Getting tested

When you get tested for hepatitis C you will have a blood test first. The blood is screened for antibodies to the hepatitis C virus. 

Antibodies are proteins of the immune system. Your body makes them as part of its defence against infection by helping to destroy ‘foreign’ molecules, such as those of the hepatitis C virus. Antibodies that are specific to the hepatitis C virus are only made when the hepatitis C virus is present.  So if they are found in your blood, it means you have been in contact with the hepatitis C virus at some point. However, the presence of antibodies doesn’t necessarily mean that you still have the virus in your blood. 

The extra definitive test actually measures the quantity of the genetic material, RNA of the hepatitis C virus, usually by a technique called polymerase chain reaction (PCR) or it variants: hence the test is generally called the PCR test.

People for whom hepatitis C testing is recommended* include:

  • People who have injected illegal drugs recently or in the past, including those who injected only once and so do not consider themselves to be drug users
  • People with conditions associated with a high risk of hepatitis C infection, including:
    • People with HIV infection
    • People with haemophilia who received clotting factor from concentrate before 1987
    • People who were ever on haemodialysis
    • People with unexplained abnormal transaminase levels
  • People who have had transfusions or organ transplants, including:
    • Those who were told that they had received blood from a donor who later tested positive for hepatitis C
    • Those who received a transfusion of blood or blood products before 1992
    • Those who received an organ transplant before 1992
  • Children born to mothers infected with hepatitis C
  • Healthcare, emergency medical and public safety workers after a needle-stick injury or mucosal exposure to hepatitis C-positive blood
  • Current sexual partners of people with hepatitis C (although the risk of infection is low, a negative test in the partner provides reassurance, making testing of sexual partners of benefit in clinical practice).

 *From the practice guidelines of the American Association for the Study of Liver Diseases (AASLD)

As well as confirming the presence of antibodies and RNA, the doctor may also request that your blood may be tested for transaminases. Transaminases (ALT, AST) are enzymes that are released from the liver cells when the liver is inflamed. When the levels of the transaminases are high it suggests that there is inflammation of the liver. However, the increase in the level of transaminases does not correlate directly with the amount of liver damage.