Wednesday, September 21, 2022

What Blood Test Checks For Hepatitis C

Immunoassays For Hcv Core Antigen

Dry Blood Spot-Testing for Hep C – how to use the kit

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.

Treatment For Hcv Infection

Treatment for HCV infection is available. The role of treatment in acute infection is being evaluated and currently the existing data shows that response to 6 months of standard therapy with interferon in terms of absence of HCV RNA from serum is excellent and progression to chronicity is reduced. The recommended treatment for chronic HCV infection is a combination of a pegylated IFN alpha and ribavirin. The treatment duration depends on the genotype of the virus and it has two goals. The first is to achieve sustained eradication of HCV, that is, sustained virologic response , which is defined as the persistent absence of HCV RNA in serum for 6 months or more after completing antiviral treatment. The second goal is to prevent progression to cirrhosis, HCC, and decompensated liver disease requiring liver transplantation.

How Often Should I Get Routine Blood Work

Your doctor will typically recommend that you get routine blood work at least once a year, around the same time as your yearly physical.

But this is the bare minimum. There are several major reasons you may want to get blood tests more often than that:

  • Youre experiencing unusual, persistent symptoms. These could include anything from fatigue to abnormal weight gain to new pain.
  • You want to optimize your health. Knowing levels of various blood components, such as HDL and LDL cholesterol, can allow you to tweak your diet or fitness plan to minimize unhealthy habits . This can also maximize the nutrients you put in your body and more.
  • You want to reduce your risk of disease or complications. Regular blood tests can catch the warning signs of almost any disease early. Many heart, lung, and kidney conditions can be diagnosed using blood tests.

Talk to your doctor first if you want to get certain tests more often than once a year.

  • nutrient tests for levels of vital nutrients, such as iron or B vitamins

Some other tests that you may want include:

  • enzyme markers if youre at risk for cancer or other conditions like liver cirrhosis, stroke, or celiac disease

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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?

What Is A Hepatitis C Screening

Patients who accepted infected kidneys cured of hepatitis C

Testing for hepatitis C involves a blood test called an HCV antibody test . This test determines if youve ever had a hepatitis C infection by checking your blood for HCV-specific antibodies.

If you test positive for HCV antibodies, youll need to undergo follow-up testing. Having antibodies doesnt mean you currently have an active infection. It may simply mean that you have had a prior exposure that your immune system cleared.

To check whether you have an active infection, a doctor will order a nucleic acid test . A positive result means the virus is currently active in your bloodstream. If you get a negative result, the virus was once in your body, but its not anymore.

  • have HIV
  • have ever had a needle-stick injury or potentially been exposed to HCV-positive blood
  • have had a tattoo or piercing done outside of a professional sterile environment

According to the , HCV may be passed through sexual activity, though this isnt common. The agency notes that your risk may be increased if you:

  • have a sexually transmitted infection
  • have sex with multiple partners
  • have anal sex

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What Is The Treatment For Hcv

There are several drugs that can be used to treat HCV infection. Most commonly, a combination of drugs is used, and new drugs are under development. Before 2000, chronic HCV was curable in only 10% of cases. Now, treatments for HCV can cure over 90% of people with hepatitis C before late complications occur, but even those with advanced liver disease often respond to treatment. This increases the opportunity to intervene early and prevent HCV-associated deaths.

  • According to the CDC, recent treatment guidelines recommend monitoring people with acute HCV but only considering treatment if the infection persists longer than 6 months.
  • Chronic HCV is usually treated with a combination of drugs.

Positive Hcv Antibody And Positive Hcv Rna

Individuals with a positive HCV EIA and positive HCV RNA should be told they have evidence of active hepatitis C infection and they should clearly understand they need medical follow-up evaluation and potential treatment of liver disease. A single positive HCV RNA value indicates infection, but must be interpreted in the context of clinical history to determine whether the individual has acute or chronic infection. For persons with a positive HCV EIA and positive HCV RNA, the CDC has generated counseling messages that focus on four areas: contacting a health care provider for further evaluation and management of their HCV infection, protecting their liver from further harm, addressing weight management in overweight and obese persons, and minimizing transmission of their HCV to others . In addition, the CDC recommends performing alcohol screening and brief intervention, which consists of screening for excessive alcohol consumption, brief counseling for individuals who screen positive, and referral to a specialized alcohol treatment program for individuals with possible alcohol dependence.

