What to Do With a Positive Hepatitis C Test

What to Do With a Positive Hepatitis C Test
What to Do With a Positive Hepatitis C Test
If the treatment goal of viral eradicatication cannot be met, strive to slow disease progression, lower risk of liver cancer, and improve quality of life.

According to the CDC, there are approximately 180 million hepatitis C–antibody-positive individuals worldwide, 4.1 million of which reside in the United States. With 3 to 4 million new cases diagnosed per year, hepatitis C is among the fastest growing illnesses.

There are more than 7 million carriers of the hepatitis C virus (HCV) and 2.7 million chronically infected individuals. Approximately 12,000 people die from hepatitis C every year. The highest prevalence of the disease is among those aged 30 to 54 years.

Hepatitis C is often not recognized until asymptomatic persons are identified as HCV-positive. Blood testing, first made available in 1992, is the only way to determine that an individual has hepatitis C. The treatment goal is viral eradication. If eradication cannot be accomplished, clinicians must slow disease progression, improve histology, decrease the risk of hepatocelluar carcinoma, and improve quality of life.


Hepatitis C (Flaviviridae hepacivirus) is a small, enveloped, single-stranded RNA virus. This virus mutates rapidly, so changes in the envelope proteins may help it invade the immune system. The virus does not incorporate itself into the host DNA, resulting in the ability to cure the infection indefinitely.

Acute hepatitis C refers to the first six months after infection. Between 60% and 70% of individuals infected with HCV develop no symptoms during this acute phase. In the minority of patients, acute-phase symptoms may be mild and nonspecific. Approximately 55% to 85% of acute hepatitis C patients will remain infected. Signs and symptoms of acute hepatitis C infection include fatigue, fever, dark urine, clay-colored stools, abdominal pain, loss of appetite, nausea, vomiting, joint pain, and jaundice. 

Hepatitis C can also be chronic and cause chronic liver disease that ranges from mild to severe, including cirrhosis and liver cancer. Liver disease associated with chronic hepatitis C is usually insidious and progresses slowly without any signs or symptoms for several decades. 

HCV can be transmitted in a variety of ways, including: 

  • Transfusions and organ transplants before 1992 

  • IV drug use

  • Intranasal cocaine use

  • Sharing personal items with an infected person (e.g., razors, shavers, and toothbrushes)

  • Tattooing and body piercing

  • High-risk sexual activity

  • Clotting factors before 1987

  • Occupational exposures (health-care professionals)

  • Mother-to-infant transmission (rare but still considered a risk)

    This article originally appeared on Clinical Advisor