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• Test Results and What They Mean
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Hepatitis C Test Results and What They Mean

This section is for people who want to know more about tests related to hepatitis C and its treatment. You can find out more about virus detection tests, more about liver function tests, and more about biopsies.

More About Virus Detection Tests

One thing doctors look for when comparing virus detection tests is sensitivity (how capable the test is of finding the hepatitis C virus in your body). A highly sensitive test provides a more accurate result because it's capable of detecting low levels of hepatitis C virus that a less-sensitive test might miss.

The most sensitive virus detection test is called a PCR (polymerase chain reaction) test. In the case of the hepatitis C virus, the PCR works by taking a sample of the blood and amplifying genetic material associated with the virus millions of times.

While there are several PCR tests available through local laboratories, AMPLICOR^® is the name of the first PCR test approved by the US Food and Drug Administration (FDA) for the detection of hepatitis C. Other, non-approved hepatitis C virus detection tests may be used as well, especially in clinical trials. Your doctor can help you understand the meaning of your PCR test results.

More About Liver Function Tests

• ALT (alanine aminotransferase)—ALT is an enzyme that is 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. An increase in ALT levels can indicate acute liver damage. However, a single ALT test cannot usually reveal the severity of liver damage. Many people with chronic hepatitis C have normal ALT levels, so this test is not considered a completely accurate marker of disease progression.

  Other liver enzymes that may be measured by blood tests include AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase), and alkaline phosphatase.

• Bilirubin—When red blood cells complete their lifecycle and break down naturally, they produce bilirubin, a yellow pigment that's passed on to the liver and excreted in the bile. Most of the time, the body produces as many red blood cells as it breaks down. However, if the red blood cells break down more rapidly or if liver function becomes impaired, bilirubin levels in the blood rise. In patients with hepatitis, bilirubin levels tend to fluctuate. A prolonged persistent rise in bilirubin for a patient with chronic hepatitis C usually indicates severe liver dysfunction.
• Albumin—Albumin is a protein manufactured by the liver. A decrease in albumin may reflect a reduction in the liver's ability to synthesize this protein, and a significant sustained decrease in this protein may mean poor liver function. However, decreases in albumin levels may also occur for reasons not related to the liver. Your doctor will take this into account when interpreting test results.
• Prothrombin time—This test measures blood clotting ability. When the liver is damaged, it may fail to produce enough blood clotting factors.
• Complete blood count—A complete blood count analysis can be used to help detect liver scarring. If the liver becomes scarred, blood may back up into the spleen. This causes the spleen to enlarge and to trap blood elements, removing them from circulation and lowering blood counts.

More About Biopsy

Today, liver biopsies are performed as outpatient procedures. General anesthesia is not necessary. Patients receive local anesthesia at the area where the needle will be inserted (usually the right side of the rib cage). Although the test itself only takes a few minutes—with the actual biopsy being done in seconds—you may be monitored at the testing facility for several hours.

Patients often describe the sensation they experience during the biopsy as a feeling of strong pressure on the spot where the tissue is removed. Some patients experience mild to moderate pain at the biopsy site. You may feel tired after the test, so it is a good idea to schedule some rest time after having a biopsy. You should speak to your doctor about the specific details and risks of liver biopsy.

The degree of liver damage measured from a liver biopsy is scored in stages:

• Mild—In the earliest stage of liver damage, the liver is inflamed (immune cells called lymphocytes are present), but scarring has not yet occurred. There is little damage to the liver at this point.
• Moderate—In this early stage of liver damage, the liver is inflamed, and mild scarring (fibrosis) has begun to form.
• Severe—In this stage, scar tissue from one area of the liver bridges (connects) to scar tissue from other areas, leading to advanced fibrosis.
• Cirrhosis—In this advanced stage of liver damage, cirrhosis (advanced scarring) has occurred. At this point, the degree of damage to the liver is more serious.

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