Everything You Need to Know About the HCV RNA Titer Test

Medically reviewed by Alana Biggers, MD on July 14, 2017Written by Tim Jewell

What is the HCV RNA PCR test?

The HCV RNA PCR test is used to determine whether the hepatitis C virus (HCV) exists in your bloodstream. If the virus is present, the test can also measure the exact amount (titer) in your blood. This amount is known as the viral load.

The test can also help your doctor decide how best to treat the virus and reduce your viral load. Giving you the test before and during treatment allows your doctor to see exactly how your body reacts to certain treatments. Keep reading to learn more.

What to expect during testing

Your doctor or lab technician will take a blood sample for analysis.

Before the test, let your doctor or technician know if you’re uncomfortable with certain needles or if you’ve ever passed out at the sight of blood. They can give you a snack to reduce your risk of fainting.

The needle may sting a little as it enters your skin, and you may have a bruise on the site of the draw for a few days.

Results are usually available within a few days or, at most, a few weeks.

How it works

The HCV RNA PCR test is conducted through a process called polymerase chain reaction (PCR). There are two approaches to this process: qualitative and quantitative.

Qualitative

This test is often used to make a hepatitis C diagnosis. It confirms whether you have the virus in your body without providing a specific number.

The qualitative test is often the second test that your doctor will use to confirm whether HCV is present in your blood. It often follows the hepatitis C antibody test.

The antibody test lets you know whether your body is making antibodies to fight off an HCV infection. If your doctor gets a positive result from the antibody test, they will use HCV RNA PCR testing to confirm and measure the amount of HCV in your blood.

Your doctor may also recommend a similar qualitative test known as a transcription-mediated amplification (TMA) test. Some research suggests that it’s a much more sensitive detection test for HCV. Your doctor may not think that it’s necessary for you if the PCR test gives sufficient results.

Quantitative

This method measures the exact amount of the HCV in your blood in international units per liter (IU/L). This number determines whether you have a high or low viral load.

The quantitative test is useful for monitoring the amount of HCV in your blood over time or measuring your response to treatment intended to reduce your viral load. Once the measurement of your viral load drops to 615 IU/L or less, the amount of the virus is considered undetectable.

At this point, the qualitative test can confirm whether the virus is actually no longer in your body or if only a small amount is still present.

What the qualitative results mean

The qualitative results indicate that HCV is present in your blood. The result will be either “detected,” meaning that you do have the virus in your blood, or “undetected,” meaning that you don’t have the virus in your blood or have a tiny amount that can’t be detected by this test.

The qualitative test results may still be positive even if viral load has decreased drastically due to treatment.

What the quantitative results mean

The quantitative test results provide an exact measurement of HCV in your blood. This number helps your doctor confirm whether you have a high or low viral load.

Measuring your viral load before treatment allows your doctor to monitor your viral load during and after treatment.

The viral load measurement doesn’t indicate how severe your HCV infection or cirrhosis is. Your doctor will need to take a biopsy (tissue sample) from your liver to learn more about how your liver has been affected by an HCV infection. Not clear on what cirrhosis is? Learn more about its connection to HCV.

About the viral load range

The viral load results from the quantitative test can range from 15 to 100,000,000 IU/L.

If your results are:

  • Less than 15 IU/L: The virus is detected, but the amount can’t be measured exactly. You may need to return later for another test to see if the measurement changes.
  • Less than 800,000 IU/L: A low viral load is detected.
  • More than 800,000 IU/L: A high viral load is detected.
  • More than 100,000,000 IU/L: The virus is detected and active infection is taking place.
  • Inconclusive: HCV RNA can't be measured, and a new sample needs to be taken.

What comes next

If your doctor determines that HCV is present, they’ll work with you to develop a treatment plan. The goal of treatment is to reduce the viral load until the virus has been completely cleared from your body. Your doctor may repeat these tests during treatment to monitor your progress. Learn more about hepatitis remission.

If your doctor believes that your liver has been damaged by the virus, they may recommend that you see a specialist for further treatment.

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