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When Is It Ordered

The CDC, the Infectious Diseases Society of America , the American Association of the Study of Liver Diseases , and the U.S. Preventive Services Task Force recommend screening with an HCV antibody test at least once in your lifetime when you are 18 years old or older . The CDC also recommends HCV screening for women with each pregnancy or for anyone who requests it.

One-time screening is recommended regardless of age if you:

  • Have ever injected illegal drugs
  • Received a blood transfusion or organ transplant before July 1992*
  • Have received clotting factor concentrates produced before 1987
  • Were ever on long-term dialysis
  • Are a child born to HCV-positive women
  • Have been exposed to the blood of someone with hepatitis C
  • Are a healthcare, emergency medicine, or public safety worker who had needlesticks, sharps, or mucosal exposure to HCV-positive blood
  • Have evidence of chronic liver disease
  • Have HIVabout 21% of those with HIV are also infected with HCV .

*The blood supply has been monitored in the U.S. since 1992, and any units of blood that test positive for HCV are rejected for use in another person. The current risk of HCV infection from transfused blood is about one case per two million transfused units.

Screening at regular intervals is recommended if you have ongoing risk of HCV infection, such as current injection drug use and sharing needles or syringes.

  • Fatigue
  • Loss of appetite, nausea, vomiting
  • Dark urine
  • Yellowing of eyes and skin

An HCV RNA test is ordered when:

How Much Does The Test Cost

Scientists divided on hepatitis C testing

The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.

For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.

At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.

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How Is The Test Used

The various hepatitis C tests have different uses:

  • An HCV antibody test is used to screen for past exposure and current infection. It detects the presence of antibodies to the virus in your blood that are produced by the immune system in response to infection. This test cannot distinguish whether you have an active or a previous HCV infection. There is some evidence that if your test is “weakly positive,” it may be a false positive. The CDC recommends that all positive antibody tests be followed by an HCV RNA test to determine whether or not you have an active infection.

    The HCV antibody test may be performed as part of an acute viral hepatitis panel to determine which of the most common hepatitis viruses is causing your symptoms.

  • HCV RNA test, Quantitative detects and measures the amount of viral RNA in your blood. This test may be used:
  • In follow up to a positive HCV antibody test to confirm the presence of the virus and diagnose an active infection
  • As an initial test for early, acute HCV infection or as follow-up to a negative antibody test if recent exposure is strongly suspected this is because HCV antibodies may not develop for two months after exposure.
  • To help determine your response to therapy by comparing the amount of virus before, during, and after treatment
  • All Adults Pregnant Women And People With Risk Factors Should Get Tested For Hepatitis C

    Most people who get infected with hepatitis C virus develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.

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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.

    Risk Factors For Hepatitis C

    Experts Advise Expanded Hep C Screening

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

    • Are a current or former injection drug user
    • Received a blood transfusion or organ donation before 1992, or clotting factor replacement therapy before 1987
    • 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
    • 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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    Specific Hcv Rna Assays And Range Of Detectable Virus

    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.

    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.
    HCV Antibody
    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.
    Negative
    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.

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    Hepatitis C Is Often Asymptomatic

    Offer testing to anyone with a risk factor or clinical indication.

    Risk factors:

    • shared drug-use equipment, even once
    • received personal services , with nonsterile equipment
    • exposed to blood during sexual activity
    • received blood, blood products, or organ transplant before 1992
    • received medical care where non-sterile equipment may have been used
    • born, travelled, or lived in a region where hepatitis C is common
    • born to a mother with hepatitis C
    • diagnosis of HIV or hepatitis B
    • clinical clues or symptoms of liver disease
    • occupational exposure

    Who Should Get Tested

    Hepatitis C Screening

    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.

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    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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