Tests and Investigations

Blood Tests

What blood tests are available to check for Hepatitis C?

Liver Blood Tests

One of the first tests you will have is a blood test. The fact that you have been infected with Hepatitis C shows on a blood test. The other reason you may have blood tests, is to show how well your liver is working. These are called Liver Function Tests, and they will show the present health of the liver. Unfortunately at the moment blood tests cannot show the amount of scarring in the liver.

Hepatitis C antibody test

This test will usually be the first test you have. It shows that you have had the virus and that you have developed antibodies to the virus. It does not tell you whether you still have the virus. Your own doctor will probably have already done this test. If you have a confirmed positive anti-HCV test then you will undertake further tests.

Hepatitis C RNA

A blood test is done, usually called a PCR test which if positive confirms that you still have the virus. If this test is negative it does not necessarily mean that you do not have the virus but that we may not be able to detect it. The test should be repeated 2 or 3 times and if it is still negative you would know that you have not got the virus now. About 20 – 30% of people will have cleared the virus and be PCR negative.

Can you have normal liver enzyme tests (i.e. ALT or AST) and still have Hepatitis C infection?

Yes. Many people have Hepatitis C for many years and the liver tests are still normal.

What does the term genotype mean?

This means the genetic make up of the virus. There are 6 types in Hepatitis C. The most common in this country is type 1 followed by 2 and 3. If it is thought that you might need treatment, some blood will be sent for genotyping as it is known that people with genotype 1 need one year of treatment and that people with the other genotypes do not benefit from more than six months treatment. Genotype 2 and 3 are more likely to clear than genotype 1 with treatment.

What does viral load mean?

This means the amount of copies of virus that are circulating in the blood. We do not make any decision about treatment based on this measurement but we are able to tell if you are responding to treatment by comparing the levels of virus.

Ultrasound Scan

This is like an X-ray of the liver, and may be performed to show any irregularities in the shape or size of the liver. A radiologist, a doctor who specialises in X-rays, will do your ultrasound. The ultrasound is usually done as an out patient.

When you have an ultrasound, some clear jelly is put on your tummy, to help the scanner handpiece move around on it. The radiologist will then move the scanner handpiece over your tummy while watching a screen by the bed, which shows the scan of the liver. An ultrasound scan does not take very long. The ultra sound scan is often normal in early Hepatitis C infection.