Measurement of antibodies against the hepatitis C virus in a blood sample; in case of positivity, active infection is confirmed with HCV RNA.
Indication
- Unexplained elevated liver enzymes (ALT, AST)
- Jaundice, fatigue, chronic tiredness, or loss of appetite
- Past history of blood transfusion (especially before 1996)
- History of intravenous drug use or needle sharing
- Hemodialysis patients, healthcare workers, organ transplant recipients
- Close contact or sexual relationship history with an HCV-positive person
- Assessment of mother-to-child transmission risk (pregnancy screening)
Preparation
- No special fasting required
- Previous test results and risk factors should be reported to the laboratory
- Regular medications can be taken normally
How it's performed
- A 5-10 mL blood sample is drawn from an arm vein
- Anti-HCV antibody is measured by automated immunoassay (ELISA/CMIA)
- If Anti-HCV is positive, an HCV RNA (PCR) test is requested to confirm active infection
- If HCV RNA is positive, the viral genotype is determined and treatment is planned
- Results are usually reported the same day or within 24-48 hours
Post-procedure
- If Anti-HCV is positive but HCV RNA is negative, this is interpreted as past infection
- If HCV RNA is positive, referral to an infectious diseases or gastroenterology specialist is made
- Sustained virologic response (SVR) is assessed with HCV RNA at week 12 after treatment
- Liver fibrosis level is evaluated with elastography or blood tests
- Screening of close family members and partners is recommended
Risks
- Pain, bruising, or hematoma at the blood draw site
- Rarely fainting (vasovagal reaction)
- Possibility of false positive result; confirmation with HCV RNA is required
- False negative results may occur during the early window period (first 2-3 months)
FAQ
Does a positive Anti-HCV always indicate active infection?
No. Anti-HCV may also be positive in past and resolved infection. An HCV RNA test is performed to confirm active infection.
Can hepatitis C be treated?
Today, with direct-acting antiviral (DAA) medications, the virus can be cleared from the body in the majority of cases after 8-12 weeks of treatment. The treatment plan is arranged by a specialist physician.
Do I need to fast for the test?
No, fasting is not required. The test can be performed at any time of day.
I am at risk but my first test was negative; should I be tested again?
After a new exposure, the first 2-3 months are the window period. If risk factors are present, retesting may be recommended after 3-6 months.
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