Testing for hepatitis C

NOMOREC

NOTE: THE C-TEST SERVICE HAS BEEN STOPPED.UNFORTUNATELY, WE CANNOT OFFER THE C-TEST ANYMORE AT A REASONABLE PRICE.YOU CAN THEREFORE NO LONGER ORDER THE C-TEST. WE FEEL VERY SORRY ABOUT THIS.

Here you can read everything about testing for hepatitis C

Important messages:
- Get tested for hepatitis C test every three months, if you regularly have sex that puts you at risk of getting the virus.
- There are several ways to get tested for hepatitis C.
- There are different types of tests. It is useful to know the advantages and disadvantages of each test.

Why take tests?

Even if you are careful, you can still get hepatitis C. Discovering the virus soon after you have been infected, reduces the chance of unknowingly passing it on to someone else. And the sooner you find out that you have hepatitis C, the sooner you can begin treatment and be cured. You can’t pass on the virus once you’ve been cured.

How often should I get tested?

Get tested for hepatitis C test every three months if you regularly have sex that puts you at risk of getting the virus .

When to take extra tests?

Get extra tested if you have had risky sex and the next scheduled test time is longer than a month. Make an appointment quickly, but wait at least 7 days. If you go earlier, the virus will usually not be detectable anyway. Tell your doctor how long ago the risk was.

Risk or not?
You are more likely to run into hepatitis C if you
- are fucked without a condom
- like fisting (active/passive) or ass play (passive)

The chance of an infection increases if you
- do this during group sex, sex parties or afters
- use chems

Men living with HIV are the most likely to contract hepatitis C. This STI is also found more often among HIV negative men who use (or want to use) PrEP.

Learn more about how hepatitis C is transmitted here. And here you can get advice on whether or not to test.

Where to get tested?

There are several ways to arrange a hepatitis C test. Here below you can read about the ways to get tested in the following situations:

 

You are HIV positive

Read more

 

At your HIV treatment centre

Only twice a year you get tested for hepatitis C at the Dutch HIV treatment centres. The doctors are mostly checking for liver activity and/or antibodies. See Which test.

At GGD Amsterdam’s STI clinic (only if you live in Amsterdam)

You can take two hepatitis C tests a year only at this clinic.
You will not be tested if you

  • visited your HIV doctor less than three months ago
  • were tested for hepatitis C at the STI clinic less than six months ago
At every GGD STI clinic

You can ALWAYS go to every STI clinic in the Netherlands if a sex partner warns you that he has hepatitis C. You can find all test locations in the Netherlands here

Remember: you can’t just call the STI clinic and say that you’ve been warned. You will need a “warning code” if you request an immediate test. Your sex partner can arrange to send you a code via a nurse, HIV nurse or GP, through the website partnerwaarschuwing.nl.

Via your General Practitionner (GP)

The test will be paid for by your health insurance. The costs of the test (but not the cost of the consultation) might affect the “eigen bijdrage” (co-payment) of your health insurance. If you are HIV positive, you are likely to have reached the maximum of your “eigen bijdrage”. If so, you won’t feel the financial burden of testing through your GP.

You take PrEP

Read more

Note: if you don’t have a prescription for PrEP through your GP or an STI clinic, you will have to arrange all of your 3-monthly checks, including hepatitis C, yourself.

At the GGD STI clinic

If you take PrEP through an STI clinic, you should be offered hepatitis C testing every three months (Dutch Guidelines).
And you can ALWAYS go to every STI clinic in the Netherlands if a sex partner warns you that he has hepatitis C. You can find all test locations in the Netherlands here.

Remember: you can’t just call the STI clinic and say that you’ve been warned. You will need a “warning code” if you request an immediate test. Your sex partner can arrange to send you a code via a nurse, HIV nurse or GP, through the website partnerwaarschuwing.nl.

Via your General Practitionner (GP)

If you take PrEP via a GP, you should be offered hepatitis C testing every three months (Dutch Guidelines).

The test will be paid for by your health insurance. The costs of the test (but not the cost of the consultation) might affect the “eigen bijdrage” (co-payment) of your health insurance. If you are HIV positive, you are likely to have reached the maximum of your “eigen bijdrage”. If so, you won’t feel the financial burden of testing through your GP.

