Hepatitis C diagnosis and treatment

What is hepatitis C testing and treatment?

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV), which spreads through blood. Many people have no symptoms for years, so testing is often the only way to find it.

Diagnosis usually starts with an antibody test, which shows whether you have ever been exposed. If that is positive, a second test (HCV RNA or PCR) checks whether the virus is still in your blood now. A genotype test may identify the type of virus.

Treatment is with direct-acting antiviral (DAA) tablets, usually for 8 to 12 weeks. These are very effective and cure the great majority of people, with few side effects for most. Curing the infection stops further liver damage, and the liver can often repair some existing damage over time.

This is genuinely good news, but it is still worth understanding properly: a cure does not make you immune, so you can catch hepatitis C again, and people with existing cirrhosis still need ongoing liver-cancer surveillance. This guide explains what to expect and what to ask. It is general information, not personal medical advice.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Antibody test vs RNA (PCR) test

A positive antibody test alone does not mean you currently have the virus; the RNA test settles that.

Preparing for your treatment

• Bring details of any possible exposure, past tests and previous treatment if you have them.
• List all your medicines, supplements and recreational drugs, as some interact with DAAs.
• Tell your clinician if you are pregnant, might become pregnant, or are breastfeeding.
• Mention any kidney or other liver problems, or if you also have hepatitis B or HIV.
• Ask whether you need a fibrosis scan to check for liver scarring before treatment.
• Plan to complete the full course of tablets, as stopping early can let the virus return.
• Keep alcohol low to protect the liver during and after treatment.

What happens

Testing usually begins with an antibody test, sometimes from a finger-prick or a free home kit in parts of the UK. If positive, an RNA (PCR) test confirms whether the virus is active now. If it is, you are assessed before treatment: blood tests, a check for hepatitis B and HIV, and a fibrosis (liver stiffness) scan to see whether there is scarring.

Your specialist or nurse then prescribes a course of DAA tablets, usually for 8 to 12 weeks, chosen to suit your situation. Most people take them with no or only mild side effects, such as headache or tiredness.

After finishing, you have a blood test about 12 weeks later to confirm cure (a sustained virological response). If you have cirrhosis, you stay under follow-up for liver-cancer surveillance even once the virus has gone.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Hepatitis C treatment is one of the real success stories of modern medicine, but two honest points matter: cure does not give immunity, so you can be reinfected, and anyone who already has cirrhosis still needs lifelong liver-cancer surveillance. Tell your clinician about all your medicines, because drug interactions are the main practical pitfall.

Published figures to discuss

Cure rates with modern direct-acting antivirals are very high across most people, but they vary slightly with the virus genotype, the degree of cirrhosis, previous treatment and how fully the course is taken. The figures below are honest, source-based pointers, not guarantees.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from a blood test or a course of tablets. "Afterwards" is about confirming the virus has gone and, for some people, continuing to look after a liver that was already scarred.

• Feeling well, or only mildly tired or headachy, during treatment
• The virus becoming undetectable by the end of the course
• An antibody test that stays positive for life even after cure
• For most people, no need for ongoing treatment once cured

Aftercare

• Complete the full course of tablets, even if you feel completely well.
• Attend the blood test about 12 weeks after finishing to confirm cure.
• Avoid sharing anything that could carry blood (needles, razors, toothbrushes) to prevent reinfection.
• If you had cirrhosis, keep attending liver-cancer surveillance scans.
• Keep alcohol low to help the liver recover.
• Tell future clinicians you have had hepatitis C, and that a positive antibody test may persist.
• Seek retesting if you have a new possible exposure, as you can catch it again.

