Appropriate Uses Of The Hcv Rna Test
There are 4 major reasons that HCV RNA tests are used:
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 patientâs infection or the patientâs risk of developing significant liver disease.
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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.
Why Hepatitis C Testing Is Important
Hepatitis C is a virus that affects the liver. It is the leading cause of liver failure and end-stage liver disease and is a major cause of liver transplants in the United States.
African Americans are twice as likely to be infected with the hepatitis C virus compared to the general U.S. population, according to the CDC. While African Americans represent only 12 percent of the U.S. population, they make up roughly 22 percent of the estimated 3.2 million persons with chronic HCV infection. Moreover, chronic liver disease, often hepatitis C-related, is a leading cause of death among African Americans ages 45-64.
Within the African American community, men in their 50s show the highest rates of infection with 1 in 7 men living with chronic hepatitis C.
When first infected, a person can develop an acute infection, which can range in severity from a very mild illness with few or no symptoms to a serious condition requiring hospitalization. Acute hepatitis C infection is a short-term illness that occurs within the first six months after someone is exposed to the hepatitis C virus. For most people, acute infection leads to chronic infection but for reasons that are not known, approximately 15% to 25% of people clear the virus without treatment.
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Chronic hepatitis C infection is much more common. It can last a lifetime and lead to serious liver problems, including cirrhosis or liver cancer.
Who should get hepatitis C test done?
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Can I Take The Test At Home
You have options for hepatitis C screening, and that includes at-home testing where you can collect a blood sample by a finger prick and send your specimen to a lab. Not all types of HCV testing can be performed at home, and these tests do not screen for hepatitis C RNA or the strains genotype.
The benefit of an at-home test is that it can expose a past or active infection, though it will not reveal which. Its a great way to initially test for HCV before advancing to lab testing. Positive results should be confirmed by a health professional through lab testing.
Can Hepatitis C Be Prevented
There is no vaccine against hepatitis C. The only way to prevent infection is to avoid contact with infected blood.
Hepatitis C cannot be spread by coughing, sneezing or sharing eating utensils. People should not be kept away from school, work, or other social settings because they have hepatitis C.
Here are some precautions that may prevent the spread of hepatitis C:
- Do not share personal care items, such as toothbrushes or razors, with others.
- Practice safe sex by using condoms.
- Dont share needles or syringes.
- Wear gloves when handling another persons blood.
- Use sterile equipment for body piercings or tattoos.
- If you are a healthcare worker, follow recommended safety measures.
People who are at greater risk for contracting hepatitis C should have their blood tested. The Centers for Disease Control recommends that Americans born between 1945 and 1965 be screened at least once for the disease.
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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.29–32 Moreover, nearly 42% of primary care physicians reported being unfamiliar with the CDC guidelines in a survey of community-based physicians.33
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.
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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.36–38 All 3 studies confirmed the higher prevalence of positive serum anti-HCV in individuals born in the years 1945-1965.
What Will My Doctor Need To Know To Treat Me
If you want to be assessed for treatment, you need to make an appointment with a doctor. They will be mostly interested in the condition of your liver. Your doctor will organise, if possible, for you to have a Fibroscan examination. If Fibroscan is not available, your doctor will probably use an APRI test. This is an online calculator that estimates the health of your liver. It involves a blood test called a liver function test.
Dont forget, its very important to get a PCR test 12 weeks after finishing treatment this will mean the doctor can make sure you are cured.
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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.
Why The Different Recommendations For Baby Boomers
In 20122013, the CDC and the US Preventive Services Task Force established guidelines that recommended all baby boomers be screened for hepatitis C. Boomers were singled out because this population had most of the undiagnosed infections.
Screening for hepatitis C is a big deal, because its a potentially serious and treatable infection affecting an estimated four million persons in the US and 100 million people worldwide. And, while its common to have it without knowing it, liver failure or liver cancer are known complications that could be prevented by screening and treatment.
Studies looking at the effectiveness of screening baby boomers have demonstrated success as well as limitations. In recent years its become clear that the fastest growing group of people newly infected with hepatitis C is young adults ages 20 to 39 who would be missed under previous guidelines.
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How Likely Am I To Become Infected With Hepatitis C From A Family Member Living In The Same House
Household transmission of hepatitis C is extremely rare. Fewer than 1 in 1,000 family members or close acquaintances becomes infected each year through common, nonsexual contact with hepatitis C-infected persons.
There are many possible ways by which hepatitis C could be passed from one person to another. Because the virus is carried in the blood, it could be transmitted between household members if a mucous membrane were to come in contact with blood or body fluids containing hepatitis C. Family members sometimes share razors, toothbrushes, or toothpicks, perhaps unknowingly. If an item were contaminated with hepatitis C-infected blood from one person, the virus could be passed to a second person if it were to tear the lining of the mouth or break through the skin.
