Diagnosis

Your doctor will ask you about symptoms related to acute or chronic hepatitis C or advanced liver disease. He or she will ask if you have any risk factors for hepatitis C, such as a history of intravenous drug use, nasal cocaine use or blood transfusions, especially before 1992. Your doctor will ask about your sexual history, because people with more than one sexual partner are more likely to develop hepatitis C. If you have ever worked in the health care field, your doctor will ask if you could have been stuck with a needle accidentally. In rare cases, people on long-term hemodialysis become infected with hepatitis C through contaminated equipment.

Your doctor will examine you, looking for evidence of liver disease, such as an enlarged liver or spleen, a swollen abdomen, ankle swelling or muscle wasting.

Hepatitis C infection is confirmed by certain tests that work in one of two ways. Either they test for the presence of the virus in your blood or they detect infection-fighting proteins (antibodies) that your body has made to fight the hepatitis C virus. These antibodies indicate that you have been exposed to the virus in the past. The virus itself can be detected with a test called a polymerase chain reaction. Antibody tests include enzyme immunoassays and recombinant immunoblot assays.

If you have hepatitis C infection, your doctor will order blood tests to determine if you have liver disease. Results of these tests are abnormal in about two-thirds of people with hepatitis C. Special blood testing will also be done to determine which subtype of the virus you have, as different subtypes have different response rates with treatment. A liver biopsy may be needed and, in most cases, is done before medical treatment is started. In a biopsy, a small piece of tissue from your liver is removed and examined in a laboratory.

Expected Duration

Less than 20% of people with hepatitis C are able to rid their bodies of the virus within six months. Most people have the infection for life. Some eventually develop cirrhosis or other forms of severe liver disease.