How to Read Hepatitis C Test Results

Hepatitis C virus (HCV) 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 role tests, imaging studies, or a biopsy can back up or ostend the diagnosis equally well.

As of March 2020, the U.S. Preventive Services Job Force (USPSTF) 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 meaning women.

Cocky-Checks/At-Habitation Testing

If y'all think that you may take HCV, there are a few signs y'all can try to look for on your own. The problem, even so, with self-checks for HCV, is that many of the signs you can observe are common to most viral infections. Some of the signs you tin can await for are signs of liver disease, but they are not specific to HCV.

Pare and Eyes

The sign that is most characteristic of HCV is jaundice, a yellowish colour of the pare and eyes. Jaundice affects the whole body and the white part of the optics. This color tin can announced equally mildly yellowish, almost like a suntan, or, if the infection has had a major impact on liver function, your optics and skin might go an extremely deep yellow color.

Jaundice indicates liver failure or liver dysfunction, so it is not specific to HCV.

Abdominal Distension

Expansion of the abdominal area, with or without discomfort, is common in belatedly-phase HCV. Many people do not have any signs of HCV in the early on stages of infection, and abdominal distention can be the first clue that y'all have HCV.

Flu-Like Symptoms

If you have agile HCV infection, you might have a mild fever, fatigue, muscle aches, loss of ambition, nausea, and breadbasket discomfort. You tin can experience this with nigh whatever viral infection, so information technology is not a strong clue that you have hepatitis.

Gastrointestinal Symptoms

If yous take an active HCV infection, y'all are likely to experience stomach upset, nausea, airsickness, or diarrhea. As with the flu-like symptoms, this is non a definite sign of HCV infection, as it tin can occur with other infections every bit well.

Hazard Factors

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Most of the fourth dimension, you will non know correct away if y'all take been infected with HCV. Carefully thinking about whether you take whatever risk factors is the best way to bank check if you might have HCV.

If you have risk factors or any of the signs of HCV, it is recommended that yous get tested for the virus.

Labs and Tests

There are several blood tests that can diagnose HCV infection, determine the best class of handling, and monitor your progress. Blood tests can check for HCV antibody, for HCV itself, and for liver function changes.

HCV Antibody Blood Tests

When hepatitis C viruses infect your liver cells, your immune organisation responds past using antibodies to marking the viruses as harmful intruders. The antibodies are specific for HCV, so their presence indicates that yous have had HCV at some fourth dimension in your life. Antibody tests cannot distinguish between past or current infection, so clinical information such every bit medical history, signs, symptoms, or other tests can decide whether you have an agile infection or a previous infection.

Blood Exam: Enzyme-Linked ImmunoSorbent Assay (ELISA) tests can observe antibodies in your blood. There are many different ELISA tests. The ELISA test for HCV searches the blood sample for the HCV antibiotic. If antibodies are found, this ways that you might have HCV infection. The ELISA exam is very sensitive and is positive 95 percent of the time if you lot take HCV antibodies. This loftier sensitivity means that when the ELISA test is negative, you can feel very confident that you do not have HCV. Notwithstanding, it is so sensitive that it may incorrectly identify HCV antibodies, and in that location is a small possibility that a positive effect could be incorrect. Because of the risk of a false positive issue, a 2nd examination may be needed to verify the original results.
Rapid Test: The rapid examination tin detect HCV in your blood or saliva with 89 percent sensitivity and 100 pct specificity. This means that it is non every bit sensitive every bit the ELISA test and can miss the presence of HCV sometimes. Simply if the test is positive, then you can be certain that you have or have had HCV in your body at some time.

Hepatitis C RNA

The detection of HCV RNA, which is genetic fabric of the virus, indicates that the virus itself is present in your body. This powerful test also allows healthcare providers to see how well you lot are responding to treatment because it can determine the amount of virus in your blood, which is ofttimes called the viral load. It detects the virus by using PCR technology (polymerase chain reaction), which is a method of detecting genetic material.

Using ELISA and HCV RNA tests together:

Negative ELISA = No hepatitis C antibodies found in blood. Y'all are probably non infected with HCV.
Positive ELISA = You may take 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.

Hepatitis C Virus Genotyping

Hepatitis C viruses are not all the aforementioned. Certainly, they are all identified as hepatitis C viruses and they all tin can cause acute and chronic hepatitis C infection, but they are non exactly genetically alike. They take slightly different genetic variations and are grouped into different genotypes (genetic types).

Knowing your genotype tin significantly alter the duration of your treatment because your healthcare provider can select the right treatment for the type of HCV you accept.

Genotypes are important because hepatitis C viruses with different genetic variations require different handling approaches. Healthcare providers make up one's mind your HCV genotype with a laboratory test that uses a method chosen reverse transcription polymerase concatenation reaction (RT-PCR). This test analyzes the genetic material of the virus to determine its sequence, which identifies the virus's genotype.

