I. Introduction

Testing for hepatitis C is important among those at risk, as 50% of people with an infection don’t know they have it. The infection can progress to chronic hepatitis C, resulting in serious complications, such as liver damage, liver failure, and death. There’s an urgent need to diagnose and treat more Americans for hepatitis C, according to the CDC.

This guide provides basic information about hepatitis C, including how the virus is spread, symptoms of an infection, and risks to your health. We also look at options for hepatitis C testing and treatment.

II. Overview of Hepatitis C Testing

Why should I get tested?

The purpose of hepatitis C testing is to diagnose an infection of the hepatitis C virus in the body. As some people may not experience any symptoms, a blood test is the only reliable way to confirm an infection.

When should I get tested?

The CDC recommends testing for hepatitis C if you:

  • Have injected drugs at any time
  • Were born between 1945 and 1965, even if you aren’t otherwise at risk. Baby boomers are five times more likely to have hepatitis C.
  • Received a blood transfusion or organ transplant prior to 1992, when blood supplies weren’t routinely tested for hepatitis C
  • Have chronic liver disease, HIV, or AIDS
  • Are on hemodialysis
  • Were born to a mother with hepatitis C
  • Are a healthcare worker who was accidentally exposed to blood through a needle stick

What is required for the test?

A hepatitis C test requires a blood sample, which is screened for the presence of hepatitis C antibodies or the genetic material of the virus (RNA).

What do I need to do to prepare for the test?

No preparation is required for a hepatitis C blood test.

III. The Basics of Hepatitis C

Hepatitis is a disease that affects the liver, a vital organ that processes food into nutrients and filters toxins from the body. If left untreated, hepatitis C can result in liver disease, including cirrhosis, liver cancer, and liver failure. It’s the most common cause of liver transplantation.

The virus is spread through contact with blood or open sores of someone with a hepatitis C infection, via:

  • Shared drug injection needles
  • Improperly sterilized tattoo or piercing tools
  • Shared razors or other personal items
  • An accidental stick with a needle in a hospital or healthcare setting
  • Unprotected sex
  • Childbirth (mother to child)

Types of Hepatitis C

There are two types of hepatitis C.

  • Acute hepatitis C is a short-term infection that occurs within six months of exposure to the virus. In some cases, the immune system successfully fights the infection and it resolves without treatment. In 75% to 85% of cases, acute hepatitis C develops into a chronic infection.
  • Chronic hepatitis C is a long-term infection of more than six months. Early diagnosis is important, as chronic hepatitis C can eventually cause liver damage, even if a person isn’t experiencing symptoms. Chronic hepatitis C causes cirrhosis in 5% to 20% of people decades after the initial infection.

Symptoms of Hepatitis C

On average, the symptoms of hepatitis C appear after six weeks but may develop as early as two weeks or as long as six months after exposure. Only 20% to 30% of people with the virus experience symptoms, which may include:

  • Fatigue
  • Fever or feeling unwell
  • Dark yellow urine
  • Pale-colored stool
  • Joint and muscle pain
  • Lack of appetite
  • Nausea and vomiting
  • Abdominal pain
  • Jaundice

IV. How a Hepatitis C Test Works

There are several blood tests that help diagnose a hepatitis C infection.

Hepatitis C Antibody Test

A hepatitis C antibody test, also known as an anti-HCV test, screens for antibodies to the hepatitis C virus. Antibodies are produced when the immune system detects a virus or bacteria in the body.

  • If the antibody test is positive or reactive, the test has found the presence of hepatitis C antibodies in your blood. This means you’ve been exposed to the virus. Because the antibodies will always be in your bloodstream, even if the infection has cleared, further testing is needed to determine if you have a past or current hepatitis C infection.
  • If the test is negative or nonreactive, it hasn’t found the presence of hepatitis C antibodies. However, if you’ve been exposed to the virus in the past six months, you need to be tested again as the antibodies may take longer to appear.

Hepatitis C RNA Test

A hepatitis C ribonucleic acid (RNA) test, also called a PCR test, is usually performed if an antibody test is positive. It screens for the genetic material of the virus in your blood and measures the number of particles, if any.

  • If the RNA test is negative, and your antibody test was positive, you once had a hepatitis C virus, but it’s no longer in your body.
  • If the RNA test is positive, you have a current hepatitis C infection.

The RNA test may also be used during treatment for hepatitis C to monitor improvement.

Viral Genotyping

A positive RNA test is usually followed by a test to determine the genotype of the hepatitis C virus. There are at least six genotypes, numbered 1-6, along with subtypes, such as 1a, 1b, and 1c. Genotype 1 is the most common in the United States, accounting for three-quarters of all cases of hepatitis C. Knowing the genotype of the virus helps your physician determine the best course of treatment.

Performing Hepatitis C Blood Tests

A hepatitis C test is performed on a blood sample. One option is to visit a lab and have a blood sample collected by a clinician.

