Recommendations Regarding Linkage To Care
All persons identified with active hepatitis C infection should be linked to a medical provider who can provide competent and comprehensive management of HCV. Available data suggest that in the current era, nonspecialists can effectively manage HCV, especially with back up and consultation for more complicated issues. The management of patients with decompensated cirrhosis should always involve a hepatologist. In addition, persons with HCV who have renal insufficiency or extrahepatic complications of HCV infection will likely require referral to a specialist. An individual with a positive HCV antibody test but negative HCV RNA level does not require a referral for further evaluation and management of HCV infection.
S To Take After A Positive Hepatitis C Test Result
When you receive a false-positive result, you may be unsure whether its a true false positive. Talk with your doctor about getting a second test, such as an RNA test, to confirm whether you have an infection.
If your RNA test result is negative, you dont have a current HCV infection. In this scenario, no further steps need to be taken. If your RNA test result is positive, your doctor will advise you on treatment options and how to move forward.
Keep in mind that false-negative results may happen, too. This often occurs in people who are in the early stages of infection and havent yet built up detectable antibodies.
People with suppressed immune systems may also get a false negative because their immune systems arent working effectively enough to respond to the test.
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.
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How Do You Test For Hepatitis C
A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.
If youve got hepatitis C you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.
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.
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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
Immunoassays For Hcv Core Antigen
As an HCV diagnostic marker, HCV core antigen has been studied, either alone or as an HCV antibody-HCV antigen combination assay. Some experts have proposed use of an HCV core antigen test as a less expensive option than HCV RNA testing, but there are no HCV antigen assays that are FDA-approved for use in the United States at this time.
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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.
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.
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Using Elisa And Hcv Rna Tests Together:
- Negative ELISA = No hepatitis C antibodies found in blood. You are probably not infected with HCV.
- Positive ELISA = You may have HCV infection. However, it is possible this is a false-positive. More testing is required.
- Negative HCV RNA = No active HCV infection.
- Positive HCV RNA = Active HCV infection.
Testing Procedures And Costs
The test for HCV antibodies, as well as follow-up blood tests, can be done in most labs that perform routine blood work.
A regular blood sample will be taken and analyzed. No special steps, such as fasting, are needed on your part.
Many insurance companies cover hepatitis C testing, but check with your insurer first to be sure.
Many communities offer free or low-cost testing, too. Check with your doctors office or local hospital to find out whats available near you.
Testing for hepatitis C is simple and no more painful than any other blood test.
But if youre at risk for the disease or think you may have been exposed to the virus, getting tested and starting treatment if necessary can help prevent serious health problems for years to come.
CDC recommends that all adults ages 18 years and older should be screened for hepatitis C except in settings where the prevalence of HCV infection is less than 0.1%.
Also, all pregnant women should be screened during each pregnancy, except in setting where the prevalence of HCV infection is less than 0.1%.
Hepatitis C is often associated with sharing needles . But there are other methods of transmission.
For example, healthcare workers who are regularly exposed to other peoples blood are at higher risk for contracting the virus.
Getting a tattoo from an unlicensed tattoo artist or facility where needles may not be properly sterilized also increases the risk of transmission.
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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:
Getting A Hepatitis C Test From Your Doctor
Ideally, you should talk with a doctor about hepatitis C screening. Theyll ask you about any potential exposures or risk factors and will probably order a blood test to check for HCV antibodies. You can get your blood tested anywhere that does routine blood work.
Its the same procedure as getting a routine blood test.
We reviewed each brands business and medical practices, checking:
- their BBB rating, if they have one
- whether theyve been involved in any lawsuits
- whether they provide help interpreting your results
- whether they make any unacceptable health claims
All companies on the list also state they use accredited labs to process their testing kits.
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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.
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.
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‘origami’ Diagnostic Test Could Help Hepatitis C Treatment
by Ross Barker, University of Glasgow
A new test for hepatitis C which uses origami-style folded paper to deliver fast, accurate and affordable diagnoses could help the global fight against the deadly virus.
The test, developed by biomedical engineers and virologists from the University of Glasgow, delivers lateral-flow results similar to a COVID-19 home test in around 30 minutes.
In a new paper published today in the journal Nature Communications, the research team describe how they developed the system. It builds on previous breakthroughs in rapid diagnostics and virology at the University, delivering results with 98% accuracy.
Hepatitis C, a bloodborne virus which damages the liver, is estimated to affect more 70 million people around the world. The virus’ effects on the liver are slow, and patients may not realize they are infected until they become severely ill with complications such as cirrhosis or cancer.
If the infection is detected before it advances significantly, it can be treated effectively with low-cost, readily available medication. However, as many as 80 percent of people with the virus are unaware of their infection until clinical complications occur.
As a consequence, around 400,000 people around the world die from hepatitis C-related illnesses each year, many of whom could have been saved by earlier diagnosis and treatment.
The team are aiming to use the system in field trials in sub-Saharan Africa next year.
How Hepatitis C Virus Is Diagnosed
Hepatitis C virus is usually diagnosed with blood tests. An antibody test can detect whether your body has had to fight off HCV infection. A blood test which measures the virus in your blood confirms the diagnosis, but results take longer. Sometimes, liver function tests, imaging studies, or a biopsy can support or confirm the diagnosis as well.
As of March 2020, the U.S. Preventive Services Task Force recommends HCV screening for all adults ages 18 to 79. The CDC also updated their guidelines in April 2020, recommending screening for all adults and pregnant women.
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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.
Screening For Hepatitis C
Although most clinicians have extensive experience with the diagnosis and treatment of disease, they have limited experience with screening for disease. Screening is characterized by interventions in a group of individuals with no signs or symptoms of disease to identify unrecognized disease. The hope is that by identifying the disease before the onset of signs or symptoms, morbidity and possibly mortality can be reduced. Screening is not intended to be diagnostic its main purpose is to detect the possibility of disease. The fact that screening is typically performed on healthy individuals can account for some of the limited experience on the part of clinicians.
The 2 most common types of screening are universal screening and selective screening. Universal screening involves screening all individuals in a certain category, such as all individuals above a certain age. Selective screening involves screening individuals who have a high risk for the disease, such as having family members with a known hereditary disease.
The World Health Organization has issued the following guidelines for screening:
Currently, the US Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend screening for hepatitis C for 2 groups of individuals:
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Reflexive Hcv Rna Testing With Positive Initial Hcv Eia
The CDC encourages setting up a procedure whereby samples that test positive with a laboratory-conducted HCV antibody assay would then undergo reflexive HCV RNA testing, using the same patient blood sample. Many laboratories now offer reflexive HCV RNA testing on HCV antibody-positive samples. The reflexive testing approach is more efficient than other approaches for follow-up HCV RNA testing that include collecting two separate venipuncture samples at the initial blood draw , or having the patient return for another venipuncture after receiving a positive antibody test result. From a practical standpoint, it is clearly preferable to have the laboratory reflexively perform the HCV RNA testing for positive HCV EIA tests utilizing the same blood sample.
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:
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