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Hepatitis C DiagnosisMost hepatitis C cases are first identified during a routine liver enzyme blood test that indicates high liver enzyme levels. Additional testing is needed before a positive hepatitis C diagnosis is made. Common diagnostic tests for hepatitis C virus include: Anti-HCV
The anti-HCV (antibody to HCV) is detected by EIA (enzyme immunoassay), which detects the presence of antibodies to the hepatitis C virus in a person's blood. A positive test result means a person either has an active hepatitis C infection, or was infected with HCV and cleared the virus from his or her body. This test is highly sensitive but may give a false positive. In 2003, the CDC recommended that a positive anti-HCV test result should be verified by a more specific blood test, such as the RIBA test. RIBA
RIBA (recombinant immunoblot assay) is used to confirm a positive anti-HCV test result. The PCR (polymerase chain reaction) or TMA (transcription-mediated amplification) tests may be used instead of RIBA. Liver enzymes test
This test measures liver enzyme (ALT, AST) levels. Because liver enzyme levels of people with chronic hepatitis C fluctuate over time, their liver enzyme levels are tested every few months to measure liver function during hepatitis C treatment. Viral load test
The viral load test measures the amount of HCV in a person's blood. The test is often used to determine how well a person is responding to hepatitis C treatment. HCV genotype test
The HCV genotype test identifies which genotype (genetic makeup) of HCV is present in a person's blood. There are 6 major HCV genotypes. Genotype 1 is the most common genotype. It doesn't respond as well to treatment and requires 48 weeks of treatment. Genotypes 2 and 3 usually require only 24 weeks of treatment. It's possible for a person to have more than one genotype. Genotyping is often used to estimate the length of the treatment required and the likelihood of its success. Liver biopsy
A liver biopsy may also be performed. During the procedure, a small piece of liver tissue is removed and evaluated to determine the extent of liver damage. Liver biopsies are the best way to determine the extent of liver damage and can identify liver cancer. Some discomfort and pain may be experienced during the procedure. Rare complications may occur, such as the puncture of another organ, infection, and bleeding (which may be severe). Imaging techniques
Less-invasive x-ray and imaging techniques are being researched. The most promising technique is elastography, which uses either ultrasound or MRI (magnetic resonance imaging) to evaluate the extent of liver damage. Testing for HIV
Due to the similar risk factors of HCV and HIV (human immunodeficiency virus) infections, the National Institutes of Health recommends that people with hepatitis C who are at risk of HIV infection should be tested for HIV. The NIH also recommends that people with documented HIV infection should be routinely screened for HCV infection.
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