There are a number of tests for hepatitis C. They are carried out to:
- find out if you have the virus (diagnosis)
- find out what type of hepatitis C you may have
- see how the disease is developing (progression)
- see how effective any treatment has been (response to treatment).
Things to think about before testing
Unfortunately having hepatitis C may not just affect your health; it may also affect you financially and those people close to you.
Most insurance companies and some other financial organisations will ask you whether you have been tested for hepatitis C, hepatitis B or HIV. If they know that you have any of these conditions you may be refused a life insurance policy, or a mortgage linked to a life insurance policy. People with hepatitis C can and do experience difficulties obtaining some financial products.
If you are diagnosed as having hepatitis C you may also have difficulty deciding who to tell. Bear in mind that if you do have hepatitis C it may well affect your family, sexual partner(s) and, if you inject drugs, anyone with whom you may have shared drug paraphernalia.
You may find it helpful to talk to your medical advisor, counsellor or, if you have one, drug worker about these issues. And if you do suffer any form of discrimination you may find it helpful to talk to your local Citizens Advice Bureau or local support agencies.
Confidentiality
Most drug agencies and GUM (genito-urinary medicine) clinics offer a confidential testing service and your GP can also arrange testing for you. If your test is positive, they will forward on your result to your GP so they can arrange on-going care and treatment. Any doctor who diagnoses hepatitis is legally required to report this information, in confidence, to local public health doctors who are responsible for preventing the spread of infection. These public health doctors work under the strictest guidance about confidentiality. Anonymised data is then reported nationally to help monitor the spread and to inform the prevention and treatment of hepatitis.
Blood tests
There are three main types of blood tests. Unfortunately all of them can be difficult to interpret
and it is best to discuss their meaning with your specialist or medical advisor.
A test that finds you have the hepatitis C virus is known as a ‘positive test’. Because of this, people with the virus are often called ‘hepatitis C positive’.
1. Antibody tests
Antibody tests look for the proteins made by the body that fight the hepatitis C virus, not the
actual virus itself. There are two main problems with the test:
a) Because it takes time for our bodies to make the right antibody for hepatitis C – usually between eight to 12 weeks, but sometimes as long as six months – you may be tested too soon after you are infected and the result could wrongly indicate that you are negative (free of the virus).
b) A positive result, on the other hand, only shows that your body has made the antibody. It is not proof that you are still infected or infectious.
2. Polymerase chain reaction (PCR) or ‘viral RNA’ (Ribonucleic acid) test
These tests are used to see if you have the virus in your blood and are still infected with hepatitis C. Most people who test positive for antibodies will also test positive for the virus. A negative test may mean that you have cleared the infection but this will need to be confirmed with a second test after a period of three to six months.
3. Liver function tests (LFTs)
Liver function tests look at chemicals in your bloodstream that show whether your liver is damaged. They are not always reliable and need careful interpretation by your doctor.
Liver biopsy
Assessing the severity of liver damage from chronic hepatitis C can be important in making decisions on how best to treat hepatitis C. Some specially developed blood tests and scans can give useful information on how much scarring there is in the liver and your doctor may use these. However a liver biopsy is sometimes needed.
During a liver biopsy a tiny piece of the liver is taken for study. A fine hollow needle is passed through the skin into the liver and a small sample is withdrawn with the needle.
The test is usually done under local anaesthetic and may mean an overnight stay in hospital, although some people may be allowed home later the same day. As the test can be uncomfortable and there is a small risk of internal bleeding or bile leakage, a stay in bed of at least six to eight hours is needed. Ask your doctor for more information on this.