Liver Function Tests (LFTs)

Liver role tests can exist abnormal if the virus and the inflammation cause impairment to the liver. These tests by and large are not expected to be abnormal until late stages. And treatments for HCV tin also change LFT levels.

The LFTs that go contradistinct if you lot have liver dysfunction include:

Albumin
Bilirubin
Prothrombin Time (PT)
International Normalized Ratio (INR)

LFTs that can become altered if y'all have inflammation of the liver include:

Alanine aminotransaminase (ALT)
Aspartate aminotransferase (AST)
Gamma-glutamyl transaminase (GGT)

Hepatitis C Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider'due south date to assist y'all enquire the correct questions.

Download PDF

Imaging

Imaging tests tin identify inflammation of the liver, enlargement of the liver, shrinking of the liver, or tumors in the liver. Imaging results cannot specifically place HCV infection. Any of these consequences can occur as a upshot of HCV infection, although they tin can occur with whatever liver illness as well. You might demand to take imaging tests if you accept intestinal distention, severe jaundice, or symptoms that suggest that you might have cancer. Y'all also may demand imaging tests if your healthcare provider is concerned about other possible diagnoses that tin be identified on abdominal imaging tests, such as appendicitis or gallstones.

Abdominal Ultrasound: This exam tin can evaluate abnormalities in the liver and belly, and may likewise discover the fluid build-up in the belly, which tin occur with liver failure.
Computerized Axial Tomography (CT) scans: An abdominal CT scan can observe changes in the size and density of the liver and may visualize masses or signs of early cancer.
Magnetic Resonance Imaging (MRI): An MRI tin can pick upwardly on abnormalities that suggest liver dysfunction or cancer.
Liver Biopsy: A liver biopsy is a section of tissue taken from the liver and evaluated nether a microscope to look for identifying features of the affliction. The procedure is ofttimes guided by abnormal lesions noted on imaging studies.

Differential Diagnoses

Several unlike medical problems can cause abnormal LFTs and produce symptoms similar to those of HCV infection. Yet, none of these conditions can cause you to have a positive HCV antibody blood exam or a positive HCV RNA examination.

Alcoholic Hepatitis: Alcoholism tin cause several serious problems in the liver, including fat liver, cirrhosis, and cancer. The evolution of alcoholic liver disease occurs gradually over fourth dimension, and imaging studies may prove different patterns than what would be expected with HCV.
Hepatitis B (HBV): The pattern of illness with HBV is more than severe than that of HCV, although there can exist similarities because they are both viruses that touch the liver.
Hepatitis A (HAV, hep A): Another virus that causes hepatitis, like HCV, hep A, tin cause flu-like symptoms. This virus is transmitted through contaminated food. It spreads because the virus is present in the stool (poop) and can be spread from person to person due to improper handwashing.
Cholecystitis (inflammation of the gallbladder) or Choledocholithiasis (gallstones): Gallstones or inflammation of the gallbladder can cause jaundice, nausea, vomiting, and fever. Cholecystitis and choledocholithiasis may be painful too.
Appendicitis: Inflammation or infection of the appendix cause astringent intestinal pain and fevers, and develops quickly. Sometimes, appendicitis can be mistaken for HCV infection if the pain of appendicitis is mild. HCV infection tin can be mistaken for appendicitis if the hurting and abdominal discomfort are worse than the usual HCV symptoms.

Hepatocellular Carcinoma: Cancer of the liver tin can cause intestinal distension, jaundice, and aberrant LFTs. Cancer of the liver may also develop as a result of belatedly-phase HCV. It is of import to determine if HCV was the cause of the cancer because the virus and cancer would both need to be treated.

Often Asked Questions

How before long later exposure to hepatitis C can the virus be detected?

It can take between eight and 11 weeks later being exposed to the hepatitis C virus (HCV) for the antibody to show up in the anti-HCV blood exam. Around 80% of people exposed to the virus never have symptoms such as jaundice, but if they practice, it may be as long as six months before they develop.
Does Medicare cover screening for hepatitis C?
Medicare will pay for hepatitis C screening when a qualified medical professional orders information technology for a patient who meets certain criteria, specifically:
- At high take a chance of infection considering of illicit use of injectable drugs
- History of a claret transfusion prior to 1992
- Born betwixt 1945 and 1965
Are at that place abode tests for hepatitis C?

Yes. For example, the OraQuick HCV Rapid Antibody Test was approved by the Food and Drug Administration in 2011 for at-dwelling screening for HCV for people showing signs or symptoms of HCV infection or who are at high risk for infection.It involves taking a sample of blood from a fingertip, mixing information technology with a special solution, so using a device similar to a pregnancy examination stick that detects the presence of HCV antibodies. The test is 98% accurate.
How long does information technology take for hepatitis C to cause liver impairment?

Around 20 years. According to the World Health Organisation, the chance of chronic HCV infection leading to cirrhosis of the liver in this corporeality of time is fifteen% to 20%.

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Source: https://www.verywellhealth.com/hepatitis-c-diagnosis-1759914