Finding the right tests…
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Finding the right tests…
Serology
Hepatitis C testing starts with an antibody screen, which checks whether your immune system has ever reacted to the hepatitis C virus. A reactive antibody result does not confirm you are currently infected - it can also reflect a past infection your body has already cleared, so it is always followed by a second test that looks for the virus's genetic material (HCV RNA) directly in your blood. If a possible exposure happened in the last six months, doctors typically order the RNA test straightaway rather than waiting for antibodies to develop, since antibodies can take weeks to appear. Together, the two tests are what separate someone who once had hepatitis C from someone who currently carries the virus.
An antibody test that comes back non-reactive generally means no current infection, unless the exposure was recent enough that antibodies have not yet had time to form. A reactive antibody result is automatically followed by an HCV RNA test: if that comes back negative, the infection was in the past and has already cleared on its own; if positive, the virus is still active and treatment can be considered. Both steps are usually run from the same blood draw without needing a second visit.
The antibody test cannot tell a past, cleared infection apart from an infection that is still going on - both leave the same antibody marker behind. The RNA test settles that question by checking for the virus itself rather than the immune response to it, which is why a reactive antibody result is never the final word.
If you know or suspect you were exposed to hepatitis C within the past six months, testing antibody alone can miss it, since your body has not yet had time to make a detectable antibody response. In that situation, doctors go straight to the RNA test rather than waiting on an antibody result that could still be falsely negative.
- Hepatitis C is now treatable with direct-acting antiviral medicines with high cure rates - Further tests, including liver function tests and sometimes a liver scan, assess how much the liver has already been affected - A cured infection is confirmed with a repeat RNA test showing the virus is undetectable months after treatment ends
Hepatitis C spreads through contact with infected blood, most often through shared needles; it is not typically spread through casual contact, and testing is now recommended for all adults at least once regardless of perceived risk.
It means your immune system has reacted to the hepatitis C virus at some point, either currently or in the past. A follow-up RNA test is needed to tell whether the virus is still active in your body.
The antibody test can't distinguish a cleared past infection from one that's still active, since both leave the same antibody behind. The RNA test checks for the virus itself, which settles whether treatment is needed.
Antibodies can take several weeks to develop, so testing too soon after exposure with an antibody test alone can miss an infection. For exposure within the past six months, doctors typically use the RNA test instead.
This page is general information about the test, not medical advice. Your own report's reference ranges apply — please discuss your results with your doctor.
Yes, some people clear the virus naturally within months of infection, which is why a reactive antibody test with a negative RNA result means past, cleared infection rather than an active one needing treatment.
There is no fasting requirement for this test. Ask your doctor or the centre when you book if other blood work is planned at the same visit.
Yes, current guidance recommends hepatitis C screening for all adults at least once, regardless of perceived risk, in addition to more frequent testing for anyone with an ongoing chance of exposure.