Hepatitis is a disease of the liver. There are several types of hepatitis, each named for the type of virus that causes it.

The hepatitis C virus (HCV) can be transferred through contact with the blood of someone with hepatitis C or during sexual contact. A birthing parent with hepatitis C can transmit the virus to her infant during childbirth.

The amount of virus in the bloodstream at any given time is called the viral load.

An HCV antibody test is a simple blood test used for screening purposes. While this test can detect that HCV has been in your bloodstream, it can’t tell the difference between a previous infection and an active one.

In some cases, a weak positive result can turn out to be a false positive.

If you test positive for HCV, it’s likely that your doctor will want to follow up with additional testing that can actually measure the viral load and determine if you have an active infection.

The HCV RNA qualitative test can tell the difference between past and current infections. This test measures the amount of virus in your blood. A third test, viral genotyping, can zero in on the specific HCV in your body.

There are several different types of HCV. Knowing the specific form of HCV that you have is important. The type factors into decisions regarding the most effective treatment for you.

Not everyone with hepatitis C has symptoms. In fact, in a small number of people, the infection resolves on its own. However, a hepatitis C infection can last anywhere from a few weeks to a lifetime.

The illness can lead to:

  • liver damage
  • liver cancer
  • the need for a liver transplant

Once the proper course of treatment is determined, viral load testing can be used to monitor its success and guide future healthcare decisions.

With certain other infections, having a higher viral load means a higher level of illness, but that isn’t the case with hepatitis C. Your viral load has no bearing on how ill you feel or how much liver damage you may experience now or in the future.

However, viral load is an important indication of how well treatment is likely to work. The lower your viral load, the more likely it is that your treatment will be successful.

Breaking down the numbers

  • Low viral load. A viral load of less than 800,000 IU/mL (international units per milliliter) is considered low. Successful treatment is more likely with a low viral load.
  • High viral load. A viral load of more than 800,000 IU/mL is considered high. This can make successful treatment more challenging.
  • Undetectable viral load. A viral load of less than 615 IU/mL means there’s no detectable HCV, or it’s too low to detect.

During treatment, a falling viral load is an indication that treatment is succeeding.

At the end of the planned course of treatment, which is generally 8 to 12 weeks, an undetectable viral load means that treatment can be stopped.

A sustained virologic response is when the most sensitive tests find no trace of HCV 12 weeks after stopping treatment. After that, viral load testing can alert you to a relapse.

Understanding the specifics of your viral load is important at the time of diagnosis. Once you begin treatment, follow-up testing will let your doctor know if the current treatment is effective.

Other than that, there’s no need for repeat testing. This is because the viral load doesn’t provide information about your symptoms or whether your liver is functioning properly. Other liver tests, such as a biopsy, can provide that information.

Certain groups are more vulnerable to contracting HCV. Among them are:

  • people on dialysis
  • children born to HCV-positive mothers
  • anyone who may have had contact with the blood of someone with hepatitis C

The most common methods of HCV transmission are:

  • sharing needles and syringes used for injecting drugs
  • a mother with hepatitis C transferring HCV to her child during childbirth

Occasionally HCV is transmitted through:

  • having sex with someone who has hepatitis C
  • getting a tattoo in a place that doesn’t have good infection control
  • sharing personal care items, such as a razor or toothbrush, with someone who has hepatitis C

Hepatitis C can’t be transmitted through:

  • coughing or sneezing
  • sharing silverware or glassware
  • hugging and kissing
  • breastfeeding
  • holding hands

There are often no symptoms of hepatitis C.

Some people experience:

  • fatigue
  • abdominal pain
  • jaundice

Those symptoms may prompt your doctor to order an HCV test.

Antibodies don’t always show up in the first months after exposure.

If you’ve tested positive for HCV, it’s important that you get tested for viral load. Viral load testing is also advised prior to and during treatment.