Chronic Hepatitis C: Clear Facts, Tests, and What To Do Next

Chronic hepatitis C (HCV) is a viral infection that quietly damages the liver over months or years. Many people feel fine at first, which is why HCV can go unnoticed until liver tests show a problem or symptoms appear like fatigue, belly discomfort, or jaundice (yellowing of skin or eyes). If you’ve been exposed to used needles, had a blood transfusion before the early 1990s, or shared personal items like razors, a test makes sense.

How testing works

Testing is simple and two-step. First, a blood test looks for HCV antibodies. A positive antibody test only shows exposure. To confirm an active infection your doctor orders an HCV RNA test (viral load). That tells if the virus is still in your blood. Doctors may also check liver enzymes (ALT/AST) and measure liver scarring with noninvasive tools like FibroScan. Genotype testing used to guide treatment; now many drugs work across types but your provider may still order it in some cases.

Treatment today and what to expect

Good news: pills called direct-acting antivirals (DAAs) can cure most people with chronic HCV. Cure rates are over 95% for many regimens, and treatment usually lasts 8–12 weeks. These drugs are much easier to take than older therapies and have far fewer side effects. Some patients still need additional drugs like ribavirin, but that’s less common now and requires precautions because ribavirin can cause birth defects.

Drug interactions matter. Tell your provider about all medicines, including over-the-counter drugs and supplements. Some DAAs interact with heart, cholesterol, and seizure medicines. Your doctor or pharmacist will adjust doses or choose a different antiviral if needed.

After successful treatment, most people no longer have detectable virus. But if you have advanced liver scarring (cirrhosis), you still need regular liver cancer screening every six months. Also, cured people can be reinfected if exposed again, so prevention matters.

Practical steps you can take now: get tested if you’re at risk, finish the full course of treatment if diagnosed, avoid alcohol (it speeds liver damage), get vaccinated for hepatitis A and B if you’re not immune, and don’t share needles or personal items that might have blood on them. Safe sex and clean tattoo/piercing practices also reduce risk.

If cost or access is a concern, ask your clinic about patient assistance programs—many manufacturers and health systems help cover DAA treatment. If you’re pregnant or planning pregnancy, bring this up early; some drugs aren’t safe during pregnancy.

If you suspect exposure or have liver-related symptoms, contact your healthcare provider. Treating chronic hepatitis C now is faster and safer than ever—and it stops damage to your liver before serious problems start.