  • Your arm is examined to locate a vein from which to draw the blood sample.
  • Antiseptic is used to wipe any germs from the site.
  • An elastic band is tied around your upper arm to help with blood flow to the vein to make it easier to draw blood.
  • A needle is inserted in your arm, and a small sample of blood is drawn into a vial.
  • The elastic band and needle are removed from your arm.
  • A small bandage is applied over the puncture site to stop bleeding.
  • The blood sample is sent for testing.

If you’re using a home test kit, you can collect a blood sample in the privacy of your own home. This involves pricking your finger with a lancet and collecting drops of blood for testing. The sample is then returned to a lab for processing.

V. Treatment for Hepatitis C

Acute Hepatitis C

Physicians often wait to see if an acute hepatitis C infection develops into chronic hepatitis C before beginning treatment. There is no recommended treatment for acute hepatitis C, as it tends to clear on its own in 25% of cases.

Chronic Hepatitis C

After six months of infection, hepatitis C is considered to be chronic. Your physician will determine an appropriate treatment plan based on a number of factors, including:

  • The virus genotype
  • Whether there’s damage to your liver
  • Your medical history and overall health
  • Any prior medication or treatments you’ve had for hepatitis

In most cases, antiviral medication in the form of pills is used to treat hepatitis C, with the goal of preventing liver scarring and eliminating the virus from your body. New antiviral medications are continually developed, so it’s best to consult with a doctor regarding an appropriate drug regimen. If diagnosed early enough, hepatitis C is curable in 90% of cases. Treatment is typically required for two to six months.

Additional blood tests are performed during and after treatment to monitor your improvement.

If you have liver damage, you may be referred to a specialist for other types of treatment. This may include medication, surgery, or liver transplantation.

VI. FAQs

Can I be vaccinated against hepatitis C?

While vaccines are available for hepatitis A and B, there is no vaccination for hepatitis C.

Do I need to see a doctor to be tested for hepatitis C?

No. There are two ways to order hepatitis C tests online without seeing a doctor:

  • You can purchase a laboratory order for hepatitis C, which includes a doctor’s order. Check the website before purchasing to ensure there’s a lab near you that will accept the order. Once you’ve purchased the order, you can print it and take it to the lab. A clinician draws the blood sample from your arm using a needle syringe and sends it for testing. The results of your test are available online.
  • You can purchase a home test kit, which is mailed directly to you, so you can collect the blood sample in the privacy of your own home. The kit contains all of the necessary supplies to obtain a blood sample, including a lancet to prick your finger. You must collect your blood sample as instructed and return it to the lab for testing. It’s important to follow instructions carefully to ensure reliable results.

What happens if my hepatitis C test is positive?

If your hepatitis C antibody test shows that there are antibodies in your blood, your doctor may request additional tests to determine if the infection is current.

If your hepatitis C RNA test shows that the genetic material of the virus is in your blood, you have a current infection, and your doctor needs to confirm the genotype and whether there’s been damage to your liver. This may include additional blood tests, imaging tests, ultrasounds, or a liver biopsy. Treatment depends on the extent of liver damage if any.

How soon after exposure can hepatitis C tests detect the virus?

The hepatitis C antibody test can detect antibodies within four to ten weeks. In 97% of cases, it’s able to detect antibodies within six months of exposure.

The hepatitis C RNA or PCR test can detect the genetic material of the virus within two to three weeks of exposure.

Can hepatitis C be spread through sexual intercourse?

Yes, but the risk is considered low. The risk increases if you:

  • Have multiple sex partners
  • Have unprotected sex
  • Engage in rough sex that may cause bleeding
  • Have sex during menstruation
  • Have sex when you or your partner have an open genital sore
  • Have a sexually transmitted disease or HIV

It’s unlikely for hepatitis C to be transmitted through oral sex.

What are the chances of hepatitis C leading to cirrhosis?

About 10% to 20% of those infected with hepatitis C will develop cirrhosis, or scarring of the liver, in 20 to 30 years. Among these, 3% to 6% develop liver failure, and 1% to 5% develop liver cancer.

Can I be reinfected with hepatitis C?

Yes. If you’ve been infected by hepatitis C and the virus cleared on its own or with treatment, you can still acquire the infection again. It may be the same genotype or a different one.

How do I know if I'm cured?

If a blood test doesn’t detect the virus in your body at least three months after completion of treatment, the virus is considered to be eliminated. Be sure to have regular checkups and take measures to reduce your risk of reinfection.

VII. Additional Resources

To learn more about hepatitis C and testing for the hepatitis C virus, use the following resources.

NameWebsiteSummary
National Institute of Diabetes and Digestive and Kidney Diseaseswww.niddk.nih.govDetailed information about hepatitis C
Centers for Disease Control and Preventionwww.cdc.govHepatitis Risk Assessment (Personalized Report)
Centers for Disease Control and Preventionwww.cdc.govHepatitis C Patient Education Resources
American Liver Foundationwww.liverfoundation.orgHepatitis C Information Center
World Health Organizationwww.who.intOverview of different types of hepatitis.

VIII. Sources Used in This Article