When to Test

Some people find out that they have Hep C when they ask to be tested for the virus. As there may be few or no symptoms, many people find out about their Hep C infection because other tests for other reasons alerted the physician to look further and do more testing. 

Routine Blood Tests

Some people find that they have Hep C when they have liver enzyme tests (ALT and AST) done as part of routine blood work, like during a physical exam, and the doctor decides to do more testing. But there are problems with relying only on liver enzyme tests or liver function tests as alerts that hepatitis C may be present. First, not everyone has access to healthcare and routine blood work that is required for these tests. Also, liver enzyme and liver function test results can fluctuate over time because of other factors (like diet, alcohol use, or medications).

Acute Infection

A small percentage of people get tested during acute infection. Often they go to a doctor if they have symptoms. But some people may ignore these symptoms because they go away after a short time or could be mistaken for a common illness, like a cold or flu.

Chronic Liver Disease

Most people do not get tested until 10–20 years into chronic infection, when the hepatitis has progressed to advanced liver disease and they become ill. Identifying a Hep C infection at this late stage can make it difficult to live healthy or succeed with treatment.

Link Testing to Risks

The earlier people are tested and diagnosed the better—ideally, this means getting tested as soon after a risk activity as the window period will allow. It usually takes six to nine weeks for people to develop antibodies to HCV so most testing is done three to six months after exposure. For example, needlestick injuries are a risk for Hep C transmission, so it is a common practice to test for Hep C after a needlestick injury in a healthcare setting. Making the link between risks and testing when discussing risk behaviours and practices is important for early diagnosis and education around transmission and prevention. In short, it is recommended that anyone who has engaged in a risk behaviour for hepatitis C get tested.

Hep C testing is available through most doctors and healthcare settings and some needle exchange programs. Places that can perform the required blood tests needed to diagnose Hep C include:

• doctors' offices
• community health centres
• walk-in clinics including some Anonymous HIV Testing clinics and sexual health clinics (although the testing for Hep C is not anonymous, the results are confidential)