Anti-HCV

Anti-HCV is a blood test for antibodies against hepatitis C virus. It indicates whether a person has ever been infected. A positive result does not necessarily mean infection persists, so it is confirmed by testing for viral genetic material (HCV RNA).

Who the test is for

• people with elevated liver enzymes (ALT, AST) of unclear cause or signs of liver disease;
• people who have ever injected drugs, even once and long ago;
• people who have had tattoos, piercings or procedures where equipment may not have been sterile;
• people with needlestick injuries or blood contact involving someone with hepatitis C;
• people on dialysis, with HIV or hepatitis B, and children of mothers with hepatitis C;
• pregnant women and people having preventive check-ups, when recommended by a doctor.

What anti-HCV is and what it indicates

Hepatitis C is liver inflammation caused by hepatitis C virus. It spreads through blood, most often shared injecting equipment, but also potentially non-sterile medical or dental procedures, tattoos, piercings and transfusions of untested blood. Sexual and mother-to-child transmission are less common. There is no hepatitis C vaccine.

According to the World Health Organization, approximately 30 % of infected people clear the virus themselves within six months. Others develop chronic infection, often without symptoms for years, and 15 to 30 % of chronically infected people develop cirrhosis within 20 years. Anti-HCV antibodies remain in blood after the virus disappears, spontaneously or after treatment, and do not protect against reinfection.

Antibodies appear on average 8 to 11 weeks after infection. Earlier testing may be negative despite infection. After a potential exposure, a doctor may therefore recommend repeat testing or HCV RNA, which can usually be detected in blood as early as one to two weeks after infection.

Preparation and sample

The test uses blood taken from a vein. No special preparation or fasting is needed.

How results are interpreted

Results are reported as negative (non-reactive) or reactive (positive), sometimes with a numerical index whose cut-off is printed on the report. A doctor interprets results alongside your risks, liver enzymes and other findings.

• A negative result means no antibodies were found. If insufficient time has passed since potential exposure or immunity is severely weakened, for example on dialysis, a negative result does not exclude infection and a doctor may recommend HCV RNA.
• A reactive result means you have been exposed to the virus but does not show whether infection is active. The next step is HCV RNA. Positive HCV RNA means active infection requiring treatment. If negative, it most often means past or cured infection, and sometimes a false-positive anti-HCV result.

Anti-HCV does not distinguish acute from chronic infection. Chronic infection means the virus has been in blood longer than six months. At Poliklinika Analiza, HCV RNA is measured by PCR detection of hepatitis B and C viruses, on medical recommendation. PCR demonstrates the virus’s presence in blood.

Hepatitis C can now be cured

Modern direct-acting antiviral medicines (DAAs) are taken as tablets, most often for two to three months, and cure more than 95 % of patients with few side effects. Earlier detection means less liver damage. An infectious disease specialist or gastroenterologist manages treatment. Anti-HCV remains positive after cure, so treatment success and possible reinfection are checked with HCV RNA, not repeat anti-HCV.

How to arrange testing

You can have blood taken without an appointment or referral at one of our branches across Croatia (listed on the Contact page). Prices for all tests and panels are available in the service price list, and an overview of hepatitis B and C markers in Hepatitis A, B and C markers.

Frequently asked questions

What does positive anti-HCV mean?

It means you were infected with hepatitis C virus at some point. Infection may be active, but also long resolved or cured. Only HCV RNA distinguishes these, so take the result to a doctor.

Can anti-HCV be falsely positive?

Yes, particularly in people without risk factors and with weakly reactive results. Every reactive result is therefore confirmed with HCV RNA and repeat testing if needed.

How long after a potential exposure can I test for hepatitis C?

Antibodies appear on average 8 to 11 weeks after infection, so negative anti-HCV before then does not exclude infection. If earlier detection matters, discuss HCV RNA with your doctor.

Does anti-HCV remain positive after cure?

Yes, antibodies remain for years or life in most people. This does not mean disease persists or that you are protected. Cure is confirmed by negative HCV RNA after treatment.