Hepatitis C is a viral infection causing liver inflammation that affects millions of people every year. The infection can be acute or chronic. Fatigue, loss of appetite, and difficulty concentrating are among its most common symptoms.

Some people who get hepatitis C never develop any symptoms at all. But other infections create severe, life-threatening complications, including cirrhosis and liver cancer.

Doctors test for hepatitis C with a reactive blood test called the HCV antibody test (also called an anti-HCV test). This blood test can determine if your body has created an immune response against the virus.

A positive HCV antibody test can indicate an active infection. A positive result can also suggest you have had a hepatitis C infection at some point in the past and the virus is no longer detectable or contagious. If you currently have hepatitis C, a HCV RNA test can confirm active infection.

We’ll break down how the HCV antibody test works, and how results are interpreted.

Key statistics

2019 CDC statistics indicate there were around 57,000 hepatitis C infections in the United States that year. Hepatitis remains a major global health concern. Data from the World Health Organization (WHO) estimates 58 million people worldwide are living with hepatitis C.

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The HCV antibody test requires a small blood sample. This sample is usually taken by a lab technician who draws a vial of blood from a vein in your arm. The actual blood draw usually takes less than a minute.

Your blood sample is then analyzed to see if antibodies for hepatitis C are present in your blood. Antibodies are Y-shaped proteins that your body creates to fight off pathogens.

Antibodies are specific to the virus or infection they are created to target, so if you’ve ever had hepatitis C, your body will have produced antibodies to fight it. If you’ve never had a hep C infection, those antibodies won’t be present in your blood.

Results from the test can take anywhere from a few days to a week or two. Rapid tests for hepatitis C are also available if you need the results in an hour or less.

If your HCV antibody test comes back as “reactive,” it means that one of two things is true:

  • you have an active case of hepatitis C
  • you have had hepatitis C at some point in the past

If you have hepatitis C, your body will have the ability to produce hepatitis C antibodies for the rest of your life. This is why a reactive result doesn’t always mean that you have an active infection.

If your HCV antibody test comes back as “nonreactive,” it means two things are true:

  • you don’t currently have hepatitis C
  • you’ve never had an active hepatitis C infection

Hepatitis C is primarily transmitted through blood contact. If you tested negative previously, but may have recently had close contact with another person with a confirmed hepatitis C infection, you should consider getting re-tested.

False negatives from an HCV-reactive test are rare, but they do happen. False negatives are more likely if you are immunocompromised (for example, if you are living with HIV). If you are concerned that your test result is incorrect, consult your doctor.

The result of your HCV antibody test will determine if there are additional steps that you need to take.

If your test had a “reactive” result, your doctor will need to determine if you have an active hepatitis C infection, or if your infection took place in the past. Your doctor may order an HCV RNA PCR test to detect how much of the virus is currently in your bloodstream.

Hepatitis C treatment

Rest, proper nutrition, and drinking lots of fluids are common approaches to treating acute hepatitis C. Antiviral medication may be prescribed. Antivirals work to stop a virus from multiplying. If your doctor determines that you have chronic hepatitis C, antiviral medication may also be necessary.

Learn more about medications used to treat hepatitis C.

The aim of hepatitis C treatment is to cure it. This means keeping the infection from progressing to the stage where complications can develop, and eliminating the virus from your body. If you are pregnant, a central goal of hepatitis C treatment will also be to prevent your baby from being born with the infection.

It is rare, but possible, to develop an active hepatitis C infection a second time.

Risk factors for contracting hepatitis C twice include:

It’s important to take precautions to prevent a hepatitis C infection, especially if you are in one of these at-risk groups. Effectively managing your HIV, seeking treatment for any substance use disorders, or making sure you use clean needles whenever possible can lower your chances of acute infection.

Preventive strategies also include avoiding contact with someone with a known or suspected case of hepatitis C until they are treated.

There is currently no vaccine for hepatitis C. However there are safe and effective vaccines available for hepatitis A and hepatitis B.

If you or a loved one is living with a substance use disorder, you’re not alone. Help is out there. Consider exploring SAMSHA’s resources for treatment facilities and support groups.

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A hepatitis C antibody test can have a reactive or nonreactive result. If your test result comes back “reactive,” it means that you have an active hepatitis C infection, or you previously had hepatitis C.

Hepatitis C can cause serious, even life-threatening complications if untreated. It’s important to seek testing if you believe you’ve had an exposure, or if you are experiencing troubling symptoms. Hepatitis C is curable.

It’s important to not just assume a hepatitis C infection was in the past, even if you presently have no symptoms. Your doctor will refer you for further testing if you have a reactive result.