Test Quick Guide

Hepatitis C is a viral disease triggered by an infection of the hepatitis C virus (HCV). If not recognized or treated, it can escalate into a chronic condition causing inflammation and possible liver damage. There are often no symptoms, so hepatitis C testing is critical. Screening will help determine HCV from other hepatitis causes, including hepatitis A and hepatitis B.

An HCV antibody test can detect if you have been infected. It looks for antibodies to HCV in the blood.

If you are 18 or older, it is a good idea to get screened at least once for Hepatitis C. Testing is also recommended during pregnancy or if you have risk factors for HCV infection. Because acute hepatitis C often has no symptoms, screening is an important way to diagnose hepatitis C before it causes liver damage.

About the Test

Purpose of the test

The purpose of hepatitis C testing is to determine if you have been infected by HCV and to guide your treatment. HCV is found in your blood and other body fluids if you have this infection.

Hepatitis C is the most common form of viral hepatitis in the U.S. HCV infections are classified as acute or chronic. A doctor may order hepatitis C testing for screening, diagnosis, and to guide and monitor treatment.

  • Acute hepatitis C: This occurs in the first six months after you are exposed to the virus. Early in the illness, acute hepatitis C is mild and may cause no symptoms. For this reason, most people do not know they have this infection. In about one-quarter of patients, the immune system fights off the HCV infection and the virus is cleared from the body.
  • Chronic hepatitis C: If your body isn’t able to fight off the virus, you will develop this. Progression from acute to chronic hepatitis C is common, occurring in about 75% to 85% of patients. Diagnosing chronic hepatitis C as early as possible is important because prompt treatment can prevent complications linked to this condition, including liver disease, liver failure, and liver cancer.

What does the test measure?

There are several types of HCV tests and depending on the test used, different analytes are detected.

  • Hepatitis C antibody (anti-HCV) test: Antibodies are a part of the body’s response to an infection. Testing for hepatitis C antibodies determines whether or not you have been exposed to HCV at some point in your life. If this test is positive, the next step is to test for hepatitis C RNA which can tell you if you have a current infection.
  • Hepatitis C RNA test: RNA is a type of genetic material from HCV that can be detected in the blood. If test results are positive after an antibody test, doctors use an RNA test to look for and/or measure the amount of the virus in the blood. Qualitative tests can detect the presence of HCV RNA, while quantitative tests measure the amount of HCV RNA. Understanding the amount of HCV in the blood helps monitor treatment response.
  • Genotype test: There are at least six types of hepatitis C; these are also called strains or genotypes. Treatment for hepatitis C depends on the strain, so genotype testing to guide treatment is performed if you are diagnosed with an HCV infection.

If you develop symptoms of hepatitis without known exposure to HCV, doctors typically order an acute viral hepatitis panel that looks for evidence of hepatitis A, B, and C in one sample of blood.

When should I get a hepatitis C test?

In the U.S., the most common way of becoming infected with hepatitis C is by sharing needles used to inject drugs. Less commonly, you can be infected with hepatitis C in other ways, including during birth, through sex with a person infected with HCV, and by coming into contact with infected blood. Currently, there is no vaccine to prevent hepatitis C.

If you are 18 or older, it is important to get screened for hepatitis C at least once in your lifetime. Again, the virus often presents without symptoms. Screening is also recommended during pregnancy and if you have risk factors for HCV infection. If you have risk factors, periodic screening is recommended for as long as risk factors persist.

Risk factors for hepatitis C include:

  • Current or past injectable drug use
  • Having a blood transfusion or organ transplant before July 1992
  • Receiving kidney dialysis
  • Having contact with needles, including at work and while getting tattoos or piercings
  • Working or living in a prison
  • Being born to a mother with hepatitis C
  • Having an HIV infection
  • Engaging in unprotected sex

Hepatitis C testing may also be performed when liver tests are abnormal or when diagnosing the cause of existing liver damage. Also, HCV screening is critical if you are experiencing symptoms. Although hepatitis C often causes no symptoms, you could develop symptoms within one to three months after contracting the virus. Some common signs include:

  • Dark yellow urine
  • Fatigue or tiredness
  • Fever
  • Clay- or gray-colored stools
  • Pain in the abdomen or joints
  • Nausea, vomiting, or loss of appetite
  • Jaundice or yellowish skin and eyes

Because many who contract HCV are asymptomatic and those who do experience signs could easily write off feelings like fever or fatigue as something else, it’s important to discuss this with your doctor. A health professional can address the nuances of when to test, if screening is necessary, and what type of hepatitis C testing is best for your situation.

Finding a Hepatitis C Test

How can I get a Hepatitis C test?

Most often, hepatitis C tests are ordered by a doctor and performed in a hospital, lab, or clinic because screening requires a blood sample drawn from the vein or via a skin prick. A laboratory then analyzes the results.

However, you don’t need a doctor’s order to get the test. You can access testing directly by confidentially purchasing it online and going to a participating lab near you for screening. At-home tests involving a finger prick can be mailed to your home. You then mail the specimen back to the lab for analysis.

Can I take the test at home?

