What Health Professionals Need To Know About Hepatitis C
Hepatitis C is not a vaccine-preventable disease.
Hepatitis C is reportable by laboratories and clinicians to local public health authorities in all provinces and territories.
- hepatitis C antibody and nucleic acid amplification testing methods for screening the blood supply were implemented in 1992
- prior to this implementation, thousands were infected with the hepatitis C virus after receiving blood or blood products
Consult the national case definition for additional information.
Public Perceptions Around Hcv And Hcv Testing
Most of the members of the public described HCV as a liver disease that manifested as a distended abdomen. The majority stated that HCV was highly transmissible through blood contact by sharing sharp implements, such as razors and needles horizontal transmission working in nursing care and through unprotected sexual intercourse. The potential for HCV transmission via oral fluids and close contact such as bed- and clothes-sharing with an HCV-infected person was mentioned. A few informants did not know how HCV was transmitted.
We know that a liver disease called HCV is transmitted through blood-to-blood contact. A person can be infected by HCV when that persons blood gets in contact with an HCV-infected persons blood. HCV can also be transmitted through sexual intercourse.
It was highlighted that older people, generally aged 50 years or more, are at high risk of HCV. Female sex workers and their clients, prison inmates, and blood transfusion recipients were mentioned by a few informants as groups at risk of HCV infection. HCWs were also identified as people at increased risk of HCV.
I think everyone should get a test so that they can know if they have hepatitis B or hepatitis C. People who are at risk of getting this disease are those working in health settings, as they meet so many patients.
Hepatitis C Virus Genotyping
Hepatitis C viruses are not all the same. Certainly, they are all identified as hepatitis C viruses and they all can cause acute and chronic hepatitis C infection, but they are not exactly genetically alike. They have slightly different genetic variations and are grouped into different genotypes .
Knowing your genotype can significantly alter the duration of your treatment because your healthcare provider can select the right treatment for the type of HCV you have.
Genotypes are important because hepatitis C viruses with different genetic variations require different treatment approaches. Healthcare providers determine your HCV genotype with a laboratory test that uses a method called reverse transcription polymerase chain reaction . This test analyzes the genetic material of the virus to determine its sequence, which identifies the virus’s genotype.
Recommended Reading: How To Find Out If You Have Hepatitis
Assessing The Severity Of The Infection
If you are found to have virus present then other tests may be advised to check on the extent of inflammation or damage to the liver. For example:
- Blood tests called liver function tests. These measure the activity of chemicals and other substances made in the liver. This gives a general guide as to whether the liver is inflamed and how well it is working. See the separate leaflet called Liver Function Tests. Other blood tests will also be done for various reasons. For example, tests to check for other illnesses which can be passed on in the same way, such as HIV or hepatitis B. Also tests of other functions of the liver, such as the ability of blood to clot properly, and levels of iron stores.
- An ultrasound scan of the liver.
- Other tests may be done if cirrhosis or other complications develop.
- There are other specialised blood tests being developed which assess the development and severity of cirrhosis.
- A small sample of the liver taken to look at under the microscope used to be recommended before considering treatment. However, this is no longer routine prior to treatment. See the separate leaflet called Liver Biopsy.
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.
Don’t Miss: What Is Chronic Hepatitis B
Instant Hepatitis C Test
- We now offer a COVID-19 Home Test. Our highly accurate PCR test requires a combined nose/throat swab.
Better2Knows instant Hepatitis C test provides you with confidential STI testing with fast, accurate results. Our private instant STI testing services are available at selected private sexual health clinics across the UK. Hepatitis C infections usually do not cause symptoms in the first years following infection. Around 200,000 people in the UK have Hepatitis C and do not know their status. There are usually no symptoms in the early stages of infection, and they can take years to become apparent. Symptoms can include feeling tired for no reason, muscle pain, joint pain and fever. If you are worried that you may have Hepatitis C from unprotected sex or sharing needles, even if this was years ago, then please get tested to prevent long term damage to your health.
