Hepatitis C

Hepatitis C infection is more persistent than Hepatitis A or B.

Spread of Hepatitis C

While less commonly spread via sexual means that hepatitis B, it is still considered as a sexually transmitted disease. The main modes of spread of hepatitis C is through contact with the blood of an infected person.

Hepatitis C is most commonly spread via infected needles and sharp objects compared to sexual transmission.

Update 25th July 2014 – Hepatitis C has been found to be very rarely spread via sexual contact except between 2 HIV +ve MSM

The Natural History of Hepatitis C infection

The symptoms of hepatitis C infection is similar to that of hepatitis A and B. Approximately 20% of individuals who become infected with HCV will clear the virus from their body within 6 months, though this does not mean they are immune from future infection with HCV.

The other 80% of people will develop chronic hepatitis C infection, during which the virus may cause mild symptoms or no symptoms at all. These people will however carry the hepatitis C virus for the rest of their lives and will remain infectious to others. Like chronic Hepatitis B infection, chronic infection with hepatitis C virus may lead to cirrhosis and liver cancer in the long run.

Currently, there is no vaccine as yet for Hepatitis C. However, being vaccinated for Hepatitis B provides some protection against Hepatitis C.

Screening for Hepatitis C

Screening is usually done with a Hepatitis C antibody serology at 1 month post exposure.

This test unfortunately has a relatively high chance of a false positive result (about 1%). To confirm the diagnosis if the serology test if positive, we would proceed to do a Hepatitis C DNA test.

Hepatitis C and HIV

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis stated  ‘Extended HIV follow-up (e.g., for 12 months) is recommended for HCP who become infected with HCV following exposure to a source coinfected with HIV and HCV.’

In other words for patients who got infected with Hep C and HIV at the same time, they need to be screened for HIV for up to 12 months. Not the usual 3 months window period.

Update March 2015

In recent published guidelines on HIV screening, it is no longer mentioned that a Hepatitis C and HIV co-infection can prolong the HIV testing window period. This could be due to the advent of better and more accurate tests.

Click here for more Info on HIV and Hep C Co-Infection Window Period
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  1. hi dr can i know the early test for Hep C? pcr rna qualitative and quantitative? thank i plan to come over your place to conduct the test.

  2. I have a short question.

    1. I tested HCV Antibody at 14 weeks is it conclusive? I saw CDC webpage mention 97% seroconvert at 6 months, should I retest? I dont have much noticeable symptoms. Some said 3 months usually is enough a lot of mix information.

    2. I saw Hep C Webmd got a section mentioned that “Your result need to be rechecked if you taking some herbs, supplement or other alternative medicine product” what is that mean? Possibly my test false negative? Personally I took Blackmores Executive B only.

  3. Hi Doctor,

    I did the following Hep C tests on 39 days and the result came negative.

    Technology used : Enzyme Linked Fluorescent Assay (E. L. F. A.)


    Can I consider the above tests conclusive at 39 days? Should I do more tests?

  4. Doctor, i did not went for hep c testing after my protected exposure. After 3 months i went multiple test of AB AG where recognised as forth gen testing and appears negative, do i need to retest at one year? Or i need to test for hep c now??

    • I believe the risk for hepatitis C is extremely low but there is no harm in checking. Your HIV test is conclusive, no need to worry.

  5. worried

    Hi Doctor, I recently went for blood test and doctor pricked my finger with lancet. After test doctor asked me to wait outside and I moved outside and forgot to pick cotton to press my finger to stop bleeding. While waiting outside I pressed my bleeding finger in clinic cushion in which i was seated and realized it at later.Will i get infected to Hepatitis with this incident considering there is dried blood on cushion. Since cushion is of black colour I am not sure if it has dried blood or not.

  6. Hi doctor, saw your update as of march 2015 regarding extending period of hiv window period, just one question would you consider arele test hiv1&2 a better,modern accurate test? Thanks so much.