Testing and Diagnosis

• How can I get tested?
  • Antibody Tests
  • PCR
  • Liver Function Tests
  • Genotype
  • Liver Biopsy
• Questions to ask your health care provider about testing.
• Where can I get tested?

How can I get tested?

There are several tests that your health care provider will do to diagnose hepatitis C, monitor the condition of your liver, and determine if you should consider treatment. Understanding the tests and what the results mean will help you become an active partner in managing your illness.

Antibody Tests
The first test usually done for hepatitis C is an antibody test such as an EIA. A reactive (positive) result means that, at some time in your life, you were exposed to hepatitis C and your body produced antibodies to fight off the virus. If the EIA test is reactive (positive), a second antibody test called the RIBA (which is more accurate) may be used to confirm the result. Most people who test reactive (positive) to both antibody tests are chronic carriers, meaning they carry the virus in their blood and can pass the virus on to others. However, some people (about 15-25%) who have a reactive (positive) result can clear the virus on their own without treatment. Further testing should be done to determine if you are chronically infected.

PCR
A PCR is a viral load test that detects the presence of hepatitis C in the blood. If the PCR is positive, you are infected with the hepatitis C virus, and are probably a chronic carrier. If you undergo treatment for hepatitis C, this test helps to monitor whether the medicines are working.

Liver Function Tests  
Liver function tests (LFTs) help your health care provider determine whether your liver is working properly. These blood tests measure the levels of enzymes and other substances in your liver. When the liver is inflamed or damaged, certain enzymes will be released or the level of some substances will change. Some common LFTs include albumin, total protein, the enzymes ALT and AST, alkaline phosphatase, and bilirubin. Learn what your numbers mean and talk to your health care provider about how often the tests should be done.

Genotype
Genotype refers to the particular type of hepatitis C. There are at least six genotypes of hepatitis C. Most people (75%) in the U.S. have genotype 1. Genotypes 2 and 3 are the next most common. If you are infected with one genotype it is possible to become infected with another type. Therefore, it is important not to expose yourself to the blood of others. If you decide to be treated for your hepatitis C infection, knowing your genotype will help determine how you may respond to treatment, and how long your treatment will be. Your health care provider can find out your genotype by testing your blood.

Liver Biopsy
Your health care provider may want to do a liver biopsy. To do a biopsy, the provider takes a small piece of your liver to check for inflammation and scarring. It is a way for your health care provider to help you decide if and when you should begin treatment and what type of treatment you should receive. A biopsy is the only way to truly know the stage of liver disease. As with any medical procedure, there is a small risk associated with a biopsy, so be sure to ask your health care provider about the risks and what to expect before you decide to have a biopsy.