Hepatitis B and C Testing: Which Test, Home Kits and What Results Mean

Hepatitis B and C often cause no symptoms, so a blood test is how most people find out. The tests themselves are simple. What trips people up is which test to choose and how to read the result.

Which test do I need for hepatitis C?

Hepatitis C testing usually happens in two steps.

• HCV antibody test. This looks for antibodies your body makes after contact with the virus. The CDC says it comes in three forms: a lab-based test, a rapid point-of-care test, and a home-based test.
• HCV RNA test (NAT). This looks for the virus itself in your blood. If the antibody test is positive, the CDC says the follow-up RNA test is run automatically.

The WHO describes the same two steps: an antibody test first, then an RNA test to confirm chronic infection.

What does a hepatitis C antibody result mean?

• Reactive (positive): you have been infected at some point. The CDC notes you will always have the antibodies, whether you cleared the virus, were cured, or still have it. The RNA test then shows which of those applies.
• Non-reactive (negative): you are not currently infected. The CDC says no further test is needed unless you might have been exposed recently.
• Positive antibody, negative RNA: you were infected before, and the virus is gone.
• Positive antibody, positive RNA: the infection is current, and a clinician can talk you through treatment. Hepatitis C is curable.

How soon after exposure can hepatitis C be found?

The CDC’s STI guidelines say HCV RNA can be detected in blood within 1 to 3 weeks after exposure, and that antibodies can be detected in about 97% of people by 6 months after exposure. If you might have been exposed in the past 6 months, the CDC says your doctor should order an RNA test rather than an antibody test alone. The NHS gives similar advice: a negative result soon after infection may not be reliable, so you may be asked to retest after 6 months.

Which test do I need for hepatitis B?

The CDC recommends a “triple panel,” which is three blood tests run together:

• HBsAg (hepatitis B surface antigen): the CDC says its presence indicates the person is infectious.
• Anti-HBs (surface antibody): generally indicates recovery and immunity.
• Total anti-HBc (core antibody): indicates a past or current infection. The CDC says it persists for life.

Reading the three together tells a clinician whether someone has a current infection, has recovered, is protected by vaccination, or has never been infected. If a recent infection is a concern, a fourth test (IgM anti-HBc) can be added. The CDC says it indicates infection within the past 6 months.

The CDC pages we checked don’t give a single window period for hepatitis B. If your exposure was recent, note when it happened and repeat the test later.

Can I test for hepatitis at home?

For hepatitis C, yes, in a limited way. The CDC describes a home-based antibody test: you collect a blood sample yourself and send it to a lab. It is still an antibody test, so a positive result needs the RNA follow-up, and the recent-exposure caution above applies. The NHS describes a finger-prick home test that adults aged 18 and over can order.

The CDC pages we checked do not mention home hepatitis B test kits, so we won’t vouch for how reliable they are. A positive result from any kit is worth confirming with a clinician.

Will an STI test include hepatitis?

Don’t count on it. What a panel covers depends on the panel. Hepatitis B and C are found with their own blood tests, as above. When you order, look for hepatitis B and hepatitis C by name, and read the list of what a panel includes. The which STD test do I need guide covers how to match tests to your situation, and at-home STD tests covers what home kits can and can’t do. Wondering how you might have been exposed? See how do you get hepatitis C.