Hepatitis C is an inflammation of the liver that may present at an acute or a chronic stage. While testing for hepatitis C is pretty straightforward, specialized tests are still needed to diagnose the condition accurately.
Most people believe that routine blood tests automatically test them for viral hepatitis. The fact is that viral hepatitis, such as hepatitis C, does not show up on routine blood tests. While the investigations used to diagnose hepatitis C are blood tests, they are not part of the routine testing panel. Instead, these tests are specialized blood tests that must be performed separately and at appropriate times to successfully diagnose hepatitis C.
Although the investigations for hepatitis C are not part of the routine blood testing panel, other tests are included in the routine testing panel, indirectly indicating any liver problems.
WOULD HEPATITIS C SHOW UP IN ROUTINE BLOOD TESTS?
As mentioned before, hepatitis C does not show up on routine blood testing. This is because the specialized tests used to detect hepatitis C are not part of the routine blood testing panel. However, there may be some parameters that a routine blood testing panel can pick up on to give a clue about a person's possible liver disease. But before we delve into that, it is best to establish what constitutes a routine blood testing panel.
A routine blood test can be of multiple types, but the most common ones include CBC, lipid profile, and metabolic profile. These tests provide valuable information about a person’s general health status by evaluating parameters like infections, anemia, coagulation disorders, cholesterol, and others. While a CBC cannot provide direct information about a person's HCV status, raised white blood cells in a CBC may indicate an infection that can very well be a case of viral hepatitis.
The reason why hepatitis C does not show up on these routine blood tests because specialized blood tests are needed to identify it. The most commonly used blood test for detecting hepatitis C is the anti-HCV antibody test. This test detects antibodies against the hepatitis C virus in the blood. Another blood test used to detect hepatitis C is the HCV RNA test. This PCR-conducted RNA test directly measures viral RNA in a person's blood.
These tests are highly specialized and require special lab equipment to conduct. These tests are also slightly more expensive than a regular blood work panel, but the price is variable and depends on every specific lab.
A routine blood test may not directly tell a doctor about your HCV status, but it can provide valuable supportive information. For example, a patient presenting with abdominal pain, nausea, vomiting, and increased white blood cells on a CBC (a routine blood test) may prompt a doctor to get a hepatitis screening done. Therefore, while not directly, these routine blood tests can lead to a definitive diagnosis of hepatitis C in some cases.
SCREENING FOR HEPATITIS C
While hepatitis C may not show up in routine blood tests, it does show up on regular screening tests. Screening tests for hepatitis C are not as prevalent as some other diseases. However, there are certain conditions where a prior screening for hepatitis C becomes a must.
For example, the CDC recommends that all adults over the age of 18 and pregnant women should undergo screening for hepatitis C at least once in their life.
Moreover, most hospitals require hepatitis B and C screening for pre-op evaluation before any major surgical procedure. The same is the case with people scheduled to have an organ transplant or blood transfusion. Similarly, your dentist's office might require a one-time hepatitis B and C screening before proceeding with your dental procedures.
WHICH TEST IS USED FOR HEPATITIS C SCREENING?
The most commonly used for diagnosing hepatitis C and screening for hepatitis C is the hepatitis antibody test. The anti-HCV antibody test is a specialized blood test that detects a person's immune response to the hepatitis C virus.
When the hepatitis C virus enters the human body, an immune response is triggered, which causes white blood cells to create antibodies against the virus. These antibodies are called anti-HCV antibodies, and they circulate in the blood to fend off the invading virus.
The anti-HCV antibody test detects these antibodies to assess a person's HCV status accurately. Keep in mind that this test only provides information about a person's exposure to hepatitis C. the antibody test does not tell if a person currently has an active infection or the antibodies in their blood are from a past infection. The distinction between a current and a past infection can be made using the HCV RNA test.
SHOULD I GET TESTED FOR HEPATITIS C?
A few indications may prompt a doctor to order a hepatitis C test for you. These indications could be directional signs and symptoms of the disease, recent high-risk exposure to hepatitis C such as an accidental needle-prick, or perhaps the presence of risk factors in your daily life which may predispose you to acquire this infection.
If you have any of these signs and symptoms, you should talk to your doctor about getting tested for hepatitis C:
- Yellowing of eyes and skin
- Dark-colored urine
- Abdominal pain
- Excessive itching
- Abdominal fullness / bloating
- Generalized edema
- Muscle wasting
This list is not exhaustive, and there may be more signs and symptoms. Talk to your doctor about any unexplained signs and symptoms that you might be experiencing.
Certain risk factors can also put you at a greater risk of acquiring this infection. These include:
- Being born between 1945-1965
- Having gotten a blood transfusion before 1992
- Getting tattoos and piercings regularly
- Using IV injecting needles
- Sharing personal hygiene products
- Having frequent unprotected intercourse with multiple partners
- Having HIV or any other STD
If you have any of these high-risk behaviors in your daily life, contact your doctor at the earliest and talk about the possibility of getting a hepatitis C test.