Ordering and interpreting HCV blood tests is straightforward:
- When testing for hepatitis C infection, write "HCV serology" or "Hepatitis C serology".
- Make sure you ask for PCR as a possible "add on" when ordering this serology test. This is the only way to known if hepatitis C infection is chronic or resolved.
- On the same path slip, write "if positive, add PCR" or similar in clinical notes. This means the path lab may do the test on the same bloods if the sample is appropriate. Your patient therefore may not need to come back and be re-bled to check if they have chronic, rather than resolved hepatitis C.
- Positive serology PLUS positive PCR = HCV infection. If PCR is positive six or more months after serology, then your patient has chronic hepatitis C.
For known PCR positive patients, you will need to know HCV genotype and subtype and quantitative RNA level to start treatment, so add these to any repeat PCR test. Make sure you get these results at least six months after first diagnosis. Patients who are still PCR positive at six months should be strongly considered for treatment.
View the steps below for determining if someone has chronic HCV or for more detail see here. For steps to be eligible for treatment see here.
*Except in case of recent (within six months) or in people with a weakened immune system
**During the first six months after HCV infection, a person may spontaneously clear the virus; if there were a recent risk, repeat viral-load testing to confirm hepatitis C infection