Hepatitis C test (antibody with reflex to RNA)

What it measures

Antibodies form after infection and usually stay for life, even after the body clears the virus or treatment cures it. That is why a positive antibody test needs an RNA test. HCV RNA measures the virus itself, so a detectable result means a current infection. Antibodies can take weeks to a few months to appear after exposure, while RNA shows up sooner.

Who should consider it

• All adults at least once, per CDC
• People who are pregnant, during each pregnancy
• Anyone who has ever injected drugs, even once, with regular testing if it continues
• People who received blood or organs before 1992, or who have had long-term dialysis
• Anyone with abnormal liver tests or a known exposure, such as a needlestick

How to read your result

• Antibody negative means no sign of past or current infection, unless the exposure was very recent.
• Antibody positive with RNA detected means a current hepatitis C infection.
• Antibody positive with RNA not detected usually means a past infection that cleared on its own or with treatment.
• A positive antibody test alone does not tell you whether you have an active infection.

Reference ranges differ between labs. Use the range printed on your own report.

What to do next

If your RNA test is positive, see a clinician soon. Current hepatitis C treatment is a course of pills, usually 8 to 12 weeks, and it cures the large majority of people. Your clinician will also check your liver. Hepatitis C spreads mainly through blood, and less often through sex, so share results with anyone who may have been exposed.