Hepatitis C Screening Test
The hepatitis C antibody test tells you if your immune system has ever encountered hepatitis C virus—but it can't distinguish past (cleared) infection from current (active) infection. About 25% of people spontaneously clear HCV. If the antibody is positive, you need an HCV RNA viral load to determine if the virus is still present. The great news: HCV is now curable in >95% of cases with 8-12 weeks of oral medication.
What is Hepatitis C Antibody?
Anti-HCV antibody is a screening test. Positive result requires confirmatory HCV RNA (viral load). RNA positive = active infection. RNA negative = past cleared infection or false positive antibody. Genotyping guides treatment selection (though pan-genotypic regimens now available).
↑ What High Hepatitis C Antibody Means
Positive antibody = HCV exposure at some point. Need HCV RNA to confirm active infection. If RNA positive: active hepatitis C (curable). If RNA negative: past cleared infection.
Common symptoms:
Acute: usually asymptomatic (80%). Rarely jaundice, fatigue, nausea. · Chronic: asymptomatic for 20-30 years until cirrhosis · Cirrhosis: fatigue, jaundice, ascites, variceal bleeding, HCC · Extrahepatic: cryoglobulinemia, glomerulonephritis, porphyria cutanea tarda
↓ What Low Hepatitis C Antibody Means
N/A—positive/negative test.
Common symptoms:
N/A
Why It Matters
When normal:
Hepatitis C is CURABLE (>95% cure rate with 8-12 weeks of oral DAAs)
CDC recommends universal screening for all adults ≥18
Curing HCV prevents cirrhosis, liver failure, and HCC
Curing HCV eliminates transmission risk
Risks if abnormal:
Untreated chronic HCV: progressive liver fibrosis → cirrhosis → HCC
Most people are asymptomatic until advanced liver disease
~75% of acute infections become chronic
What Can Cause Abnormal Levels?
Hepatitis C Virus Infection
100% likelyTransmitted primarily by blood exposure. IV drug use is the most common route in developed countries.
IV Drug Use (current or past)
Most common risk factor. Even remote, one-time use carries risk.
Blood Transfusion Before 1992
HCV screening began in 1992. Transfusions before this carried risk.
Birth Year 1945-1965 (Baby Boomers)
Higher prevalence in this cohort—all should be screened.
Needlestick/Healthcare Exposure
Occupational risk for healthcare workers.
What You Can Do
All adults ≥18 should be screened at least once (CDC/USPSTF)
Impact: Most people with HCV don't know their status \u00B7 Timeline: One-time
If antibody positive: get HCV RNA viral load
Impact: Determines if infection is active (treatable) or cleared \u00B7 Timeline: Immediately
If lifestyle changes aren't enough:
If RNA positive: liver fibrosis assessment (FIB-4, FibroScan, or biopsy)
Impact: Determines liver damage severity and treatment urgency \u00B7 Timeline: At diagnosis
Genotype testing (though pan-genotypic DAAs often make this less critical)
Impact: Some regimens are genotype-specific \u00B7 Timeline: Pre-treatment
Recommended retest: SVR12 post-treatment to confirm cure; ongoing risk: rescreen if new exposure
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