Blood Test Guide

Hepatitis C Blood Tests

Name: Hepatitis C Test: Antibody, RNA & What Results Mean
Creator: Suman Konda
Published: 2026-07-05

Hepatitis C is curable with 8–12 weeks of medication. The first step is testing. Here's what each hepatitis C blood test means and what happens after a positive result.

Written and clinically reviewed by Suman Konda, PharmD, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last reviewed and updated: 01 August 2026 · How we check our content

Hepatitis C testing sequence

Test	Purpose	What positive means
HCV antibody (anti-HCV)	Initial screening test	Past or current HCV infection (antibodies persist lifelong)
HCV RNA (viral load)	Confirms active infection	Virus is present: active infection requiring treatment
HCV genotype	Type of virus (1–6)	Guides choice and duration of antiviral treatment
LFT + liver fibrosis assessment	Assess liver damage	Cirrhosis affects treatment decisions

Understanding the antibody vs RNA test

Why both tests are needed

A positive HCV antibody test means you have been exposed to hepatitis C at some point. However, about 15–25% of people clear the virus naturally after acute infection. They have a positive antibody but negative RNA. Only an HCV RNA test can confirm current (active) infection. All anti-HCV positive patients need an HCV RNA test. If RNA is positive, they have chronic hepatitis C and are candidates for curative antiviral treatment with direct-acting antivirals (DAAs).

Hepatitis C treatment: cure is possible

Modern direct-acting antiviral (DAA) medications such as sofosbuvir/velpatasvir (Epclusa) or glecaprevir/pibrentasvir (Mavyret) cure hepatitis C in over 95% of patients with just 8–12 weeks of once-daily tablets. Treatment is recommended for virtually all patients with chronic HCV. After treatment, a sustained virological response (SVR), undetectable HCV RNA 12 weeks after finishing treatment, means the virus is cured.

Who should be tested for hepatitis C?

All adults aged 18–79 (one-time universal screening recommended in the USA)
Anyone who has ever injected drugs
Recipients of blood transfusions before 1992
People with HIV
People with unexplained raised liver enzymes

Questions to ask your doctor

Is my HCV RNA positive: do I have active hepatitis C?
What genotype do I have?
Do I have cirrhosis?
Which antiviral treatment is right for me?

Frequently Asked Questions

What's the difference between the antibody and PCR test?

The antibody test shows whether you've ever been exposed to hepatitis C, while the PCR (RNA) test detects the virus itself: confirming a current, active infection.

Is hepatitis C curable?

Yes. Modern direct-acting antiviral tablets cure the great majority of cases within 8–12 weeks, which is why testing and diagnosis are so important.

Can you have hepatitis C without symptoms?

Very often, yes: many people have no symptoms for years while the virus quietly affects the liver, so testing based on risk factors is the main way it's detected.

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Hepatitis C. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK430897