Although these sorts of possibilities are often discussed as potential ways for hepatitis C to infect family members, such events occur very rarely.
If you arent sure of your hepatitis C status, get tested. If you test negative and have lived in a household with an infected family member or close acquaintance, you shouldnt worry that any more contact will put you at risk.
What Is Hepatitis C And How Common Is It In The United States
Hepatitis refers to inflammation of the liver. There are a handful of viral hepatitis types , but hepatitis C is the cause of the majority of serious liver disease in the United States. The hepatitis C virus is spread when blood from a person infected with the virus enters the body of someone whos not infected. There is no vaccine to prevent hepatitis C, which makes early detection so important.
In the United States, its estimated that between 3 and 5 million people have chronic hepatitis C, and most of those people dont know theyre infected. The majority of people with chronic hepatitis C are from the baby boom generation.
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Over 250000 Canadians Believed To Be Infected But Many Unaware They Have Blood
Canadians born between 1945 and 1975 should be tested for the potentially liver-destroying virus hepatitis C, a new set of guidelines recommends.
More than 250,000 Canadians are believed to be infected with hepatitis C, but an estimated 40 to 70 per cent are unaware they harbour the blood-borne virus because it can take decades before symptoms become evident. Chronic infection can lead to cirrhosis of the liver or liver cancer.
The Canadian Association for the Study of the Liver, a national group of health-care providers and researchers, published its guidelines on testing and treating hepatitis C in Mondays edition of the CMAJ.
A key recommendation is that people be tested based on their age not only possible risk factors, said Dr. Jordan Feld, a liver specialist at Torontos University Health Network and a co-author of the guidelines.
And the reason weve done this is it just happens that somewhere between two-thirds and three-quarters of people with hepatitis C were born between 1945 and 1975 in Canada, he said.
So just the way someone gets a blood pressure check or a cholesterol check or a colonoscopy based on their age, we would recommend that they get a hepatitis C test if theyre born between those years.
And if we do that, we hopefully diagnose the vast majority of people living with hepatitis C.
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Early Treatment Can Help You Prevent Liver Cancer Or Liver Failure
According to the CDC, out of every 100 people with hepatitis C:
- More than half will develop chronic liver disease.
- About 5 to 25 will get cirrhosis, a dangerous scarring of the liver.
- 1-5 will die from liver cancer or liver failure.
Getting tested and treated early can stop the hepatitis C virus from triggering cirrhosis or cancer. Your doctor will be able to keep an eye out for signs of liver trouble. They can start treatment before you serious damage starts.
Show Sources
CDC: “Hepatitis C FAQs for Health Professionals,” “Hepatitis C Fact Sheet,” “Hepatitis C: What to Expect When Getting Tested,” “Living with Chronic Hepatitis C.”
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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.
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 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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How Does The Test Kit Work
Its quite simple to test yourself at home. All you have to do is buy the iDNA kit, after which it will be mailed to your door in a small, discreet, unmarked package. Follow the directions to collect the sample, mail it off to the cutting-edge and certified lab, then register and wait for your results. We work 7 days a week to test samples and deliver results as quickly as possible.
The best part is, as soon as youre registered, you can use iDNA test kits regularly without extra work. All you have to do is order your kit once a year , supply a sample and wait for results. If you get a positive, only then do you make an appointment with a doctor for next steps.
Along the way, were happy to answer any questions you may have with a knowledgeable in-house customer service team.
Aasld/idsa Hcv Testing Guidance
The American Association for the Study of Liver Diseases and Infectious Diseases Society of America guidance for hepatitis C addresses HCV testing in the section HCV Testing and Linkage to Care. The AASLD/IDSA recommends one-time, routine, opt out HCV testing for all individuals aged 18 years and older, one-time testing for persons younger than age 18 who have increased risk for acquiring HCV, periodic testing for persons who have risk activity for acquiring HCV, and annual testing for men with HIV who have condomless sex with men men who have sex with men and are on HIV preexposure prophylaxis and people who inject drugs . The AASLD/IDSA recommendations for testing incorporate birth-cohort screening as well as testing based on risk behaviors, risk exposures, and medical conditions associated with acquisition of HCV.
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Why Everyone Should Get Tested For Hepatitis C
Hepatitis C is one of the deadliest infectious diseases in the United States. Hep C contributed to at least 14,242 deaths in the U.S. in 2019 alone.
While we dont have a vaccine for this type of hepatitis to prevent it from spreading , it is treatable and curable for most people.
The number of new viral infections among adults of all ages has quadrupled in the last decade. Why? Many people with hep C are unaware that theyre infected and, as a result, can infect others. Now, leading health organizations recommend that all adults get tested for HCV at least once.