Tuesday, February 27, 2024

Screening Test For Hepatitis C

Other Things To Know:

Hepatitis C Screening
  • 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.

What To Expect During An Hcv Test

Initial screening for hepatitis C involves taking the HCV antibody test, which can show whether a person has ever had the infection.

These antibodies are chemicals in the bloodstream that the body makes to combat the HCV. The test checks the blood for these antibodies.

For of people with the infection, the body clears the virus within 6 months without treatment.

Once the body makes these antibodies, they remain detectable, even after the person has cleared the infection. If a test shows that the HCV antibodies are present, the healthcare professional will perform a second test. This is called a nucleic acid test, and it can confirm whether the person still has the infection. If so, it is called a chronic infection.

Is There Anything Else I Should Know

The tests that are typically included in an acute viral hepatitis panel may not always be able to tell whether someone has had a previous hepatitis infection or has developed antibodies in response to a vaccine. Usually other types of tests are performed to provide this type of information. See the individual articles on Hepatitis A Testing, Hepatitis B Testing or Hepatitis C Testing for more on this.

The presence of hepatitis A IgM antibodies in the blood are considered diagnostic for acute infection with hepatitis A when the test information is combined with a persons signs and symptoms. When the hepatitis screening test is performed for people who do not have symptoms of acute hepatitis, the presence of hepatitis A IgM antibodies may represent a false-positive result. Therefore, the Centers for Disease Control and Prevention has recommended against using the test for screening in people without acute hepatitis symptoms to decrease the possibility of false-positive results.

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Can A Man With Hep C Have A Baby

There is no evidence to show that hep C can be transmitted from a father, through his sperm, either at conception or in the womb. There is no increased risk that the baby will be born with the virus if both partners have hep C. Because of limited safety data, pregnancy should be avoided during hepatitis C treatment.

Dried Blood Spot Testing

Hepatitis C Virus (HCV) Positive Stock Image

Dried Blood Spot testing uses drops of blood from the end of your finger. It doesnt use a needle and syringe and you can do it free of charge in the privacy of your home. Your details and the results are kept private. If your test result shows you have hep C, the people who give your results can help you access hep C treatment and cure.

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What Are Cdcs Hepatitis C Screening Recommendations

All patients 18 years and older should be screened for hepatitis C at least once in their lifetime, except in settings where the prevalence of HCV infection is < 0.1%.

Patients with recognized exposures should be tested for hepatitis C regardless of age or setting prevalence, and regular periodic testing should continue as long as risk persists.

Other Related Uspstf Recommendations

The USPSTF has made recommendations on screening for hepatitis B virus infection in pregnant persons,17 screening for hepatitis B virus infection in adults,18 and screening for HIV infection.19

This recommendation statement was first published in JAMA. 2020 323:970975.

The Update of Previous USPSTF Recommendation,Supporting Evidence, and Recommendations of Others sections of this recommendation statement are available at .

The USPSTF recommendations are independent of the U.S. government. They do not represent the views of the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the U.S. Public Health Service.

Read the full article.

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Home Screening Tests For Hepatitis C

At-home screening tests provide privacy if you prefer not to go to a doctor or clinic for testing. These tests typically look for antibodies to hepatitis C, but they may not always test for active viral infection. Make sure you know what type of test youll be taking before you buy.

Many at-home tests have close to or the same reliability as blood tests received by a medical professional.

If youve recently been exposed to hepatitis C, wait several weeks before testing at home.

When Should I Get Hepatitis C Testing

Hepatitis C Screening – Dr. Anurag Maheshwari – Mercy

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.

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Appropriate Uses Of The Hcv Rna Test

There are 4 major reasons that HCV RNA tests are used:

  • To confirm a positive HCV Ab result and make the diagnosis of current HCV infection
  • To measure a patient’s baseline viral load prior to starting HCV therapy
  • To monitor a patient’s response to therapy
  • To determine whether a patient has achieved a sustained virologic response
  • 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.

    So Who Should Be Screened

    Everyone should be screened for hepatitis C. The US Preventive Services Task Force recommends that doctors should ideally screen all of their patients by checking to see if they meet the at-risk criteria. “Hepatitis C should be routinely screened for in all adults at their routine medical visits,” says infectious disease expert Amesh A. Adalja, MD, Senior Scholar at the Johns Hopkins Center for Health Security.

    That criteria, according to the CDC, includes a long list of people:

    • Current or former injection drug users
    • Everyone born from 1945 to 1965
    • Anyone who received clotting factor concentrates made before 1987
    • Recipients of blood transfusions or solid organ transplants before July 1992
    • Long-term hemodialysis patients
    • People with known exposure to the hepatitis C virus, like healthcare workers after needle sticks involving blood from someone infected with hepatitis C
    • People with HIV
    • Children born to mothers with hepatitis C

    The U.S. Preventive Services Task Force also recommends screening for people in jail, those who snort drugs, and those who have received an unregulated tattoo.

    Then, if someone is determined to be at risk, USPSTF recommendations say that a blood sample should be taken and tested to see if it contains antibodies that react to the hepatitis C virus. It’s followed by a second test that determines the level of the virus in the blood. When the tests are used together, it can accurately determine whether someone has a hepatitis C infection.

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    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.

    How Do You Confirm Hepatitis

    Hepatitis C

    Tests that can help diagnose hepatitis B or its complications are:

  • Blood tests. Blood tests can detect signs of the hepatitis B virus in your body and tell your doctor whether it’s acute or chronic. …
  • Liver ultrasound. A special ultrasound called transient elastography can show the amount of liver damage.
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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.

