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Diagnosis of hepatitis C
The diagnosis of hepatitis C usually starts with a clinical suspicion of the disease. Patients often come to the doctor’s office with signs and symptoms of severe liver disease. In some cases, they detect a vulnerability (as in a needle prick) and run specific tests to rule out various conditions. In any case, patients should run various exams to confirm the diagnosis of hepatitis C.
We can break them down into HCV-specific tests and additional tests. These tests are specific to detect a hepatitis C infection:
- Hepatitis C antibodies using rapid diagnostic tests or more reliable enzyme immunoassays
- Quantitative and qualitative HCV-RNA assays to evaluate the severity of the infection
- HCV genotyping tests to know which subtype of hepatitis C is causing the infection
- Serologic testing
- Sometimes, liver biopsy. It is only performed in case of coinfection, in patients with a severe immunocompromise, or in an uncertain diagnosis.
We also have additional tests usually performed in patients after a diagnosis is made or as a part of the diagnostic process:
- A complete blood count with a white blood cell differential count, useful to evaluate the user’s response to the viral load
- Liver enzyme tests, especially aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
- Serum bilirubin and albumin levels
- Glomerular filtration rate to evaluate kidney function in chronic patients
- Serologic tests against HIV due to a very likely association in some patients
- Tests to evaluate the presence of hepatitis B (surface antigens HBsAg, surface antibodies anti-HBs, and core antigens anti-HBc)
- Thyroid function tests (TSH, T3, T4)
- Pregnancy test to evaluate a woman’s eligibility for treatment
