Diagnosis starts with a simple blood test. A virus detection test looks for the presence of the hepatitis C virus, or viral load, in the blood or body tissue. If the virus is detected, it means you have hepatitis C. Then your doctor may check your liver's health.
The most commonly used way to check for liver problems is through liver function tests. These blood tests look for chemicals in the body that are produced when the liver does its various jobs:
- ALT—an enzyme normally found in the liver cells and in the blood. When liver cells become damaged, they leak into the bloodstream, causing levels of liver enzymes to be raised. (However, a single ALT test does not always reveal the severity of liver damage, and many people with chronic hepatitis C have normal ALT levels). Other liver enzymes that may be measured by blood tests include AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase), and alkaline phosphatase.
- Bilirubin—a yellow pigment that's passed on to the liver when red blood cells break down. If the liver is not working well, bilirubin levels in the blood rise.
- Albumin—a protein manufactured by the liver. A decrease in albumin may reflect poor liver function.
- Prothrombin time—When the liver is damaged, it may fail to produce enough blood-clotting factors. This test measures blood-clotting ability.
- Complete blood count—A complete blood count analysis can be used to help detect liver scarring.
Your doctor may also perform a liver biopsy—a procedure in which a tiny sample of tissue from the liver is removed and examined in a laboratory. A liver biopsy is the best way to measure the extent of liver damage and may also help rule out other forms of liver disease.
With respect to the liver, the goals of therapy for the hepatitis C virus are to delay or stop disease progression by:
- Delaying the progression of scarring
- Preventing cirrhosis
- Preventing liver cancer
What Is a Genotype?
Have you ever had a key copied and found that the new key did not work very well or did not work at all? If so, then you know that even a small difference can be very important. Although the keys may look the same, may be made from the same material, and have the same function, the shape of the new key may not match up as well with the keyhole.
In much the same way, small genetic differences between viruses can make them very different or only slightly different. In the case of hepatitis C, these differences do not change the way the virus affects your body, but they may influence the way the virus responds to treatment.
The hepatitis C virus has 6 major known types (called genotypes). Each type is assigned a number from 1 to 6. Different types are common in different parts of the world. For example, types 1, 2, and 3 are the most common types in North America and Western Europe, Australia, and the Far East. In the United States, type 1 accounts for most cases of
hepatitis C.
Your genotype is important because it influences your treatment plan and response to therapy. If you don't know the genotype of the virus causing your infection, use the Questions Worksheet so you can ask your doctor at your next appointment.
Only your doctor can tell you how your genotype relates to your treatment, but generally people with genotypes 1 and 4 require 48 weeks of treatment, and people with genotypes 2 and 3 need only 24 weeks of treatment.
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