I'm Pregnant: Do I Need A Hep C Test?

If your antibody test result is positive, then a PCR test is usually done. A PCR (Polymerase Chain Reaction) test looks for the hep C virus itself, rather than the antibodies. Having a PCR test will confirm whether or not you currently have hep C. The window period for PCR tests is three weeks.

A negative PCR test result means that you do not have hep C and you cannot pass it on. A positive PCR test result means that you do have hep C and you can pass it on.

Who will know I have had a test for hep C?

You do not have to tell anyone that you have had a test for hep C. In NSW, there are strict laws about hep C and confidentiality. Health services must keep your files private and cannot tell anyone that you have been tested for hep C. All blood tests are coded so that no-one other than your doctor or nurse knows what you are being tested for.

What you need to know before you have a hep C test

Thinking about being tested for hep C can raise issues you might not have thought about or discussed before. Before you are tested for hep C, the doctor or nurse will talk to you and ask you some questions. The things they will cover include: •

possible risks you have had

•

how hep C is passed on

•

what a positive or negative test result

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might mean for you

•

what will happen when you come back for your results

•

confidentiality (what happens to your information).

What you need to know when you get your results

The doctor or nurse who gives you your results will talk to you and might ask you some questions.

They will talk to you about: •

what your result means

•

how you can maintain your health if the result is positive

•

what other tests you might need

•

how to avoid catching hep C or how to avoid passing it on

•

where to find information and support about hep C.

weeks after birth using a PCR test. This should be followed with a hep C antibody test when the baby is 18 months old. Babies with hep C-positive mothers will carry their mother’s antibodies for 18 months, without actually having hep C themselves.

These “maternal” antibodies will clear by the time the baby is 18 months old. Remember though, the decision on whether to test your baby is up to you, and you should only do it when you are ready.

What if my baby has hep C? Babies with hep C need the same care and attention as other babies. This includes a healthy diet, immunisation, health checks and development checks.

Some children can clear hep C naturally. This happens in up to 20% of children with the virus, and usually happens before the age of three.

Children with hep C can live happy and healthy lives.

It is unusual for them to get sick because of their hep C, and they usually don’t need treatment until later in their lives. Even if a child with the virus is not sick, it is important to see a specialist and monitor their health, because liver damage can happen without any obvious symptoms.

Working towards a world free of viral hepatitis

If you have a positive result, it is very important to remember that you’re not alone. There is information and support available for newly diagnosed people. The Helpline and website below are great places to start.

How do I know my baby has hep C?

If you do not have hep C there is no chance that you can pass it on to your baby. If you receive a positive PCR test result, then it is possible to pass hep C on to your unborn baby. The risk is around 5-7%. For this reason, and to find out if they should be monitored, it is important that babies with hep C-positive mothers are tested. Testing the baby is the only way to find out whether a baby has hep C or not. Babies can be tested from four

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PCR tests

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What is hepatitis C?

Hepatitis C (hep C) is a virus that lives in blood and can cause liver damage. It is passed on when the blood of someone who has the virus gets into the bloodstream of a person who doesn’t have the virus. This is called blood-to-blood contact.

One in four people who are exposed to hep C will clear the virus naturally. Other people develop what is called chronic hep C, and over time their liver may be damaged. Hep C is a slow progressing illness: it takes a long time for liver damage to happen, and people can have the virus for many years and not feel sick. There is no vaccine for hep C, but there is treatment which can cure the virus for some people.

Over 220,000 people in Australia are living with hep C. That’s around 1% of Australia’s population.

How do you get hep C?

Hep C is passed on through blood-to-blood contact. The virus is only found in blood, and is not passed on through any other bodily fluids. In Australia, the virus is usually passed on through shared drug injecting equipment.

You may be at risk of contracting hep C if you: •

have ever shared any injecting equipment

(including spoons, swabs, filters, water and tourniquets)

•

had a blood transfusion, received blood products or received donated organs in Australia before 1990

•

have had an unsterile tattoo or body piercing

•

have had an unsterile medical procedure

•

were born in a country where a lot of people have hep C.

Sharing razor blades, toothbrushes and other personal items that might come into contact with

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blood is very low risk.

Hep C is rarely passed on through sex. It is not passed on through hugging, kissing, coughing, sharing food or using the same toilet as someone with hep C.

What does hep C have to do with being pregnant?

Hep C can be passed on from a mother to her baby. The risk of a mother transmitting hep C to her baby while pregnant or during birth is 5-7%.

This means that for every 100 babies born to women with hep C, around 93 of them will NOT have the virus.

How can hep C be passed from mother to baby?

Passing hep C from a mother to a baby is called vertical transmission. It’s not clear whether vertical transmission happens during pregnancy or during childbirth, but there is no known difference in risk between different birthing methods (eg. vaginal births and caesareans).

It is not possible for a mother to pass on hep C through changing nappies or other close physical contact where there is no blood-to-blood contact.

Breastfeeding

Women with hep C are encouraged to breastfeed their baby, as are all mothers. Breast milk from women with hep C is safe for babies.

As a precaution, if a mother with hep C has cracked or bleeding nipples it is recommended that she express and discard the milk until the nipples have healed, as there might be blood present in the breast milk. Baby formula can be used until the nipples have healed.

Should I be tested for hep C? Many women are tested for hep C during pregnancy.

Testing for hep C is recommended if you are one of the people described in the section above (How do you get hep C?). The decision to have a test or not is up to you and the test won’t be done without your consent. You can discuss the option of testing with your doctor, your partner and other support people if you are unsure.

Sexual health clinics may also offer hep C tests as part of sexual health screening. Pre and post-test discussion is an important part of being tested for hep C. The person doing the test should give you information about the testing process. They should also discuss issues like confidentiality, how hep C is passed on and how it can be prevented.

After that discussion, and with your informed consent, a blood sample will be taken from you and sent to a laboratory for testing.

Do I have to have a test?

You have the right to say no to the test.

Nobody should be pressured into having a hep C test or be tested without agreeing to it. If you choose to be tested, the results will tell you whether you have hep C or not. If you find out that you have hep C, remember that there are lots of services and support available for people living with the virus, and that treatment is available.

You can find out where to get more information at the end of this brochure.

Antibody tests

The first test that is usually done for hep C is called an antibody test.Your body produces antibodies as a defence against anything foreign which enters it, such as a virus or vaccine. A hep C antibody test will show whether you have ever had the hep C virus.

Getting the test results

Results for your blood tests will usually be available within one week by returning to where you were tested. When you get your results, the person giving them to you should explain what your test results mean and should be able to answer any questions you might have.

What does a negative antibody test result mean?

If your blood test shows that you are antibody negative, then you do not have the hep C virus and you have never been exposed to it.

Hep C antibodies can take as long as six months to show up. This six month period is called the window period, and if you have been at risk in the last six months your doctor or nurse may suggest you have another test later to make sure that the result is accurate.

What does a positive antibody test result mean?

If your blood test shows that you are antibody positive it means that you have been exposed to the hep C virus at some time. This does not necessarily mean that you have the virus now.

In 25% of cases, people’s immune systems are able to fight off hep C. This happens within six months of getting the virus. Even if a person has cleared the virus this way, they will still carry virus antibodies.

Antibodies do not protect a person from getting the virus again, but they will not hurt you or make you sick. False positive antibody tests can be more likely when a woman is pregnant.For these reasons it is important to follow up a positive antibody result with more tests.

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