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How is hepatitis C diagnosed?

Blood tests for hepatitis C

There are several blood tests for the diagnosis of hepatitis C infection. Blood can be tested for antibody to hepatitis C. It takes up to six months for antibodies to develop after the initial infection with hepatitis C, so screening for antibodies may miss a few newly-infected individuals. Having antibodies is not an absolute indication of active, multiplying hepatitis C virus, but if the antibody test is positive (antibody is present), the statistical probability of active infection is greater than 99%.

Several tests are available to measure the amount of hepatitis C virus in a person's blood (the viral load). The hepatitis C virus's RNA can be identified by a type of test called polymerase chain reaction (PCR) that detects circulating virus in the blood as early as 2-3 weeks after infection, so it can be used to detect suspected acute infection with hepatitis C early infection. It also is used to determine whether active hepatitis is present in someone who has antibodies to hepatitis C, and to follow the viral load during treatment.

Blood tests are also performed to identify the genotypes of HCV. Genotypes respond differently to different treatment, so this information is important in selection of the most appropriate treatment regimen.

Estimation of liver fibrosis using blood tests also is quite reliable in diagnosing clinically significant scarring; these include FIB-4, FibroSure, Fibrotest, and Aspartate Aminotransferase-to-Platelet ratio index (APRI).

Return to Hepatitis C (HCV, Hep C)

See what others are saying

Comment from: snowdancer, 45-54 Female (Patient) Published: June 26

I have had hepatitis C since 1976. When I got it, I was very ill. I lost 20 pounds in two months, and I was told that I had a form of hepatitis that was not A or B. (They didn't have a name for it, so they would call it B.) In 1996, after they discovered C, I had my family doctor test me for it, and it was confirmed as hepatitis C. I was 22 when I got it. I am now 54 and have had a pretty healthy life so far, with only a few complications from my disease. I am frightened to take the interferon/ribovarin treatment because of the side effects, and also because I have genotype 1A known not to respond well to treatment, especially after 34 years with the virus. I had a biopsy a month ago, I was found to be free of cirrhosis and cancer, although I do have some scarring due to inflammation. I've been taking herbals for three years, selenium, milk thistle, omega 3, licorice root, esther c, and generally feel well with a good energy level. My white blood cell count is excellent, my viral load is two million, and my platelets are good. I seem to be in good health other than the hepatitis C. I don't drink or do things to damage my health, and I eat nutritious foods known to be good for your liver and digestive system. You can live a long time with this disease and remain active and healthy if you just use common sense and self-discipline. I'm hoping to make it into my 70s. Oh, and people think I'm only in my 40s when they meet me.

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Comment from: newdad, 45-54 Male (Patient) Published: June 16

I was diagnosed with hepatitis C in September of 2008. I went in for a routine physical. I asked for the blood test, as my family has a history of diabetes/heart problems. My doctor performed a biopsy at the end of December and determined I was at the end of stage 0/beginning of stage 1. I just had blood work done this month. My AST is 45 and ALT is 78. Everything else is within limits. My wife and I are searching, debating, and researching when/how my course of treatment should go. So as of now, treatment is on hold.

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Comment from: chimom, 45-54 Female (Patient) Published: June 08

I was diagnosed with hepatitis C, stage II, genotype 1 in 5/06 at age 52 after feeling lousy for a couple of months. Never in my wildest dreams did the idea of having Hepatitis C come up in my mind. The doctors estimated that I had the virus for 20 years. I began the peginterferon-ribavin therapy, which lasted 48 weeks. It was a grueling treatment. I never had felt so exhausted 24/7. Some days I had to tell myself to put one foot in front of the other so I could walk. I chose to take my shots Thursday nights, took every Friday off work, and slept for two days. I would come home from work and fall sleep sitting up on the sofa. My family, doctor, and co-workers were wonderful and I would not have been able to complete the treatment if it was not for them. There were times when I almost quit. The first six weeks of treatment were hell, and I asked my doctor if I could have a note to take a couple of weeks off work to take care of me. His comment was "if you can't handle this, then maybe we should discontinue treatment." I convinced him to give me the note, and found another doctor in his practice. The new doctor called me when I had questions, was supportive, and was the complete opposite of the first doctor. Finding the right doctor is essential in getting through this treatment. I have achieved sustained virological response within three months from when I started treatment. Almost three years later, I am still virus free. I consider myself cured.

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