other investigations to consider in general practice, before referral, if hepatitis C antibody positive

Last reviewed 01/2018

The following investigations can be offered in primary care to all positive patients before referring them. Practitioner's preference may cause these tests to be carried out in specialist centres.

  • HCV RNA to test for active infection in the blood
  • full blood count (FBC) including differential to check for anaemia, neutropenia etc, low platelets and signs of high alcohol consumption etc
  • urea and electrolytes (U+E), creatinine and calcium
  • liver function tests (LFT) - such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) (these indices are not good indicators of liver damage or the severity of the HCV infection)
  • glucose
  • thyroid function tests (TFT) - since treatment with interferon may lead to thyroid dysfunction (hyper or hypo thyroidism)
  • ferritin - to check if the iron stores are elevated in patients with CHC
  • investigations for hepatitis B infection
    • hepatitis B surface antigen (HBsAg, also known as Australian Antigen, which signifies presence of HBV);
    • hepatitis B core antibody (HBcAb or Anti-HBc, which indicates acute or chronic infection)
    • hepatitis B surface antibody (HBsAb or Anti-HBs which indicates antibodies to the surface and if positive means that the person is immune to hepatitis B (from either having had the disease or from having been given the vaccine); and
    • antibodies to 'e' (Anti-HBe) which indicates low infection rate and probable recovery
  • hepatitis A, if not done previously as any other form of hepatitis can be detrimental to hepatitis C
  • HIV antibody test, even if they previously tested negative as HIV is currently increasing in injecting drug users (1)