The only way you can really know that you have hepatitis C is by having a number of blood tests. The blood tests for Hep C will:
- determine if you have the virus
- determine which Hep C virus (genotype) you have
- determine the amount of virus in your blood
- determine if the virus is damaging your liver
Doctors can only get the whole picture by doing a number of tests.
First test: This test looks for the antibodies to Hep C in your blood. If this test is positive, it means you have been exposed to the hepatitis C virus in the past and will have antibodies for the rest of your life. This test does not tell you if there is active virus in your body. You need the second test to find this out.
Second test: This test checks for the presence of the Hep C virus itself. It is called an RNA test. If it is positive, you are infected with Hep C. If it is negative, you don’t have the virus and are not chronically infected.
If the test results show that you don’t have Hep C, you can still get infected with the virus if you are exposed to it at another time—even if you have antibodies. (See Are you at risk?)
Viral load test: This test is to check how much virus is in your blood, but it doesn’t tell you how long you have been infected. It is done at the same time as the RNA test.
Genotype test: This test checks to see which type of Hep C virus you have. Knowing the genotype is important when it comes to choosing the length of treatment and predicting the likelihood of treatment success. Like the viral load test, you don’t need to have more blood taken for this test because it’s done at the same time as the RNA test.
More tests: Other tests might be done to see how the virus has affected your liver. These include:
- blood tests (such as liver enzyme tests and liver function tests) which look for chemicals in the blood that come from the liver.
- an ultrasound which takes a picture, like a photograph, of the liver to measure how much damage is there.
- a biopsy which uses a small needle to take out a tiny sample of the liver that the doctor can look at and see if there is liver damage. It is more accurate than the ultrasound, but can be an uncomfortable procedure. The biopsy is often required before you can get provincial drug coverage in Ontario.
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