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Diagnosing Hepatitis C

by Jerry Kennard
for About.com

Updated February 11, 2006

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Diagnosing Hepatitis C
Unless it is in a severe form and with obvious symptoms there can be many ways in which people find out that they have Hepatitis C. Because there are sometimes so few specific symptoms beyond, say, fatigue, it may only be diagnosed when blood tests are carried out for unrelated reasons, i.e. prior to giving blood donations, medicals for insurance purposes, general health checks or following work-related injuries. It can come as a very big shock that someone has contracted hepatitis, and that sometimes there are signs of liver failure.

Signs and Symptoms of Chronic Hepatitis C
Although signs and symptoms can vary a lot most people will be unaware that anything is wrong with them. Yet others may have vague symptoms and some people more profound ones. These may include mild or restless fatigue, dark colored urine, jaundice and/or an enlarged liver.

Unfortunately if chronic hepatitis is not cleared by the body or is not successfully treated and cured then liver disease or liver failure may result. For many people this process happens over many years and someone with hepatitis C may never suffer any real ill effects of hepatitis in their life time.

Diagnostic Tests for Hepatitis C

Blood tests A blood test is required to identify the type of hepatitis C present, that is, what genotype they have.

Liver Function Blood Tests These tests show how well the liver is functioning but it does not accurately assess all of the functions that the liver is responsible for. They do however check the level of liver enzymes, transaminases and cholestatic enzymes, bilirubin and liver protein levels. High levels of transaminases in the blood do not always reveal how badly the liver is inflamed or damaged. Elevations of transaminase can also occur in genetic liver disease, liver tumors, heart failure. The normal ranges of AST and ALT transaminases are around 0 to 40 IU/L and 0 to 45 IU/L respectively.

Liver Proteins Blood Test Albumin, prothrombin, and immunoglobulins, proteins made by the liver are checked and abnormal levels are indicative of severe liver disorder. Prothrombin times, because the liver produces many of the clotting factors required to stop bleeding, needs to be determined.

Liver Biopsy The biopsy is the most accurate of the diagnostic procedures and can determine what is wrong with the liver and how badly it has been damaged. As most liver diseases affect the entire organ uniformly, the small sample obtained by biopsy, generally performed under a local anesthetic, will show any abnormalities and the extent of liver damage present. Liver biopsy can be repeated regularly (every year or 3 or 5 yearly) to monitor the progress of the disease. For most people the guided liver biopsy is a safe and efficient diagnostic tool.

Updated 11/25/2005

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