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Test Results: Do I Have Hepatitis C?

The term “cascade of care” may be familiar to you, but if not, it refers to the steps from testing through to aftercare post-treatment. It is a general term that describes the steps from your first antibody test, the next step to confirm whether you have chronic hep C, a genotype test, treatment, and beyond.

Do I have hepatitis C, or just the antibodies?

If there is a gap in these steps, it can lead to a breakdown in the full cascade. This can be problematic in providing you with the best outcome and I don’t just mean cure, which is seen as the biggest prize. The breaks or gaps in this process have caused a number of people to not move on to the next step. If all you have had is an antibody test, it is not confirmed that you “have hep c”, as is often incorrectly said. Having chronic hep C can only be determined with an RNA test to confirm you have virus copies in your blood.

Understanding viral load

There is no inactive or remission state for chronic hep C. The viral load (which is the result of the RNA test) can fluctuate a lot. I share my own experience with a test of nine million, and with the following test three months later, it was five million. I was doing nothing different and was not is any therapy or using milk thistle- nothing. Nine million may seem like a lot, but I have had people tell me of much higher viral loads. The viral load is really only significant as a way of determining chronic hep C. Viral load is also used during and after treatment to determine the effectiveness of the therapy.

Which test is best?

There are many things that make up a robust or complete cascade of care, and despite established protocols, we see variations. These variations can depend on a list of things, some reasonable, at least mostly, while others appear less than the best. Some treating physicians engage people into care/treatment with the minimum of testing, and to be fair, how much of an assessment is needed prior to treatment and after is not something that is set in stone. There are some who will argue that in order to increase capacity (numbers) engaged in care, we need the simplest, barebones testing. It is my opinion that it depends, and it can depend on some important factors like how long a person may have lived with the virus.

Hep C in primary care

The care required after treatment is something lacking in almost all settings. Typically, people who have reached SVR (cured) will be told to talk to their primary care doctor about any continuing or new health issues. Few primary care doctors have a good understanding of the potential damage done by hep C, and too often they do not see any connection to liver disease. This can be problematic, as I know this from personal experience. It can be frustrating, and this may be where the biggest gap in the cascade, so we must persevere until we get better answers and solutions.

Click here to learn more about common tests for hepatitis C.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.