Diagnostics

In Ukraine, according to estimates, about 5% of the population is infected with viral hepatitis C, and a significant portion of these people are unaware of their status. That is why the WHO and the Press Service of the Ministry of Health of Ukraine recommend testing all adults.

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Step 1. Screening

The WHO and the Public Health Center of the Ministry of Health of Ukraine recommend screening for viral hepatitis for all individuals aged 18 and older.

In accordance with the Procedure for the Provision of Primary Health Care
(Order of the Ministry of Health of Ukraine No. 504 dated March 19, 2018), family doctors must conduct rapid testing for hepatitis B and C free of charge for patients.

This means that every patient who visits a family doctor must be assessed for the need for screening. 

For hepatitis C, the following are determined at this stage:

• anti-HCV (total antibodies) — an indicator of exposure to the virus.

Separate testing is particularly recommended for people at increased risk of infection, including:

• people who use or have used drugs by injection or intranasally;
• people living with HIV or hepatitis B;
• sexual and domestic partners of people with hepatitis C;
• people with elevated liver enzymes and/or symptoms of liver damage;
• people who have received donated blood, blood products, or transplants;
• patients undergoing hemodialysis;
• people with tattoos or piercings;
• people with a history of incarceration;
• people at occupational risk of infection (healthcare workers, first responders);
• children whose mothers have hepatitis C;
• blood, organ, and tissue donors;
• men who have sex with men and sex workers.
  

This screening is sufficient to identify an infected person and initiate further action. Typically, if the test result is positive, the patient is referred to an infectious disease specialist to confirm or rule out the diagnosis.

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Step 2. Confirming the diagnosis

The presence of antibodies does not indicate an active infection, as they remain in the body for life, even after recovery. Only after the presence of the virus is confirmed is a diagnosis of hepatitis C considered definitive.

It is important to remember: even after successful treatment, reinfection with the hepatitis C virus is possible.

Therefore, if the test result is positive, you must:

• determine the hepatitis C virus RNA (quantitative/qualitative)
  or
  
• HCV core antigen (if RNA testing is not available).
  

👉 Detection of HCV RNA in the blood confirms the diagnosis of chronic hepatitis C.

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Step 3. Assessing liver function and preparing for treatment

After confirming the diagnosis, an infectious disease specialist conducts a comprehensive follow-up examination, which usually includes:

1. a complete blood count;
2. biochemical blood tests (ALT, AST, bilirubin, creatinine);
3. Quantitative or qualitative HCV PCR (if resources are limited);
4. HCV genotyping (not required when treating with pan-genotypic regimens);
5. Hepatitis B virus (HBV) testing, HBsAg, total HBcore antibodies;
6. HIV test (if HIV-positive — referral from an infectious disease specialist with an ART regimen);
7. assessment of the degree of liver damage (ultrasound, elastometry/fibroscan, APRI and FIB-4 indices);
8. chest X-ray to rule out TB;
9. medical records regarding comorbidities (Form No. 027/o);
10. For women, a pregnancy test.
    

⚠️ Additional tests may be ordered and interpreted only by a doctor.

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Why is this necessary?

Without treatment, hepatitis C gradually damages the liver, leading to fibrosis, cirrhosis, and liver cancer, which can be fatal.
Early detection of the infection allows for timely treatment, preserves health, and breaks the chain of viral transmission.

Some tests, such as those listed as Nos. 1, 2, 5 (HBsAg), 6, 7 (excluding elastometry/fibroscan), 8, and 9, can be performed free of charge with a doctor’s referral, while the remaining tests and examinations, such as items 3, 4, 5 (total HBcore antibodies), and 7 (elastometry/fibroscan) from the list, can be performed at any certified private laboratory or diagnostic center at your own expense.

Early detection of the infection allows for timely treatment and prevents complications.

*List of healthcare facilities providing services for the diagnosis and treatment of hepatitis G.

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We’re here to help you navigate these steps calmly and clearly—from testing to the next steps.