient with a positive HCV antibody test has current or resolved HCV infection. In addition, the NAT can be used in combination with other laboratory studies, such as prior antibody test results or hepatic aminotransferase levels, to suggest the possibility of acute HCV infection. The results for the commercially available quantitative HCV RNA assays, which were previously reported as copies/mL, are now given in International Units /mL.
Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
Are There Supplements That Are Good For My Liver
If a person eats a balanced diet, they will normally get enough vitamins and minerals. People with liver disease should avoid taking large amounts of supplements or mega-vitamins. This is because the liver has to do extra work to process them. Your provider may put you on a general multivitamin without iron.
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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 patient’s 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.
What Is Hepatitis C
Although hepatitis can be caused by heavy alcohol consumption, toxins, certain medical conditions, and some medications, the most common cause of hepatitis is a viral infection due to hepatitis A, B, and C virus.
Two types of hepatitis C include:
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Pregnancy And Hepatitis C
Should pregnant women be tested for HCV antibodies?
Yes. All pregnant women should be screened for anti-HCV during each pregnancy, except in settings where the prevalence of HCV infection is < 0.1% . Pregnant women with known risk factors should be tested during each pregnancy, regardless of setting prevalence. Any pregnant women testing positive for anti-HCV should receive a PCR test for HCV RNA to determine current infection status.
Can a mother with hepatitis C infect her infant during birth?
The overall risk of an infected mother transmitting HCV to her infant is approximately 4%8% per pregnancy . Transmission occurs during pregnancy or childbirth, and no prophylaxis is available to protect the newborn from infection. The risk is significantly higher if the mother has a high HCV viral load, or is coinfected with HIV with which the rate of transmission ranges from 8%15% . Most infants infected with HCV at birth have no symptoms.
Should a woman with hepatitis C be advised against breastfeeding?
When should children born to HCV-infected mothers be tested to see if they were infected at birth?