Top Five Reasons To Get Tested For Hepatitis
Should you get tested for hepatitis? Roselyn Castaneda, a Registered Nurse and Program Coordinator for the Viral Hepatitis Program at The Ottawa Hospital thinks so. Getting tested for hepatitis is easy, and it can help protect yourself, your family and your friends from serious health problems like liver cancer.
You Can Protect Your Family And Friends
You can pass the hepatitis C virus to others through your blood, even if you don’t have any symptoms. To prevent this, cover wounds carefully and avoid sharing:
- Razors, nail clippers, toothbrushes, or diabetes supplies
- Needles for injecting drugs, or steroids
- Tools for body piercings or tattoos
Hepatitis C doesn’t spread through kissing, coughing, sneezing, or sharing eating utensils. Although it’s uncommon, you can get it from unprotected sex.
Treatments Can Suppress Or Even Wipe Out The Virus
Hepatitis C is treated with a combination of medications called antivirals. For many people, they get rid of the virus completely. They do have serious side effects and they donât work for everyone. New drugs recently approved by the FDA are more effective and have fewer side effects. But some are expensive.
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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.
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
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How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site, and then put on a bandage.
Limitations Of Screening For Hepatitis C
Barriers to screening for hepatitis C include limited access to healthcare, inadequate health insurance coverage, individuals’ decreasing recall of past risky behaviors, lack of knowledge of hepatitis C prevalence, natural history, and available tests and treatments for hepatitis C at the provider level.- Moreover, nearly 42% of primary care physicians reported being unfamiliar with the CDC guidelines in a survey of community-based physicians.
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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
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.
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Cdc Recommendations For Hepatitis C Screening Among Adults In The United States
- Universal hepatitis C screening:
- Hepatitis C screening at least once in a lifetime for all adults aged 18 years and older, except in settings where the prevalence of HCV infection is less than 0.1%*
- Hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is less than 0.1%*
- Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons may be reluctant to disclose stigmatizing risks
Hepatitis C Testing And Diagnosis
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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Dried Blood Spot Testing
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.
What About People Under 18 Or Over 79
Theres little evidence available on whether treatments for hep C are effective in children, teenagers, or the elderly. For that reason, the new guidelines dont suggest the same blanket testing among these age groups. But because the medications work well for large segments of the population, public health experts still recommend that if youre at high risk of exposure to the virus, particularly from past or current injection drug use, you should be screened for hep C regardless of age.
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Are There Other Reasons For The New Recs
Yes. A big reason for the re-think is that the number of hep C cases has risen dramatically in recent years, in part due to the opioid epidemic. Public health experts estimate that about one in three people who inject drugs under the age of 30 are infected with hep C, while the majority of older injection drug users are also likely to be infected. These factors convinced infectious disease experts that screening should be widespread and reach a broad age demographic.
How Does Hepatitis C Spread
The most common way to contract Hepatitis C is through needles . Pregnant women infected with Hepatitis C can spread the virus to their children at the time of birth. Less common ways to spread Hepatitis C include sexual contact, sharing personal care items like razors, and getting body modification procedures, such as tattoos and piercings, in non-sterile environments.
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What Do You Do If You Become Ill
Talk to your health care provider about getting tested if you think you:
- are at risk
- may have hepatitis C
If you have hepatitis C, tell those who may have been exposed to your blood or bodily fluids. They should get tested and be treated if necessary. Bodily fluids, like semen and vaginal fluid, are a concern because they could be carrying small amounts of infected blood.
Some adults with hepatitis C will recover from the disease on their own within 6 months. Until your health care provider confirms your recovery status, you are still contagious and can spread the disease.
After recovery, you are no longer contagious because you will not have the disease anymore. But you can get hepatitis C again.
Unfortunately, most adults with hepatitis C:
- cannot recover on their own
- develop a more serious form of the disease if they are sick for longer than 6 months
How Much Does The Test Cost
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 Do You Get Tested For Hepatitis C
Several testing procedures are available to accurately diagnose hepatitis C infection.
Hepatitis C, an inflammation of the liver caused by the hepatitis C virus , often goes undiagnosed until serious liver problems develop decades after contracting the virus. This is because the illness is asymptomatic for most people, according to the Centers for Disease Control and Prevention .
For these asymptomatic people, hepatitis C is generally detected when blood screenings show they are HCV-positive, or routine examinations show they have elevated levels of the liver enzyme alanine aminotransferase , an indication of liver cell damage.
Potential Sites For Screening For Hepatitis C
Screening for hepatitis C can be offered in several venues the most likely are primary care offices, emergency rooms, urgent care clinics, and public health fairs.
Following the CDC recommendation, 3 studies were presented at the 2013 meeting of the American Association for the Study of Liver Diseases in Washington, DC. One study was conducted in an emergency department, the second in the outpatient clinics of the US Department of Veterans Affairs, and the third involved individuals undergoing screening colonoscopies for colorectal cancer at a community hospital.- All 3 studies confirmed the higher prevalence of positive serum anti-HCV in individuals born in the years 1945-1965.
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Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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.
Some groups of people are at an increased risk of hepatitis C, including:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991 or blood products before 1986 in the UK
- 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 Africa, the Middle East and central 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, family members and close contacts 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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Besides Hcv Testing What Other Tests Might Be Done
Healthcare practitioners may also order a liver panel, which is a group of tests that help assess the health of your liver. Liver tests such as ALT and AST may be used to detect ongoing liver injury. You will likely be checked to see if you are immune to hepatitis A and hepatitis B, and if not, you will be offered vaccination, since infection with these other viruses can further damage your liver. Other tests such as albumin, prothrombin time, and bilirubin can also be used. They are typically normal unless you have developed cirrhosis. Sometimes a liver biopsy may be performed to determine the severity of liver damage. If you are going to be treated, you will be checked for exposure or infection with hepatitis B virus, as HCV treatment can cause a flare-up of hepatitis B.
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.
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