Hepatitis test in Puerto Rico: A, B and C, with a lab order

Hepatitis means inflammation of the liver. According to the CDC, heavy alcohol use, toxins, some medications and certain medical conditions can cause it, but it is often caused by a virus. The most common types of viral hepatitis are A, B and C:

• Hepatitis A: spreads by the fecal-oral route: close or sexual contact with someone who has it, or contaminated food and water. According to the CDC, most adults with it turn yellow (jaundice).
• Hepatitis B: spreads through blood, sex and from mother to baby. It can become chronic.
• Hepatitis C: spreads mainly through blood, such as shared needles. According to the CDC, most people who get it develop a chronic infection, and many do not look or feel sick.

Vaccines prevent hepatitis A and hepatitis B; there is no vaccine for hepatitis C. Because hepatitis B and C often cause no symptoms for years, testing is the only way to know.

If you are not sure whether you have one or whether a vaccine protects you, the doctor gives you a lab order for a hepatitis test at a lab near you during a video visit. Request a visit online 24/7.

According to the CDC:

• Hepatitis C: all adults 18 and older, at least once in their lifetime, and pregnant women during every pregnancy. Also anyone with risks, such as having injected drugs, having HIV or having received blood before 1992.
• Hepatitis B: all adults 18 and older, at least once in their lifetime, with a three-part panel; pregnant women, during every pregnancy. The CDC adds that anyone who asks for a hepatitis B test should get one, without having to explain their risks.

Hepatitis C is a liver infection caused by a virus that spreads through blood. According to the CDC, most people get it by sharing needles, syringes or other equipment used to inject drugs. It can also spread by sharing razors, nail clippers, toothbrushes or personal medical equipment such as a glucose monitor; from mother to baby; through tattoos or piercings done in unlicensed places; and, though it is uncommon, during sex. It does not spread through hugging, kissing, coughing, sneezing, sharing eating utensils, food, water or breastfeeding.

Symptoms. According to the CDC, many people with hepatitis C have no symptoms and do not know they are infected. When symptoms appear, they can include tiredness, fever, nausea, stomach pain, vomiting, loss of appetite, joint pain, dark urine, clay-colored stool and yellow skin or eyes. In chronic infection, symptoms can take decades to show up.

The hepatitis C test. The CDC recommends testing at least once for all adults 18 and older, and during every pregnancy. It starts with an antibody blood test; if that is reactive, an HCV RNA test (the virus test) follows to confirm whether the infection is active now. A reactive antibody result on its own does not confirm a current infection.

Treatment. According to the CDC, hepatitis C can be cured: pills called direct-acting antivirals cure more than 95% of people in 8 to 12 weeks, with very few side effects. Being cured does not protect you for good: you can be infected again.

In your video visit, the doctor gives you a lab order for a hepatitis C test at a lab near you, explains your results and guides your treatment or referral based on your situation. Book an evaluation; the doctor decides the next steps with you. Book your visit.

You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish.

The doctor asks about your risks, vaccines and symptoms, and gives you a lab order for a lab near you. For hepatitis C, the CDC recommends starting with an antibody test and, if it is reactive, automatically running the virus test (RNA). For hepatitis B, the three-part panel shows whether you have the infection, are protected, or were ever exposed.

It often makes sense to get an HIV test and other STI tests at the same time. If what came back high on another test was your liver enzymes, see fatty liver. If you also want to prevent HIV, read about PrEP.

Video doctor visits 24/7 — book online and choose your time right away.

A doctor visit has a published price, with no membership, and includes the lab order. You pay the lab for the tests. Reviewing the result is a follow-up visit. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. See all prices.

The doctor explains the result, orders the tests that come next and guides your treatment or your referral to a liver specialist (gastroenterologist or hepatologist) or an infectious-disease specialist.

There is good news: according to the CDC, treatment cures more than 95% of people with hepatitis C, usually with pills for 8 to 12 weeks. That is why testing matters so much.

If you ate somewhere with a hepatitis A outbreak or live with someone who has it, according to the CDC the vaccine or immune globulin can protect you if given within 2 weeks of the exposure. That is given in person: call your doctor, your pharmacy or the Department of Health soon. Hepatitis A and B vaccines are given in person.

The CDC locator, gettested.cdc.gov (opens in a new tab), helps you find places that offer hepatitis, HIV and STI testing.

For your safety, go to the emergency room or call 911 if you have any of these signs. See when to go to the ER.

If the patient is under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.