• Full course of DAA tablets understood and supply arranged
• Date booked for the 12-week confirmation blood test
• Fibrosis/cirrhosis status known and surveillance arranged if needed
• Hepatitis B and HIV checked before starting
• List of current medicines checked for interactions
• Advice on avoiding reinfection understood

⚠ Get urgent help if…

• Yellowing of the skin or eyes (jaundice) that is new or worsening
• Severe tummy pain, dark urine or pale stools
• Marked tiredness, confusion or drowsiness
• Vomiting blood or passing black, tarry stools - call 999
• Swelling of the tummy or legs
• A new rash, breathlessness or severe reaction after starting tablets

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a sustained virological response (SVR): a blood test about 12 weeks after finishing treatment showing no detectable virus. This is regarded as a cure, and it stops further liver damage from hepatitis C.

What a cure cannot do is make you immune, so you can be infected again if exposed to infected blood. It also does not erase scarring that has already happened: people with cirrhosis remain at some risk of liver cancer and need ongoing surveillance even after the virus has gone.

For most people, a single successful course of treatment clears hepatitis C for good, and they need no further treatment. The benefit is durable as long as you are not reinfected. Because the antibody test stays positive, future testing for active infection uses the RNA (PCR) test. People who already had cirrhosis keep being monitored long-term despite cure.

Related tests, treatments or support

Hepatitis C care usually includes testing for hepatitis B and HIV, and vaccination against hepatitis A and B where appropriate. Treating other liver risks, such as alcohol or fatty liver, helps the liver recover. For people who inject drugs, treatment is often combined with harm-reduction support to prevent reinfection.

Follow-up & long-term care

Most people need only the confirmatory blood test about 12 weeks after finishing, after which they are discharged if cured and without cirrhosis. People with cirrhosis stay under follow-up for six-monthly liver-cancer surveillance. Anyone at ongoing risk of exposure should be retested periodically.

• One confirmatory RNA blood test about 12 weeks after treatment
• Ongoing liver-cancer surveillance for those who had cirrhosis
• Avoiding blood-to-blood exposure to prevent reinfection
• Retesting after any new possible exposure
• General liver care, including keeping alcohol low

Repeat, follow-on and what comes next

• If the first course does not clear the virus, a different regimen can usually be tried successfully.
• Reinfection after cure can be treated again, but prevention is better.
• People with cirrhosis move from treatment into long-term surveillance rather than full discharge.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A booked 12-week blood test to confirm cure, with results clearly communicated.
• Clear advice on avoiding reinfection and when to be retested.
• Liver-cancer surveillance arranged for anyone who had cirrhosis.
• Coordination with hepatitis B/A vaccination and HIV testing as needed.
• Harm-reduction and drug-treatment support where relevant.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Initial antibody and confirmatory RNA (PCR) tests
• A fibrosis scan and checks for hepatitis B and HIV
• The specialist or nurse consultation and assessment
• The course of direct-acting antiviral tablets
• The 12-week confirmation blood test after treatment
• Ongoing liver-cancer surveillance if you have cirrhosis

• The consultation and assessment fees
• Costs of antibody, RNA and other diagnostic tests
• The cost of the antiviral medicines and the full course
• Whether the 12-week cure-confirmation test is included
• Whether fibrosis scanning and surveillance are covered
• What happens, and who pays, if the first course does not cure the virus

On the NHS? Hepatitis C testing and treatment are free on the NHS as part of a national elimination programme; private care is mainly used for speed, choice of clinician or a second opinion.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Do I have a current, active infection (RNA positive), or only past exposure?
• Do I have any liver scarring or cirrhosis, and will I need surveillance after cure?
• Which tablets will I take, for how long, and do they interact with my other medicines?
• When will my cure be confirmed, and what happens if the first course does not work?
• How can I avoid catching hepatitis C again after I am cured?
• Should I be vaccinated against hepatitis A and B, and checked for HIV?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for hepatitis c diagnosis and treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: British Liver Trust - Hepatitis C NHS - Hepatitis C The Hepatitis C Trust - Drug treatment Mortality after DAA cure of hepatitis C - cohort study (PMC) NICE - Hepatitis C topic overview

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.