Hepatitis C
Hepatitis C infection is more persistent than Hepatitis A or B.
Spread of Hepatitis C
While less commonly spread via sexual means that hepatitis B, it is still considered as a sexually transmitted disease. The main modes of spread of hepatitis C is through contact with the blood of an infected person.
Hepatitis C is most commonly spread via infected needles and sharp objects compared to sexual transmission.
The Natural History of Hepatitis C infection
The symptoms of hepatitis C infection is similar to that of hepatitis A and B. Approximately 20% of individuals who become infected with HCV will clear the virus from their body within 6 months, though this does not mean they are immune from future infection with HCV.
The other 80% of people will develop chronic hepatitis C infection, during which the virus may cause mild symptoms or no symptoms at all. These people will however carry the hepatitis C virus for the rest of their lives and will remain infectious to others. Like chronic Hepatitis B infection, chronic infection with hepatitis C virus may lead to cirrhosis and liver cancer in the long run.
Currently, there is no vaccine as yet for Hepatitis C. However, being vaccinated for Hepatitis B provides some protection against Hepatitis C.
Screening for Hepatitis C
Screening is usually done with a Hepatitis C antibody serology at 1 month post exposure.
This test unfortunately has a relatively high chance of a false positive result (about 1%). To confirm the diagnosis if the serology test if positive, we would proceed to do a Hepatitis C DNA test.
Hepatitis C and HIV
Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis stated ‘Extended HIV follow-up (e.g., for 12 months) is recommended for HCP who become infected with HCV following exposure to a source coinfected with HIV and HCV.’
In other words for patients who got infected with Hep C and HIV at the same time, they need to be screened for HIV for up to 12 months. Not the usual 3 months window period.
Update March 2015
In recent published guidelines on HIV screening, it is no longer mentioned that a Hepatitis C and HIV co-infection can prolong the HIV testing window period. This could be due to the advent of better and more accurate tests.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.
hi dr can i know the early test for Hep C? pcr rna qualitative and quantitative? thank i plan to come over your place to conduct the test.
I have a short question.
1. I tested HCV Antibody at 14 weeks is it conclusive? I saw CDC webpage mention 97% seroconvert at 6 months, should I retest? I dont have much noticeable symptoms. Some said 3 months usually is enough a lot of mix information.
2. I saw Hep C Webmd got a section mentioned that “Your result need to be rechecked if you taking some herbs, supplement or other alternative medicine product” what is that mean? Possibly my test false negative? Personally I took Blackmores Executive B only.
I would consider your tests conclusive.
Hi Doctor,
I did the following Hep C tests on 39 days and the result came negative.
1. HEPATITIS C ANTIBODY ( ANTI HCV ) ELFA
Technology used : Enzyme Linked Fluorescent Assay (E. L. F. A.)
2. HEPATITIS C ANTIBODY (Anti-HCV), (EIA)
Can I consider the above tests conclusive at 39 days? Should I do more tests?
Doctor, i did not went for hep c testing after my protected exposure. After 3 months i went multiple test of AB AG where recognised as forth gen testing and appears negative, do i need to retest at one year? Or i need to test for hep c now??
I believe the risk for hepatitis C is extremely low but there is no harm in checking. Your HIV test is conclusive, no need to worry.
Hi Doctor, I recently went for blood test and doctor pricked my finger with lancet. After test doctor asked me to wait outside and I moved outside and forgot to pick cotton to press my finger to stop bleeding. While waiting outside I pressed my bleeding finger in clinic cushion in which i was seated and realized it at later.Will i get infected to Hepatitis with this incident considering there is dried blood on cushion. Since cushion is of black colour I am not sure if it has dried blood or not.
No you will not get hepatitis C in this manner. Stop worrying.
Thanks dr, so no risk of hep b as well here?
Hi doctor, saw your update as of march 2015 regarding extending period of hiv window period, just one question would you consider arele test hiv1&2 a better,modern accurate test? Thanks so much.