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If you feel you are at risk for hepatitis C you should consider getting tested. Below is some general and specific information regarding testing for hepatitis C
Testing
The liver is the largest organ in the human body. It is located at the right side of the body behind the lower ribs. It performs many complex functions which are essential to life and your health.
Importance of testing:
- Early detection of the disease will help you get the treatment and support that you need
- A blood test is the only way to find out if you are infected with hepatitis C
- The hepatitis C test is free and confidential
- If you are having various tests done at once, make sure you specifically request a hepatitis C test to be included in your blood work, as it is not included in all physical exams
- The test results may take up to four weeks to come back to your doctor. If the result is positive, your doctor will call you back into the office to discuss your results.
- For more information regarding testing, information and/or support regarding hepatitis C please contact your family doctor or Peel Health at (905)799-7700.
Types of hepatitis C tests
Liver enzymes test
Liver enzymes are proteins produced by the liver. Everyone has a low level in their blood but when the liver is injured in any way more liver enzymes are released into the blood stream. Elevated liver enzymes are a red flag to doctors to investigate the cause of this increase. The two most common liver enzymes that doctors check through a blood test are the ALT (SGPT) and the AST (SGOT)
Enzyme-Linked Immunosorbant Assay (ELISA, EIA)
It is the test that is used as the initial screen for hepatitis C and is only able to detect antibodies. It is more than 90% sensitive for the detection of established infection. Due to the fact that it has to wait for the antibodies to develop, it can take up to six months (generally 6 -26 weeks) to become positive after infection. Therefore, the person can be infected with hepatitis C and have a negative EIA or ELISA test during the ‘window period’. The antibody reaction may also be lengthened in immunocompromised clients. The ELISA or EIA test cannot distinguish between acute and chronic hepatitis C infection.
Recombinant immunoblot assay (RIBA)
This test is usually referred to as the confirmatory test and is used to supplement the ELISA (EIA) screen. The RIBA test can detect 4 antigens; if 2 are positive, it is considered positive; if 1 is positive, it is considered “indeterminate”. This test eliminates false positive ELISA (EIA) reactions and improves the specificity of the test. However, it will not detect hepatitis C any earlier than the ELISA (EIA) and cannot distinguish between acute and chronic infection.
Polymerase-Chain Reaction (PCR)
The PCR tests for viral antigens. It can detect the amount of virus circulating in your blood. The PCR can also be used for the early detection of acute hepatitis C infection, generally 1-2 weeks after exposure, much earlier than the ELISA/EIA test. This is the test that is frequently used to determine the genotype of the person to guide treatment.
The PCR can also detect hepatitis C in immunocompromised persons whose antibody response is delayed, in infants born to HCV positive mothers and it can help to determine whether the person who is ELISA positive is actually infectious or not.
The PCR test, however, can give both false positives (if the specimen is contaminated) and false negatives (if the specimen was not rapidly frozen/transported under optimal conditions).
Ultrasound
An ultrasound or imaging test uses sound waves to create a picture of the liver. It reveals the size and texture of your liver, and the size of bile ducts and blood vessels. It is a safe and painless way to investigate your liver and the supply of blood to it.
Liver biopsy
A liver biopsy or tissue analysis involves removing a small piece of liver tissue through a needle that is inserted through your skin. The area around the insertion site is frozen with local anaesthetic and then the needle is inserted. The specimen or piece of tissue removed is then analysed under a microscope to determine the amount of liver damage. A liver biopsy confirms the diagnosis from a blood test and rules out other potential disorders and also gives your doctor a true picture of the stage and degree of activity of hepatitis C in your liver.
Liver biopsies are generally performed as outpatient procedures. After the biopsy, the patient is observed by a nurse for 3-6 hours. High-risk patients are observed overnight.