How to test for hepatitis C

Perform hepatitis C virus (HCV) antibody testing initially—a positive result indicates current or past infection. To confirm current infection, test for HCV RNA in blood using a sensitive polymerase chain reaction (PCR) assay. In practice, it is useful to order the HCV antibody and HCV RNA tests simultaneously¹, to save the patient time and an additional blood test.

The introduction and widespread use of pangenotypic (effective against genotypes 1 to 6 of hepatitis C) direct-acting antiviral therapies for hepatitis C means it is not necessary to perform HCV genotype testing for every patient. However, HCV genotype testing is funded on the Medicare Benefits Schedule (MBS), and remains useful if a genotype-specific direct-acting antiviral is required, or in people at high risk for reinfection, when a change in HCV genotype can differentiate reinfection from relapse (see Monitoring after hepatitis C treatment).

¹ Order both HCV antibody and HCV RNA on the same pathology request form, and note that HCV RNA should only be measured if HCV antibody is positive. The Medicare Benefits Schedule (MBS) covers the cost of the HCV RNA test only if the HCV antibody test is positive.Return