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Hepatitis C virus (HCV) infection is a significant global health concern that primarily affects the liver. The virus is transmitted through contact with infected blood, most commonly through sharing needles or other drug injection equipment, receiving contaminated blood transfusions or organ transplants (particularly before widespread screening began in 1992), needlestick injuries in healthcare settings, or being born to an infected mother. Less commonly, transmission can occur through sharing personal items that may have blood on them, such as razors or toothbrushes, or through sexual contact with an infected person, though this is relatively rare.

Many people with hepatitis C do not experience symptoms initially, which is why the infection often goes undetected for years. When symptoms do appear, they may include fatigue, fever, nausea, poor appetite, abdominal pain, dark urine, gray-colored stools, joint pain, and jaundice (yellowing of the skin and eyes). Without treatment, chronic hepatitis C can lead to serious liver complications over time, including cirrhosis (scarring of the liver), liver failure, and liver cancer. The progression of liver damage can take decades, during which time individuals may not realize they are infected.

Laboratory testing plays a crucial role in diagnosing hepatitis C infection. The initial screening test is typically an antibody test that detects antibodies the immune system produces in response to HCV infection. If this test is positive, it indicates that a person has been exposed to the virus at some point. However, because some people clear the infection naturally, a positive antibody test must be followed by an HCV RNA test, which detects the actual genetic material of the virus in the blood. This confirmatory test determines whether the infection is current and active. Additional tests may include liver function tests to assess liver damage, genotype testing to identify the specific strain of the virus, and viral load measurements to determine the amount of virus present in the blood.

The Centers for Disease Control and Prevention recommends one-time hepatitis C screening for all adults aged 18 and older, as well as screening for pregnant women during each pregnancy. People at higher risk, including those who have ever injected drugs, received a blood transfusion or organ transplant before 1992, have been on long-term hemodialysis, have HIV infection, or were born to a mother with hepatitis C, should definitely be tested. Healthcare workers who have experienced needlestick injuries with HCV-positive blood should also undergo testing. Early detection through laboratory testing is essential because highly effective antiviral treatments are now available that can cure hepatitis C in most cases, preventing serious liver complications and improving long-term health outcomes.