One tool that might help slow the spread of HCV is the self-test, which is done at home and detects the hepatitis C virus. In summer 2021, the WHO released its first guidelines about self-testing for the virus, saying they “strongly recommend offering self-testing for hepatitis C virus as an additional approach to HCV testing services.” Given the growing number of companies offering home testing kits for HCV, you may be wondering whether they’re right for you. Here are the possible benefits and drawbacks, plus what to know if you’re considering taking an at-home test.

Everyone Should Be Tested for HCV

There’s no overstating the importance of HCV testing for people who don’t know if they have the infection. “The U.S. Preventive Services Task Force recommends that all asymptomatic adults, regardless of risk factors and age, should be screened for HCV,” says Joseph Yao, MD, a researcher for the Mayo Clinic, in Rochester, Minnesota, who focuses on the development of clinical diagnostic tests for viral hepatitis, HIV infection, and transplant-associated viruses. Those who have continued risk factors, such as engaging in intravenous drug use, need to be screened periodically. People who are on dialysis may also need to be screened. “For symptomatic individuals, if you have a history of liver disease, injection drug use, HIV, or other liver disorders, you should also be screened for HCV,” he says. The symptoms of acute (short-term) or chronic (long-term) hepatitis C are indistinguishable from other hepatitis or liver disorders, but they usually include nausea, vomiting, weight loss, fatigue, jaundice, and general itchiness (due to high levels of bilirubin, a substance found in the liver, irritating the skin), he explains.

How At-Home Tests for HCV Work

When a person is infected with hepatitis C, their body produces certain proteins, called antibodies, which help fight the virus. HCV self-tests work by detecting those antibodies in a blood sample. This at-home sample is collected and then sent to a centralized lab for testing. “The test contains a complementary protein — what we call antigens — which the antibody will bind to,” Dr. Yao explains. “When the antigen and antibody bind, it causes a color change that allows the lab to detect whether antibodies are present.” There are two methods of sample collection. The most popular is a dry blood spot, which involves pricking your finger and squeezing drops of blood onto a blotting paper. The other device is a capillary blood collection device, which is attached to a thick part of the skin like the shoulder. The device then pierces the skin so capillary blood (blood from a small blood vessel) can be sucked into the device. Since you need to send your HCV self-test to a lab, you should know that you won’t get the results right away. Rapid tests for HCV, which allow you to collect a sample and receive a result on the spot, are only available at some medical facilities like clinics and hospitals as a preliminary screening measure, Yao says. They aren’t available as at-home tests. In fact, if you come across a so-called rapid self-test for hepatitis C on the internet, it’s probably not legitimate, he says. Either that, or the kit isn’t an at-home test at all, instead “meant for sample collection [rather than interpreting results],” he explains.

What Are the Pros and Cons of At-Home HCV Tests?

The primary benefit to at-home tests is access. “At-home tests will help identify individuals who are infected and don’t know their status otherwise,” says Yao, who hopes more manufacturers will develop these devices and tests. One potential pitfall is the cost. While HCV and sexual transmitted infection (STI) tests performed in a medical facility are typically covered by insurance or made available for free at a local public health clinic, at-home HCV tests aren’t covered by insurance, he says. For some, the wait time may be a deal breaker. “To a lot of people, at-home tests mean you can do self-testing, like for HIV, and receive a result in 20 minutes,” he says. Other potential issues include a person’s ability to follow instructions and whether they’re able to do a blood prick themselves.

What Should You Do Once You Receive Your Results?

At-home HCV testing is only the first step. If the test is positive for HCV antibodies, your next step is to seek medical care. You’ll need to be retested with a laboratory-based screening test to confirm the result; further molecular tests will determine if you have an active infection. “Testing positive for antibodies can mean you were exposed to HCV 20 years ago and it spontaneously resolved or that you have chronic hepatitis C,” Yao explains. While more than half of people who are infected with HCV will develop a chronic infection, many will spontaneously clear the virus from their body and won’t develop chronic hepatitis C, according to the Centers for Disease Control and Prevention. If further testing shows that you have the hepatitis C infection, an internist, liver specialist, or infectious disease specialist will be able to decide whether you need treatment or observation. And if the result is negative? Your doctors may want to wait a little longer to confirm those findings. “The antibodies take anywhere from 30 to 60 days to show up in the blood, so if you’ve just had a risk event, like intravenous drug use, and you test a week later, you could receive a false negative,” he says. Yao says your real status depends on whether you have any ongoing or recent risk factors. If you participate in high-risk activities, Yao recommends being screened every month or two.

What Are Some At-Home Collection Kits to Consider?

Here are some of the most popular HCV tests on the market. All of these tests are performed in labs that have received Clinical Laboratory Improvement Amendments (CLIA) certification.

EverlyWell

The most popular HCV test currently on the market, EverlyWell offers a personalized report with physician recommendations based on your results. Price: $49 Available at: https://www.everlywell.com/products/hepatitis-c-test/

LetsGetChecked 

This test screens for both hepatitis B and C and offers 24-hour medical support. Price: $79 Available at: https://www.letsgetchecked.com/home-hepatitis-c-test/

myLAB Box

If your result is positive, myLAB Box provides information on how to receive a free telemedicine consultation with a physician in your state. Price: $95 Available at: https://www.mylabbox.com/product/hepatitis-c-home-test/

iDNA

iDNA allows you to customize a test box or choose from two testing bundles for common STIs and infectious diseases. Price: $78 for hepatitis C testing only; bundles start at $198 Available at: https://idna.com/