Hepatitis C (HCV) can be serious. Many infections become chronic, often silently damaging the liver over years and leading to cirrhosis, liver failure or liver cancer. It also causes extra‑hepatic problems like fatigue and joint pain. Modern direct‑acting antivirals cure most cases if diagnosed and treated early, preventing long‑term complications, so testing and timely treatment are important.

The normal (negative) result for an HCV antibody test is "non‑reactive" — commonly reported as a signal‑to‑cutoff (S/CO) index below 1.0. A reactive/positive antibody (S/CO ≥1.0) does not distinguish past from current infection and requires confirmatory HCV RNA testing to detect active virus. Different assays and labs may use slightly different cutoffs, so confirm with your clinician.

If an HCV test is positive, you’ll usually get a confirmatory HCV RNA (PCR) test to see if the virus is active. Active infection prompts evaluation of liver health and fibrosis; most people can be cured with direct-acting antiviral treatment. Without treatment, chronic HCV can cause cirrhosis, liver failure, or liver cancer. You’ll also receive advice on prevention and vaccinations.

Hepatitis C spreads when infected blood enters another person’s bloodstream. Common routes are sharing needles, syringes or other injecting equipment, unsterile medical/dental procedures, and needlestick injuries. Transmission also occurs from infected mothers to babies during childbirth and, less commonly, through sexual contact (higher risk with HIV or multiple partners). It’s not spread by casual contact, hugging, coughing, food or water.

People at highest risk for hepatitis C include current or former injection drug users who share needles, recipients of blood transfusions or organ transplants before screening began (around 1992), long-term hemodialysis patients, and people with occupational needle-stick exposures. Also higher risk are people with HIV, those incarcerated, people who had tattoos or piercings with unsterile equipment, and babies born to infected mothers.

"HCV negative" is generally good — it means no hepatitis C infection was detected. An antibody-negative result suggests no prior exposure; an RNA-negative result means no active infection. However, recent exposures can produce false negatives during the window period, so repeat testing as recommended (typically 1–3 months). Discuss results and next steps with your healthcare provider.