How to read hepatitis C test results

Hepatitis C, or hep C, is a virus that can damage your liver, cause cirrhosis, and lead to other long-term health conditions if left untreated.

But, many people never experience symptoms, so testing can be the only way to know if you have hepatitis C.

If a doctor suspects you have a hepatitis C infection, they will order a reactive blood test called the HCV antibody test. This blood test looks for an immune reaction to see whether you have had an infection of the virus.

Your doctor will look for one of the following results:

• A negative test result: A non-reactive result means you do not have the virus. However, if you have recently had contact with the virus, such as through the blood of a person with the virus, you may need another test.

• A positive test result: A reactive result shows that you have or previously have had an infection of hepatitis C.

What does the test entail?

An HCV antibody test for hepatitis C is a blood test that requires a small sample of blood. A healthcare professional will draw a small amount from a vein in your arm. This procedure will only take a short time.

The blood test looks for specific immune molecules in your bloodstream that are only present if you have come into contact with the hep C virus. These molecules are antibodies. The structure of antibodies varies depending on the infection or virus your body is trying to fight off.

So, if you contract the hep C virus, your immune system will create specific antibodies for hep C. A blood test can identify these antibodies.

If you suspect you have hep C, speak with a healthcare professional in person. They will help you arrange a test and explain the results and next steps if you receive a positive result.

If your result is negative, a doctor may suggest regular screening tests.

If you cannot get to a doctor, different at-home hep C tests are available. It is important to seek advice from a medical professional to discuss the results of your at-home test.

How to interpret the results

Results of HCV testing can take from a few days to 1–2 weeks. However, rapid result tests are available if you need your result within 30 minutes.

Research, including one 2017 review of studies, has found that rapid diagnostic tests can accurately diagnose hepatitis C.

There are two main outcomes of an HCV test:

Negative, or non-reactive, test results

A negative test result means there are no detectable hep C antibodies in your bloodstream. This means you do not currently have hep C. However, if you have recently had close contact with someone with hep C, consider having another test.

Receiving a false negative is very rare, but this is more likely if you have a compromised immune system (for example, if you have recently had transplant surgery). If this is possible, consider talking with a doctor about having another test.

Positive, or reactive, test results

A positive test result means you have hep C antibodies in your blood sample. This means one of two things: you have active hep C or have previously had hep C and have since overcome it.

If you receive a positive or reactive result, a healthcare professional will order further tests to find out if the hep C virus is still active in your body.

An HCV PCR test can tell your doctor about the amount of the virus in your bloodstream at the time of testing. This is known as the viral load.

HCV PCR test

While viral load does not affect how strong your hep C symptoms are, it can indicate how well your body will respond to treatment.

The lower your viral load, the more likely you will respond well to treatment.

Doctors define viral loads as follows:

• Low: less than 800,000 international units (IU) per milliliter (mL).

• High: more than 800,000 IU/mL.

Next steps

If you have received a positive diagnosis for hep C, a healthcare professional will order more tests to determine how the virus is affecting your body.

Mostly, these tests will look at your liver function and check for signs of cirrhosis. This will help inform your doctor about the best treatments for your needs.

Around 25% of people with hep C eliminate the virus without treatment. The rest might develop complications, such as chronic liver disease or cirrhosis.

Up to 90% of people who receive treatment for hep C can clear the virus from their body using antiviral medications. These also help slow down damage to the liver.

Medications include:

• sofosbuvir (Sovaldi)
• simeprevir (Olysio)
• daclatasvir (Daklinza)

You may require regular testing during treatment to ensure the medication is working. Making some lifestyle changes where necessary, such as getting enough sleep and avoiding alcohol, can help your treatment do its job well.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, everyone between 18–79 should get a test for hep C. Most people with hep C never notice symptoms until their condition becomes severe.

Receiving a diagnosis before it causes serious health conditions means that treatment is more likely to be effective.

A doctor or healthcare professional will recommend having a test if you:

• believe you have had exposure to the virus
• have symptoms of hep C
• have never had a test for hep C
• are pregnant
• have any risk factors for hep C

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Summary

Hepatitis C is a serious viral infection that can cause liver damage and cirrhosis if left untreated. An early diagnosis can improve the effectiveness of your treatment.

Understanding the results of your test is important. If you are unsure, ask your doctor to explain your results and advise you on treatment if necessary.

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