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How do I know if I have hepatitis C?

Initially:

You might have flu-like symptoms right after being exposed.  Most people who have these symptoms attribute them to the flu.:

• Feel tired. Persistent fatigue is often the first recognizable sign of hepatitis C
• Feel sick to your stomach.
• Have a fever.
• Not want to eat.
• Have stomach pain.
• Have diarrhea.

Later on:

Some people have:

• Dark yellow urine.
• Light-colored stools.
• Yellowish eyes and skin.

What blood tests are there?

There are several blood tests that can be done to determine if you have been infected with HCV. Your doctor may order just one or a combination of these tests. The following are the types of tests your doctor may order and the purpose for each:

Anti-HCV (antibody to HCV) 
confirms the presence of the antibody but does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.  9 out of 10 people test positive for the antibody within 3 months after symptoms begin.

1. EIA (enzyme immunoassay)...This test is usually done first. If positive, it should be confirmed

2. RIBA (recombinant immunoblot assay)...A supplemental test used to confirm a positive EIA test

Liver Enzymes
People who are HCV+ will have their liver enzymes (e.g. ALT) checked by their doctors. Liver enzyme counts go up as an indication that the liver is in distress. Sometimes, the liver enzymes will be normal or may go up and down.

Viral Presence Tests - tell you if the virus is in your blood.  These are qualitative tests to detect presence or absence of virus (HCV RNA).  It is possible to find HCV within 1 to 2 weeks after being infected with the virus.

1. Generic polymerase chain reaction (PCR)

2. Amolicor HCV

Viral Load Tests - tell you how much hepatitis C virus you have in your blood. These are quantitative tests to detect amount (titer) of virus (HCV RNA)

1. Amplicor HCV Monitor

2. Quantiplex HCV RNA (bDNA)

A false positive can happen (you test positive but you’re not really positive). It is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti-HCV tests are reported as negative on supplemental testing. This is done routinely.

A false negative can also happen (you test negative, but you really have the virus). Persons with early infection may not as yet have developed antibody levels high enough that the test can measure. In addition, some persons may lack the immune response necessary for the test to work well.

Children born to HCV+ mothers should not be tested for anti-HCV before 12 months of age as anti-HCV from the mother may last until this age. If testing is desired prior to 12 months of age, PCR could be performed at or after an infant's first well-child visit at age 1-2 months.