You have options for hepatitis C screening, and that includes at-home testing where you can collect a blood sample by a finger prick and send your specimen to a lab. Not all types of HCV testing can be performed at home, and these tests do not screen for hepatitis C RNA or the strain’s genotype.

The benefit of an at-home test is that it can expose a past or active infection, though it will not reveal which. It’s a great way to initially test for HCV before advancing to lab testing. Positive results should be confirmed by a health professional through lab testing.

How much does the test cost?

Several factors determine the cost. At-home HCV tests are less expensive and can cost $79, but this is best used as a tool to determine if further testing is necessary at a lab. HCV lab tests can range from $57 for a basic antibody test to $299 for quantitative real-time (PCR) testing that measures how much of the HCV RNA per millimeter is present. This is appropriate if you know you are positive and is generally the next step after a basic antibody test.

Your health insurance might cover hepatitis C testing, and the cost also depends on where you get the test. Discuss pricing and insurance coverage with your doctor. Keep in mind that with insurance you may also have a copay or deductible. There are hepatitis C testing resources if you do not have insurance and need financial assistance.

Taking a Hepatitis C test

Hepatitis C testing requires a blood sample that is gathered from a vein (usually your arm), or by a skin prick. With lab testing, a doctor, nurse, or another health care provider will draw blood and prepare the sample for analysis. If you choose at-home hepatitis C testing, a kit will be mailed to you and generally includes a dried spot card and necessary supplies to collect a blood sample. The kit will include specific instructions for you to follow.

Before the test

No preparation is needed prior to hepatitis C testing. Before the test, though, tell your doctor about any medications you’re taking for hepatitis or other medical conditions. If you are taking an at-home test, carefully review all kit instructions first. Let your doctor know you are taking the test and follow up with results.

During the test

If you are an adult seeking a lab hepatitis C test, you can expect a blood draw from a vein, usually your arm or the back of your hand. As with typical blood draws, a health care provider will clean and prepare the site, and possibly tie a tourniquet around your arm to increase blood flow in order to gather the sample. Blood is collected through a small needle attached to a vial. The entire process usually takes less than five minutes.

If an infant or child is being tested for hepatitis C, blood is usually collected using a skin prick using a lancet. The health care professional will gather just a few drops of blood and the process takes less than a minute.

With an at-home hepatitis C test, the kit will include a lancet to perform skin-prick blood collection. Some tests include a dried spot card and others might require blood to be collected in a vial. At-home tests vary, so be sure to carefully read kit instructions.

Overall, there is very little pain associated with the testing. If a phlebotomist draws blood from a vein, you might experience minimal bruising and soreness. A skin prick might sting but the process is quick.

After the test

Other than a bandage to reduce bleeding after the skin draw, there are no restrictions on activities after collecting the sample. If blood was drawn from a vein, you could experience some minor bruising and soreness, but nothing that will prevent you from living normally.

Hepatitis C Test Results

Receiving test results

You will usually receive results within one to five business days. It depends on how and where you take the test, and what kind of screening is being performed. For instance, if you order an HCV test kit online and go to a lab for an antibody test, you’ll normally get the results in one to three business days. If you select more advanced RNA PCR testing, usually reserved for those who have tested positive in an antibody test, the results can take up to five business days.

Some clinics and medical offices offer rapid HCV antibody tests and provide results in 20 to 30 minutes. You can get results delivered in person during your appointment.

Usually, lab results are delivered in a secure email or the testing company’s website might have a secure smartphone app where results are confidentially posted. Some labs will provide results by phone. You might be able to choose how results are delivered to you. Ask about this before you take the test.

Interpreting test results

Interpreting hepatitis C test results involves analyzing numerous factors and is best performed by a health care professional. For example, if you take an acute hepatitis C test, it will detect hepatitis A, B, and C by processing antibodies and antigens. These tests usually report a positive or negative result.

If you receive a positive hepatitis C antibody result, it means that you have been infected with the virus at some point but you might not still have HCV. Your test report will either show a non-reactive or negative result or a reactive or positive result.

If you test reactive or positive, the next step is more advanced by testing for HCV RNA. This is also known as a PCR test. The result is reported as positive, meaning you have the virus, or negative meaning your body cleared the virus without treatment. A hepatitis C RNA quantitative test reports copy numbers rather than a positive or negative result. This test determines the viral load of HCV in the blood.

If you are HCV positive and want to determine the best treatment approach, a genotype test will identify the strain of hepatitis C. This strain can help doctors evaluate liver health. Follow-up testing is necessary to monitor your health and guide treatment. Your doctor might also decide to screen for HIV and hepatitis B since these infections are spread the same way as HCV.

If you test positive and are in treatment, your doctor will continue quantitative HCV RNA tests to see if the treatment is working. A decreasing viral load means the treatment is effective.

Talk to your doctor about hepatitis C test results. Here are some helpful questions to ask:

  • What type of hepatitis C test(s) did I receive?
  • What was my test result?
  • How do you interpret the results of the hepatitis C tests that I had?
  • Do I need any follow-up tests based on my test result?

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