Hepatitis C: testing and diagnosis
If you think you might be at risk of having hep C, the only way to tell is a hepatitis C test. You cannot rely on symptoms or how you are feeling.
Should you get a hepatitis C test?
The highest risk of contracting hep C is using a needle or syringe (and other paraphernalia e.g. spoon, filter) that has been used by someone else with hep C.1
If you are concerned that you may have been infected you may consider taking a hep C test to give yourself peace of mind. Hep C tests are recommended for people who:2
- Have a history of drug use involving needles, snorting or pipes, even if this was only once
- A history of steroid use involving needles
- Have had sexual partners who have chronic hepatitis C or have had many sexual partners
- Received a blood transfusion before September 1991 or an organ or tissue transplant before 1992
- Have lived or had medical treatment in countries in areas such as the Middle East and North Africa where hepatitis C is common
- Are children of mothers infected with hep C
- May have been accidentally exposed to the virus through their profession; such as health workers
- Have received a tattoo or piercing in an environment where the equipment may have not been properly sterilised, such as abroad
If any of these apply to you or you are just worried, please speak to a healthcare professional. The test is free and available in a variety of locations. See below for a list of centres and organisations that provide free testing.
What are the benefits of getting tested for hepatitis C?
Hep C testing is quick and simple, and involves a blood sample being taken by needle and syringe. This is then tested for the presence of the virus in the blood. If you seek out testing and support, you may hear the term ‘viral load’. This is the number of hepatitis C viral particles in the blood and can be used by a healthcare professional to help guide treatment. Some areas can offer dried blood spot (finger-prick) testing or oral swab testing for which shows if you’ve ever been exposed to hep C. Don’t delay: get tested if you think you might be at risk.
Dealing with a hep C positive test result is a difficult experience, however knowing you have hep C is the first important step towards being able to beat it.
Being diagnosed allows you to:
- Understand symptoms you might have been feeling for some time, such as fatigue (see managing common hep C symptoms for more info)
- Make lifestyle changes to help protect your liver from further damage
- Find out how to avoid transmission to others (see staying safe for more info)
- Get support from loved ones and patient support organisations (see telling people about having hep C and our Resources section for more info and contact details)
- Seek treatment that may reduce complications and in many cases lead to cure (see Hep C Treatment)
If you have tested positive for hep C or if you already know you have hep C, taking steps to get the right care is straightforward. You will be referred to see a specialist, probably at your local hospital but possibly in a local clinic. It is here you will be able to get expert advice around your liver and your treatment options.
It is important to remember that hep C is treatable and curable for the majority of patients. By speaking with a specialist you will be able to find out what treatment and care options are right for you.
Hepatitis C testing, what’s involved?
Diagnosis begins with a blood test to detect hep C antibodies. If you are infected, antibodies which are produced by the body to fight the infection, will be present in your blood.3 These can be detected within two to three months after the virus enters the body. This test shows that you have been exposed to the virus in the past, about 15 to 25% of people who are infected with hep C are able to clear the virus from their body by themselves.4
The next step is to detect the actual virus in the blood, this is done using a test called a viral load test. This measures the amount of virus in the blood. If a person is in the early stages of an infection (first few weeks) they may not have developed antibodies yet so this test is necessary to confirm that they’re infected.3
Once the infection is confirmed, a hepatologist will perform a test to determine the particular genotype of the hep C virus you are infected with. A genotype refers to the particular genetic makeup of an organism. There are seven known genotypes of hep C, however there has only ever been a handful of cases presenting with genotype 7. The most common genotype is genotype 1, accounting for 60% of cases globally.5,6
Where to seek a hepatitis C test?
There are many places you can go for free and confidential hep C tests:
- GPs. Your GP clinic will be able to assist you in getting tested. Some clinics will be able to take a blood test on site others may refer you to a local hospital for the test
- Sexual health clinics. Most sexual health clinics provide hep C testing, some clinics have a walk-in facility but it may be worth checking before hand that you will not need an appointment
- Drug and alcohol dependency units and teams. If you are currently being supported by a drug or alcohol dependency team they should be able to undertake a hep C test
Questions to ask your doctor if you’re diagnosed with hepatitis C
To help you fully understand the next steps in your recovery, here are some simple questions to consider asking your doctor after you are diagnosed:
- What are the next steps in my care?
- What treatment options are available?
- What can I expect from these treatments?
- What can I do to help prevent the disease getting worse?
- Are there any lifestyle changes I need to consider?
- Are my family members at risk of hep C?
- How will you monitor the status of my liver?
- What can I do to avoid spreading hep C to others?
1 NHS Choices. Causes of hepatitis C. http://www.nhs.uk/Conditions/Hepatitis-C/Pages/Causes.aspx [date accessed: Oct 2017]
2 American Liver Foundation. Who should get tested for Hepatitis C?. http://hepc.liverfoundation.org/diagnosis/who-should-get-tested/ [date accessed: Oct 2017]
3 The Hep C Trust. Testing for hepatitis C. http://www.hepctrust.org.uk/information/testing/testing-hepatitis-c [date accessed: Oct 2017]
4 Centers for Disease Control and Prevention. Hepatitis C FAQs for the public. https://www.cdc.gov/hepatitis/hcv/cfaq.htm [date accessed: Oct 2017]
5 The Hep C Trust. Genotypes of hepatitis C. http://www.hepctrust.org.uk/information/about-hepatitis-c-virus/genotypes-hepatitis-c [date accessed: Oct 2017]
6 Global Distribution and Prevalence of Hepatitis C Virus Genotypes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303918/ [date accessed: Oct 2017]