Hepatitis C is a viral infection that affects your liver. You may not have symptoms.

Hepatitis C is a viral infection caused by the hepatitis C virus (HCV) that affects the liver. It can be acute or chronic and is primarily spread through blood-to-blood contact. Diagnosis involves a series of blood tests.

Read on for more information about how hepatitis C is diagnosed, where you can get these tests, and what to do next.

You may need more than one blood test to diagnose hepatitis C. The tests that diagnose hepatitis C include:

HCV antibody test (anti-HCV)

The first test is called a HCV antibody test (anti-HCV test). It checks for the presence of antibodies to the virus.

A negative result means you do not have hepatitis C. A positive result means you have been exposed to the hepatitis C virus at some point, but it does not confirm that you have an active infection.

HCV ribonucleic acid (RNA) test

After a positive antibody result, your doctor will recommend a nucleic acid test (NAT), such as an HCV ribonucleic acid (RNA) test, to detect the presence or levels of HCV RNA in your blood.

If HCV RNA is detected, this confirms that the virus is active and currently circulating in your blood. If RNA is not detected, it means you are not currently infected.

Other tests for hepatitis C

Additional testing for hepatitis C may include:

  • Genotype test (blood test): This blood test identifies the specific strain of HCV to help your doctor determine the best course of treatment.
  • Liver function test (blood test): This blood test assesses your liver function to help determine whether your liver has been affected.
  • Liver imaging: Multiple types of imaging tests may be used to diagnose the level of liver injury or cirrhosis (scarring), including:
    • liver scan
    • ultrasound
    • CT scan
    • MRI
    • contrast-enhanced ultrasound (CEUS)
  • Liver biopsy: During a liver biopsy, a small sample of liver tissue is removed and sent to a lab for examination.

Make an appointment with your doctor, healthcare professional, or local clinic to discuss testing if you’re concerned that you’ve been exposed to hepatitis C or if you have certain risk factors that increase your chance of exposure.

It’s important to note that there is a hepatitis C window period of 8 to 11 weeks between exposure to the virus and when the antibodies can be detected in your blood. Testing too early in this period may result in a false negative result.

Your doctor may order either traditional lab testing or rapid testing. The main difference is in the time it takes to get the results. Rapid testing results may be ready in just 30 minutes. Results from traditional lab tests may take much longer.

Other testing options include:

  • finding a community testing center (public health clinic, health center, etc.) that offers free or low cost testing
  • using an at-home test kit where you collect a blood sample at home and mail it to a lab for analysis

In all cases, follow-up with a healthcare professional is essential to help interpret your results and make a treatment plan, if needed.

Knowing your hepatitis C status is an important first step to managing the disease. If your results come back positive, it means that the virus is currently circulating in your blood and that you need treatment to clear the virus and avoid complications.

What you need to know:

  • Hepatitis C is treatable: Nearly 95% of people who are diagnosed with hepatitis C effectively treat the virus within 8 to 12 weeks of starting an oral medication.
  • Early treatment is important: Receiving prompt and early treatment is key to preventing complications like cirrhosis, liver failure, or liver cancer.
  • Regular monitoring is essential: Seeing a healthcare professional to track your liver health and check for any signs of recurrence is an important part of recovering from hepatitis C.
  • Hepatitis C does not have to be a lifelong condition: With prompt and appropriate treatment, you can cure hepatitis C, and most people who’ve had hepatitis C go on to live healthy lives.

Hepatitis C is primarily spread through blood-to-blood contact, such as sharing needles or receiving blood products containing the virus.

While it’s uncommon to contract the virus through sexual contact, and it’s not classified as a sexually transmitted infection (STI), it’s possible to contract the virus through sex.

Related factors that increase the risk of hepatitis C include:

You may lower your risk of contracting the hepatitis C virus by wearing condoms and avoiding sharing personal care items that can have blood on them, such as razors, needles, toothbrushes, and other items.

Hepatitis C typically causes no symptoms until the virus leads to significant liver injury. For this reason, it’s sometimes referred to as a “silent” killer.

One in 3 people with hepatitis C does not know they have it, and 65% to 75% of people with the virus don’t have any symptoms. It’s possible to have the virus for years before it causes severe liver injury and notable health effects.

An estimated 2.4 million people in the United States are living with hepatitis C, and half of them don’t know they have the virus.

Doctors recommend that everyone over 18 years old get tested, as well as at-risk pregnant people (during each pregnancy), and others who have additional risk factors.

If you are diagnosed with hepatitis C, you don’t have to face it alone. In addition to prescribing effective treatment, your healthcare professional can help you find support groups, counselors, and other resources to address both your physical and mental well-being.