Definition

Hepatitis C is a viral infection caused by the hepatitis C virus (HCV). If undetected or untreated, this infection may become chronic, leading to liver inflammation and potential liver damage. Often asymptomatic, hepatitis C requires early detection through testing, distinguishing it from other forms like hepatitis A and B.

The HCV antibody test identifies whether the body has encountered HCV by detecting antibodies specific to the virus in the blood.

For those aged 18 or older, it is recommended to undergo hepatitis C screening at least once. This screening is also suggested during pregnancy or when risk factors for HCV infection are present. Because acute hepatitis C commonly lacks symptoms, screening plays a crucial role in diagnosing the virus before liver damage occurs.

The primary objective of hepatitis C testing is to determine HCV exposure and guide potential treatment. HCV can be transmitted through blood or other body fluids of infected individuals.

Indications

Individuals aged 18 and older should undergo hepatitis C screening at least once. This virus often presents without symptoms, making screening essential. Screening is also advised during pregnancy and for those with HCV risk factors, with regular screenings recommended as long as risk factors persist.

Hepatitis C risk factors include:

• History of injection drug use
• Past blood transfusion or organ transplant
• Dialysis treatment
• Exposure to needles, including through occupational hazards, tattoos, or piercings
• Working or residing in prison environments
• Being born to a mother with hepatitis C
• HIV infection
• Engaging in unprotected sexual activity

Hepatitis C testing may also be recommended when liver function tests show irregularities or to diagnose the cause of liver damage. Although hepatitis C frequently presents without symptoms, signs may emerge one to three months after infection.

Typical symptoms of HCV infection include:

• Dark yellow urine
• Fatigue
• Fever
• Gray-colored stools
• Abdominal or joint pain
• Nausea, vomiting, or decreased appetite
• Yellowing of the skin and the whites of the eyes (jaundice)

Contraindications

There are no specific contraindications that prevent an individual from undergoing this test.

Preparations Before the Test

No specific preparation is necessary for the anti-HCV test, and fasting is not required. However, it is advisable to consult with a physician prior to testing, as certain conditions may impact the test's accuracy.

Getting adequate rest and staying hydrated before the test can also facilitate blood sample collection.

Test Procedure

This test involves drawing a blood sample, typically from a vein in the arm or hand. Once the blood is collected, the puncture site will be covered with a bandage. Normal activities can be resumed immediately following the test. Some may experience minor bruising or discomfort, which should subside quickly.

Normal and Abnormal Values

A positive hepatitis C antibody test result indicates past exposure to the virus, while a non-reactive (negative) result suggests no current infection.

If the result is reactive or positive, further testing, such as the HCV RNA (PCR) test, will be recommended to confirm active infection. This follow-up test will either indicate the presence of HCV or show a negative result if the virus is absent.

When necessary, a quantitative hepatitis C RNA test, which provides a numeric viral load in the blood, may be conducted to assess the infection's severity.

Results and Recommendations (Further Testing)

For individuals who test positive for HCV, determining the most effective treatment may involve a genotype test to identify the specific hepatitis C strain. This information aids doctors in assessing liver function. Additional testing may be necessary to monitor health and refine treatment, potentially including screenings for HIV and hepatitis B due to their similar transmission routes.

If the test is positive and treatment has begun, the physician may use a quantitative HCV RNA test to monitor treatment effectiveness.

Consult the Right Doctor

Adults with positive anti-HCV test results should discuss their options with a general practitioner, who may initiate further testing or treatment as needed. Consulting an internist or hepatologist may also be beneficial for a detailed liver function assessment. In pediatric cases, any result indicating infection or abnormality should be discussed with a pediatrician.

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