You are HIV negative and you don’t take PrEP

Read more

 

At the GGD STI clinic

Only if a sex partner warns you that he has hepatitis C. None of the Dutch STI clinics routinely test for hepatitis C among gay men who are HIV negative. This only happens if you are a PrEP user or in case you are warned. You can find all test locations in the Netherlands here.

Remember: you can’t just call the STI clinic and say that you’ve been warned. You will need a “warning code” if you request an immediate test. Your sex partner can arrange to send you a code via a nurse, HIV nurse or GP, through the website partnerwaarschuwing.nl.

Via your General Practitionner (GP)

The test will be paid for by your health insurance. The costs of the test (but not the cost of the consultation) might affect the “eigen bijdrage” (co-payment) of your health insurance. If you are HIV positive, you are likely to have reached the maximum of your “eigen bijdrage”. If so, you won’t feel the financial burden of testing through your GP.

 

Which test?

There are different types of tests for hepatitis C. It is useful to know the advantages and disadvantages of each test.

Antibody test
This test detects hepatitis C as soon as your body starts producing antibodies.

Read more


Most people who become infected start producing hepatitis C antibodies about two months after infection. If you are HIV positive, it may take longer; more than four months after infection is not unusual. So remember that you can test negative for antibodies (= no antibodies are detected) even though you do have the virus. In other words, an antibody test is not the best test to detect a very recent infection.
The antibody test is also unsuitable if you have had hepatitis C before. After you’ve been cured of hepatitis C, the antibodies that your body produced will often remain in your body for the rest of your life. An antibody test would therefore be pointless. If you’ve had hepatitis C before, only an RNA test (see below) will tell you whether you’ve got it again.

Advantage: an antibody test is relatively cheap.
Disadvantage: antibody tests can miss a recent infection. It can sometimes take a while for your body to start producing hepatitis C antibodies.
Disadvantage: antibody tests are not suitable if you have had hepatitis C before.

Liver values (Only available through an HIV doctor or your GP)
This blood test detects any increase in particular liver values. An increase could indicate hepatitis C infection.

Read more


Your blood is checked to see if there is an increase in the ALAT liver enzyme. An increase could be a sign of liver inflammation caused by hepatitis C. There can also be other reasons for the increase. Your doctor will check this first. If you think that you have been at risk of hepatitis C, we advise you to tell your doctor. A possible next step could be an hepatitis C RNA test. Your doctor will perform this test to know if you have hepatitis C or not.

An increase in liver activity can also be caused by the use of alcohol, chems or medication (for HIV or other infections). Always tell your doctor if you use any of these. This will allow them to diagnosis you correctly.

A liver enzyme test is much cheaper than an RNA test. This is why you will first be given a liver enzyme test. Measuring liver values has one disadvantage: it records just one moment in your liver values, while liver values move up and down over time. It is therefore possible to miss a peak in your liver’s production of ALAT enzymes; this peak may have passed by the time you take the test. Or the peak occurs after you took the test.

Advantage: it is a relatively cheap test.
Disadvantage: an increase in liver values may be caused by something else than hepatitis C.
Disadvantage: it’s possible to miss the peak in liver values. You may have hepatitis C, but the moment of testing has missed the increase of liver values.

RNA test
This test detects hepatitis C by checking your blood for particles of the virus. An RNA test can detect the virus very soon after infection. 

Read more


An RNA test can tell you as soon as seven to ten days after contact with the virus if you have been infected. The test checks the blood for RNA (= virus particles) of hepatitis C. This is an advantage over the antibody test: it may take up to four months for your body to produce antibodies against the hepatitis C virus.

RNA tests are also suitable if you have had hepatitis C before, because it checks for the virus itself. If you’ve had hepatitis C before, you can no longer take an antibody test — see Antibody test.

An RNA test is expensive (about €90). Doctors will usually only offer this test if they suspect you have hepatitis C. For instance, if your antibody test was positive (= antibodies were found in your blood).

Advantage: RNA tests detect the hepatitis C virus very soon after infection (within a couple of weeks).
Disadvantage: the standard RNA test is expensive (about €90).