When To Get Tested
For screening: at least once when you are age 18 years or older when you are pregnant when you have risk factors for HCV infection, regardless of age
For diagnosis: when you may have been exposed to the hepatitis C virus, such as through injection drug use, or when you have signs and symptoms associated with liver disease
For monitoring: before, during, and after hepatitis C treatment
Also Check: How To Get Rid Of Hepatitis B
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
Tests After The Diagnosis
Once the doctor knows you have hep C, theyâll do tests to find out more about your condition. This will help determine your treatment. They could include:
- Genotype tests to find out which of the six kinds of hepatitis C you have.
- Liver function tests. They measure proteins and enzymes levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C.
- Tests to check for liver damage. You might get:
- Elastography. Doctors use a special ultrasound machine to feel how stiff your liver is.
- Liver biopsy. The doctor inserts a needle into your liver to take a tiny piece to examine in the lab.
- Imaging tests. These use various methods to take pictures or show images of your insides. They include:
Don’t Miss: How Does Someone Get Hepatitis C
Contact Programs And Testing Sites Before Visiting
Contact community-based programs and testing sites before visiting their locations. Hours and availability may have changed due to COVID-19 .
Hepatitis C is caused by a virus that can permanently damage the liver, leading to cirrhosis, liver failure and liver cancer. It is passed from one person to another through blood.
Most people who have hepatitis C do not show symptoms, but it can still cause harm if left untreated. The most common reasons people have hepatitis C is because they received a blood transfusion before 1992, or because they have shared drug-use equipment. If you have ever injected drugs, even once, you should get tested for hepatitis C as soon as possible. Hepatitis C can be cured.
To connect with other people searching for help, check out the Hep Free NYC network of patients and providers.
Should Every Patient Of Hepatitis Be Screened For All Types Of Hepatitis As Included In The Panel Tests
It is not necessary to conduct a hepatitis panel test on all patients. If the specific hepatitis virus that has caused the infection is known, then the specific hepatitis test may only be conducted. In some cases, doctors may want to know how the treatment is going on or to evaluate the progression of a disease. In such cases, only specific hepatitis tests are conducted.
Don’t Miss: Chronic Hepatitis C Without Hepatic Coma
Hcws Preferences For Hcv Self
Overall, HCWs expressed a positive attitude towards HCV self-testing. The majority emphasised the need to raise awareness about the availability of HCV self-testing and to decentralise HCV self-testing to the lowest level of the health system or make it available in pharmacies at any time. Some preferred HCV self-testing to be delivered by community health workers.
The majority of HCWs preferred the use of non-invasive procedures for HCV self-testing because, in their opinion, some people would fear finger-pricks or other procedures that involved sharp implements. It was noted that specimens such as saliva and urine are easy to collect, although saliva samples were the preferred option. The majority thought that there would be no problem regarding the trustworthiness of the results, as long as the testing procedure was explained to the user.
Using an oral specimen, it is easy, and not a painful method accepting it would not be a problem.
Most HCWs agreed that people should perform HCV self-testing themselves and suggested that HCV self-test providers should explain their use to clients. If someone were to have a problem while using the test, there must be a provider at the health facility or a free hotline to offer support. The need for facility-based counselling for those who received a positive self-test result was highlighted. Some HCWs thought that it would be easier for men to accept a positive result than women, while some people might be downhearted.
Hepatitis C Screening: Questions For The Doctor
Hepatitis C is a serious liver disease caused by the hepatitis C virus . The most common way to get hepatitis C is by coming into contact with the blood of someone who has it.
Everyone ages 18 to 79 needs to get tested for hepatitis C at least once.
Many people who have hepatitis C live for years without feeling sick. But the virus can still damage your liver even when there arent any symptoms. You could also spread the virus to others without knowing it.
The only way to know for sure if you have hepatitis C is to get a blood test. Medicine can cure most cases of hepatitis C.
Read Also: How Did You Get Hepatitis B
Can You Prevent Hepatitis C Infection
Thereâs no vaccine to prevent hepatitis C. To avoid getting the virus:
- Use a latex condom every time you have sex.
- Don’t share personal items like razors.
- Don’t share needles, syringes, or other equipment when injecting drugs.
- Be careful if you get a tattoo, body piercing, or manicure. The equipment may have someone else’s blood on it.
