Blood tests are used to diagnose the hepatitis C virus (HCV).
Hepatitis C Virus (HCV) Antibody Test
This blood test tells us if we have been exposed to the hepatitis C virus. If the hep C virus has entered our body at any time in the past, we will usually have “antibodies” from our body trying to fight the infection.
This test is sometimes done using blood drawn from a vein in our arm, but there are other ways antibody tests can be done.
- Point of Care Tests (sometimes called rapid tests): These tests give fast results for hep C antibodies and take about 40 minutes to give a result.
Point of care tests are most often done with a finger-prick blood test, but may also be done with saliva from a mouth swab. - Dried Blood Spot Tests: Sometimes, it can be hard for our blood samples to get to a lab. Dried blood spot tests use a finger prick of blood that is put onto a special card for a lab to test for viruses like hepatitis C, and other infections.
About 25% of the time, a person’s body will clear (get rid of) the hep C virus on its own, and they don’t develop chronic hep C. If the hep C antibody test is positive, more tests will be done to see if a person still has the hep C virus.
Hepatitis C Virus (HCV) RNA Test (“Viral Load” Test)
After a positive HCV antibody test, doctors need to confirm if the hep C virus is still in your body—if it is, this is called chronic hep C. It’s important to know if you have chronic hep C, as you can pass the virus to others.
If your HCV RNA test is positive, you can be treated for hep C—and cured!
Hepatitis C Virus (HCV) Genotype Test
There are many different types of hep C virus, known as “genotypes” and “subtypes”—this blood test tells us what genotype and subtype we have. Some hep C treatments are “pan-genotypic” which means they can treat all types of hep C. Others work only for specific types of hep C. Knowing our hep C genotype helps our doctor decide which type of hep C treatment is right for us.
Learn more about hep C genotypes and subtypes.
Reflex Testing for Hepatitis C
In British Columbia, all blood tests for hep C are done at the BC Centre for Disease Control (BCCDC) lab. The BCCDC uses what is called “reflex testing”, which means that if the first blood test shows more tests are needed, they are done right away. This means people only need to give one blood sample to have all the tests needed to diagnose hep C done by the lab.
For hep C blood tests, this means if our hep C antibody test is positive, our blood sample will automatically have a hepatitis C RNA and genotype test done, without us having to make a second visit to the lab!
Who should be tested for hepatitis C?
It’s important to remember that you can have hep C for a long time before it makes you sick. All adults should get tested for hepatitis C at least once!
There are many groups of people who should be screened for hep C. A person should be screened if they:
- Had a blood transfusion, received a blood product, or received an organ transplant in Canada before 1992
- Have hep B or HIV
- Were born by a parent who is HCV positive (“vertical transmission”)
- Have used substances with shared drug-use equipment, even just once. People who use drugs should get tested every 6-12 months if they’ve used any shared injection, smoking, or snorting supplies.
- Have been exposed to non-sterile medical or dental equipment, such as for dialysis, through a workplace needlestick injury, or surgical procedures.
- Have had a medical procedure done abroad, in a country not practicing proper sterilization of medical equipment
- Were born in or travelled to areas where hep C is prevalent, including:
- East and Central Asia and the Pacific
- Eastern Europe
- Latin America and the Caribbean
- The Middle East and North Africa
- Sub-Saharan Africa
- Have used shared or unsterilized tattooing or piercing equipment
- May have been exposed to blood during sex or are a man who has sex with men.
While the following groups of people do not on their own have higher risk of getting hep C, hep C may disproportionately affect these populations (hep C may affect them more often):
- Men who have sex with men
- People who are or have been incarcerated
- People who are homeless or face housing instability
- Indigenous peoples
- People from countries with high prevalence of hep C
If you’re not sure if you should be tested, ask for a hepatitis C test with your next round of routine blood work!
Watch Hep C 101: Testing