    Risk Factors For Hepatitis C

    You are at a greater risk of having the hepatitis C virus if you:

    • Are a current or former injection drug user
    • Are on dialysis for kidney failure
    • Are HIV positive
    • Have a mother with hepatitis C
    • Have undergone body modification without the use of sterile instruments
    • Received a blood transfusion or organ donation before 1992, or clotting factor replacement therapy before 1987
    • Were born between 1945 and 1965

    The Centers for Disease Control and Prevention recommends that anyone born between 1945 and 1965 take a hepatitis C antibody test at least once. If you have never done testing for the hepatitis C virus, our at-home hep C test makes it easy to collect a small sample of blood from the convenience of home and send it to a lab for testing. Our HCV antibody test, sometimes called an anti-HCV test, checks if the infection is present in your body by looking for antibodies released by the immune system in response to the hepatitis C virus.

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    When Should I Test For Hep C

    Many people dont feel sick when they first get hep C. If you are exposed to hep C, your body will try and fight the virus for 6 months. 1 in 4 people will clear hep C in those first 6 months.

    People who dont clear their hep C will have whats called chronic hep C. You can get tested for hep C straight after you think you have been exposed, but you will need to go back for another test after 12 weeks and possibly again at 6 months.

    You might be able to access testing and healthcare via your computer or phone.

    Hepatitis C Testing And Diagnosis

    Singapore studying new, faster test for hepatitis C

    Doctors will start by checking your blood for:

    Anti-HCV antibodies: This blood test is the first — and sometimes only — one you may get. Also called the ELISA screen, it checks for antibodies that your body releases to fight the virus. These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection. Your test will be either negative or positive for antibodies. It usually takes a few days to a week to get results, though a rapid test is available in some places.

    What the results mean

    Negative . This is when your blood shows no signs of HCV antibodies. Most of the time, thatâs because you never came in contact with the virus and you do not have hep C.

    Sometimes, your negative result can be false, meaning you have HCV. That may happen if you:

    • Took the test too soon after your exposure. This test checks for only HCV antibodies, which can take several months to appear.
    • Have HIV, a donated organ, or other conditions that weaken your immune system, which can suppress your antibodies
    • Get hemodialysis for kidney problems

    If youâve been exposed in the last 6 months, youâll need to be retested.

    Positive . This means youâve been infected with HCV. But false positives are surprisingly common. More than 1 in 5 people who test positive donât actually have hepatitis C. Possible reasons include:

    What the results mean

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    Interpreting Hcv Rna Test Results

    It is essential that the provider understands how to interpret HCV RNA test results, especially during the course of HCV treatment.

    Result of HCV RNA Test Interpretation
    A quantified viral load — any exact number Ongoing HCV infection
    “Detected” The HCV RNA is detectable but the number of international units is so low that it cannot be quantified accurately. This indicates extremely low level of virus is present.
    “< 12 IU/mL” or “< 15 IU/mL” or “< 25 IU/mL” All of these are “less than the LLOQ” HCV RNA is undetectable. No virus is detected at all in the patient’s serum specimen.

    Why Test All Your Adult Patients

    • New cases of hepatitis C are on the rise, particularly among reproductive age adults. Rates of new HCV infections increased by more than 60% from 2015 to 2019. And in 2019, more than 63% of HCV infections occurred among adults 20-39 years of age.
    • Your patients arent aware of their risk. Almost half of people with hepatitis C are unaware of their infection. Testing is the first step to accessing curative treatment. Without treatment, approximately 15-20% of adults with chronic HCV infection will develop progressive liver fibrosis and cirrhosis.
    • Hepatitis C can be cured. Over 90 percent of people infected with HCV can be cured with 8-12 weeks of oral therapy. Treatment of hepatitis C is associated with reductions in mortality among persons with chronic hepatitis C.

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    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.

    Specific Hcv Rna Assays And Range Of Detectable Virus

    Hepatitis C Virus Test

    HCV RNA tests use target amplification techniques. Several assays exist for HCV RNA testing. Methods include polymerase chain reaction , transcription mediated amplification , and branched chain DNA tests. Results are expressed as international units/mL . The different methods and different commercial assays each have a lower limit of quantification and lower limit of detection , therefore a patient’s results could be reported differently depending on the assay used. HCV RNA tests must have an LLOQ of 25 IU/mL or lower when used to assess treatment response with DAAs.

    LLOQ = the lowest HCV RNA level that is within the linear and analytically acceptable range of the assay.

    LLOD = the lowest level of HCV RNA that is detected 95% of the time.

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    Current Hepatitis C Testing Recommendations

    Recently, several organizations have issued hepatitis C virus screening recommendations. In general, major guidelines now recommend routine one-time universal HCV testing for adults 18 years of age and older, routine HCV screening of pregnant individuals, screening younger persons at risk of acquiring HCV, and repeat screening for those with ongoing risk for HCV acquisition.

    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.34,35 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%15,16 and the test result was a false positive.

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    Benefits Of Screening For Hepatitis C

    If individuals with chronic hepatitis C are identified before they develop advanced fibrosis, cirrhosis, or hepatocellular carcinoma, 90%-100% can now be expected to respond to treatment, whereas previously only 66%-75% of individuals responded to treatment.813,2427 Thus, detecting individuals with hepatitis C before they develop signs or symptoms of the disease can have an important impact on their subsequent clinical course. Sustained virologic clearance for more than 6 months after treatment of hepatitis C is also associated with a reduction in all-cause mortality.28

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