Hepatitis C is a liver disease. It is passed from person to person through contact with blood, most often through shared drug use equipment (past or present), pregnancy and sometimes through sex (when blood is present). You can have hepatitis C (hep C, HCV) for years and not know about it, so if there’s a chance you’ve been exposed, it’s a good idea to get tested.

Who should consider testing?

It is a good idea to talk to a doctor about your history and current health to decide about whether hep C testing is a good idea. If you’re already living with HIV, hep C testing is recommended, as having both can be very hard on your body. No one is absolutely safe from risk. Here in BC, hepatitis C is most commonly diagnosed in the following populations:

  • People using (or who have used) needles or equipment for injection or inhalation. Needles or other equipment for drug use (spoons, pipes) can hold tiny bits of blood infected with hep C, which can be passed from person to person if equipment is shared. People who have shared needles for steroid, hormones, or any other injections may also be at risk.
  • Baby Boomers (people born between 1945 and 1964) might have been exposed to hepatitis C in various ways, including untested blood products and needles used more than once in health care settings before the risk was known, and recreational drug use with shared equipment, even one time. They may have no risk for transmission currently, but have the virus nonetheless.
  • People who come from countries where hepatitis C is commonly found in the population.
  • Indigenous people experience a long history of colonization has resulted in cultural destruction, racism, discrimination, violence, sexism, and trauma. A lack of appropriate primary care and mental health resources can put Indigenous people at risk of substance use, a significant risk factor for hep C transmission.
  • People who received blood products and/or transfusions before July 1990 and haven’t been tested for HIV or Hep C.

Testing and Diagnosis Procedure

First step: Hepatitis C Antibody Test

The first step to see if you have hep C is a blood test. If you’re nervous about needles (or are in recovery and worry this could trigger you), tell the person drawing blood and figure out how to be most comfortable. We can help you find a place if you’re not sure where to go. The blood sample will be used to look for antibodies to the virus. It will show whether you have been exposed to hep C at any point in your life. Twenty to twenty-five percent of those who have been exposed to hep C “clear” the virus on their own, so you may have a positive test, but then clear the virus. The only way to know for sure if you have hep C is by having a second test that finds the actual hep C virus.

Next step: Hepatitis C PCR Test

This test finds the presence of the hep C virus in your system. Until you have this test, you don’t know for sure if you have hep C. Sometimes doctors will wait until you have some signs of liver disease (which can take decades) before doing this test. You can ask to have it done sooner.

Once you are showing signs of liver disease progression, the doctor will need to find out which genotype (variation) of hep C you have to choose the best treatment.

Hep C can be cured for many people, but once you are cured, you can get hepatitis C again so it is important to take care to avoid it. If you use drugs or inject hormones or steroids, get your own equipment and use it for yourself alone. Have safer sex. If you get pregnant, be tested for HIV and hep C.

For more in-depth information on hep C diagnosis, treatment and care concerns: Pacific Hepatitis C Network.