What Does The Test Result Mean
Screening and diagnosis
An HCV antibody test is typically reported as “positive” or “negative.”
Results of HCV viral load testing are reported as a number of virus copies present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as “negative” or “not detected.”
Interpretation of the HCV screening and follow-up tests is shown in the table below.
- In general, if your HCV antibody test is positive, then you have likely been infected at some time with hepatitis C.
- If the laboratory reports results as weakly positive, most of these results are false positive and some laboratories will retest your sample with another test before reporting it as positive.
- If your HCV RNA test is positive, then you have a current infection.
- If no HCV viral RNA is detected, then you either do not have an active infection or the virus is present in very low numbers.
|Negative||No infection or it is too soon after exposure and HCV antibody has not yet developed if suspicion remains high, an HCV RNA test is done.|
|Past infection or no infection|
|Positive||Current, active infection|
Guiding and monitoring treatment
The result of your HCV genotype test identifies which strain of HCV you have and helps guide the selection and the length of your treatment. Treatments may differ depending on a variety of factors, including HCV genotype and the health of your liver.
An HCV viral load can indicate whether or not treatment is effective.
Don’t Miss: How Does One Get Hepatitis B And C
Your Instant Hepatitis C Testing Process
Better2Knows experienced sexual health advisors are available 24 hours a day, 7 days a week for your convenience. They will listen to your circumstances, concerns and help you select the sexual health test or screen that most suits your requirements. Your call and appointment are completely confidential. You do not have to give us your real name at any time, and we will not share your results with anyone without your consent.
Chronic Hepatitis C Infection
Approximately 25% of those infected with the HCV will spontaneously clear the virus within 6 months. However, in most cases , the infection will become chronic. Chronic hepatitis C is often asymptomatic.
Some individuals with chronic hepatitis C infection experience:
- abdominal pain
Fluctuating alanine aminotransferase levels are characteristic. In addition, thrombocytopenia may be an indication of cirrhosis. Thrombocytopenia is known to increase with the severity of liver disease.
The late sequelae of chronic hepatitis C infection include:
- liver fibrosis or cirrhosis
- hepatocellular carcinoma
Cirrhosis and hepatocellular carcinoma may develop over a period of 20 to 30 years depending on factors such as sex, age, and level of alcohol consumption. Approximately 1% to 5% of individuals with chronic hepatitis C infection will develop hepatocellular carcinoma.
If cirrhosis develops, individuals may experience:
The diagnosis of hepatitis C requires 2 types of tests:
You May Like: Most Common Way To Get Hepatitis C
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.
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.
Recommended Reading: Is Hepatitis C Contagious Sexually
Why Take The At
The hepatitis C test is an essential tool for screening and detecting a possible hepatitis C infection. It can also help assess and monitor the treatment. The only way to detect if a person has a chronic hepatitis C infection is though a blood test. This test can expose a past exposure and an active one but it cannot pinpoint whether the infection is current or past.
People who are at high risk of being infected with hepatitis C need to be tested for the hepatitis c antibodies. These include people who inject illegal drugs, those who have been on long term dialysis, kids who are born to HCV positive women, anyone who has been exposed to the blood of somebody who is infected with hepatitis C, anyone who has chronic liver disease, people who are HIV-positive, and health care workers who come in close contact with hepatitis C positive blood. This test is also recommended for anyone who has abnormal results on a liver panel.
Hepatitis B Antibody And Antigen Test
Most people who come into contact with hepatitis B will clear the virus during the first six months of their infection. During this phase, the condition is known as acute hepatitis B. People who do not clear the virus after six months will be diagnosed as having chronic hepatitis B, which can cause liver damage.
Tests are carried out to look for antigens and antibodies in your blood. The results of these may indicate several possibilities:
- you have been infected by the virus in the past
- you have a new infection
- the infection is likely to go away by itself
- the infection has become chronic .
These antigens and antibodies are known as serological or viral markers. Doctors will look for markers in your blood over the course of your infection to see how the virus is progressing and/or responding to treatment. In particular, finding surface and e antigens known as HBsAg and HBeAg and their corresponding antibodies will help your healthcare team understand more about the pattern of your disease, and how its likely to progress
Read Also: What Is Hepatic Function Panel