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Hepatitis C Test: Antibody, RNA and Results

By Richard D. Porter, Patient Advocate Updated

Quick answer

Hepatitis C is found with a blood test. The usual first step is an antibody test, and if it is reactive, an RNA test (also called a NAT) shows whether the virus is in your blood now. The CDC says every adult 18 and older should be tested at least once, and that antibodies usually take 8 to 11 weeks to become detectable after infection. If you may have been exposed in the past 6 months, the CDC recommends an RNA test even if the antibody test is negative.

The test you need

Hepatitis C: RNA test (tests for the virus)Reliable by day 14

Hepatitis C: Antibody testReliable by day 77

Too earlyMay detect; retest if negativeReliable

Counted from your most recent exposure. Source: CDC. Work out your own dates

Test
Hepatitis C antibody test, with an HCV RNA (NAT) test if it is reactive
Sample
Blood
When
Antibodies are usually detectable about 8 to 11 weeks after infection (CDC). An RNA test can detect the virus as early as 1 to 2 weeks after exposure.
Results
STDCheck says its antibody results are ready in 1 to 2 days. A lab or clinic may differ.

Hepatitis C is a virus that affects the liver. The CDC says most people with it have no symptoms, which is why testing matters. The test is a blood test, and the CDC says treatment cures most people.

What is a hepatitis C test?

There are two tests, and they answer different questions.

  • The antibody test looks for your body’s response to the virus. The CDC says antibody tests find out whether you have ever been infected with hepatitis C.
  • The RNA test (also called a NAT) looks for the virus itself. The CDC says it looks for the presence of the virus in your blood, so it shows whether infection is current.

In practice, a lab runs the antibody test first. The CDC says the RNA test follows when the antibody result is reactive, and recommends that clinicians order it automatically.

What do the results mean?

  • Antibody reactive, RNA detected. The CDC says a detectable RNA result indicates current infection. People with a current infection should be evaluated for treatment.
  • Antibody reactive, RNA not detected. The CDC says a non-detectable RNA result indicates no current infection, and a reactive antibody means infection at some point. A clinician will go through what it means for you.
  • Antibody non-reactive. The CDC says this means you are not currently infected. After a possible exposure in the past 6 months, the CDC advises further testing, which is covered next.

How soon after exposure does a hepatitis C test work?

The CDC says it usually takes 8 to 11 weeks before antibodies are detectable, and that some people may not make a detectable response in that time. An RNA test can detect the virus as early as 1 to 2 weeks after exposure.

If you think you were exposed in the past 6 months, the CDC recommends an RNA test even when the antibody result is negative. The NHS also says a negative result may need to be repeated at about 6 months, because the test isn’t always accurate if you were infected recently.

Who should get tested for hepatitis C?

The CDC recommends testing for:

  • All adults 18 and older, at least once in their lifetime
  • Pregnant women, during each pregnancy
  • People with ongoing risk factors, who need periodic testing

You don’t need symptoms or a known exposure for the one-time test. If you were tested years ago and your situation has changed, ask a clinician whether you should be tested again.

Can you get hepatitis C from sex?

The CDC’s STI guidelines say hepatitis C is not efficiently transmitted through sex. The NHS lists unprotected sex where blood is present as a less common route. If you are asking because of a recent sexual exposure, the timing steps above still apply.

What happens if the result shows current infection?

The next step is a clinician, ideally one who treats hepatitis C. The CDC says people with a current infection should be evaluated for treatment, and that simple, well-tolerated treatments can cure more than 95% of cases. It also says less than half of people clear the virus without treatment. If you are pregnant, tell your prenatal clinician.

Where can I get a hepatitis C test?

Your doctor, a sexual health clinic or a local health department can order it. The CDC’s GetTested site helps you find confidential testing near you. Not every STD panel includes hepatitis, so ask for it by name.

You can also order online. STDCheck lists hepatitis C as an individual test and in its 10-test and 13-test panels, with a blood sample taken at a testing center. Its page describes the antibody test and doesn’t mention an RNA test. If your exposure was recent, ask a clinician whether you also need an RNA test.

Get care now if

  • Your skin or the whites of your eyes look yellow
  • Dark urine together with pale stools
  • Severe belly pain, or repeated vomiting that stops you keeping fluids down
  • You feel confused or unusually drowsy

Call 911 for a medical emergency. Otherwise, an urgent care clinic, sexual health clinic or your doctor can see you.

When to test

  1. Once, as an adult, with no exposure neededThe CDC recommends that all adults 18 and older be tested for hepatitis C at least once in their lifetime, and that people be tested during each pregnancy.
  2. 1 to 2 weeks after a possible exposureAn RNA test can detect the virus this early. The antibody test usually can't yet, so ask a clinician for the RNA test if you need an answer sooner.
  3. 8 to 11 weeks after a possible exposureThe CDC says it usually takes this long before antibodies are detectable, and some people may not make detectable antibodies in that time. In that case, clinicians should consider RNA (virologic) testing.
  4. Within 6 months of a possible exposureThe CDC recommends an RNA test for anyone who might have been exposed in the past 6 months, whatever the antibody result. The NHS says a negative test may need repeating at about 6 months for the same reason.

Common questions

Does a positive hepatitis C antibody test mean I have hepatitis C?

Not by itself. The CDC says a reactive antibody result means a person has been infected with the virus at some point. Antibodies can stay in the blood after the virus has cleared or been cured, so the RNA test is what shows whether the infection is current.

Can hepatitis C be cured?

Yes, in most cases. The CDC says simple, well-tolerated treatments can cure more than 95% of hepatitis C cases. A clinician arranges treatment, so the test is the first step to getting it.

Do I need to be tested again if I was cured?

Possibly, if you are still at risk. Antibodies stay positive after a cure, so the CDC says later testing for reinfection in people with ongoing risk should be limited to the RNA test.

Is hepatitis C included in a full STD panel?

It depends on the panel, so check the list before you pay. STDCheck's 10-test panel lists hepatitis C, along with hepatitis A and B, HIV, herpes, chlamydia, gonorrhea and syphilis. Its page describes the antibody test and doesn't mention an RNA test.

Next: Hepatitis C antibody test, with an HCV RNA (NAT) test if it is reactive.

Blood. Antibodies are usually detectable about 8 to 11 weeks after infection (CDC). An RNA test can detect the virus as early as 1 to 2 weeks after exposure.

Read next

Sources

This guide is general information written by a patient advocate using public health sources. It is not a diagnosis. Only a clinician or a lab test can tell you whether you have an infection. Read how we write and check our guides.