Could I have made my daugher sick??

I have hecp c 1b and was treated for a year with combo treatment but relapsed after 3 months and have done nothing since. I had a firbro spec test done which showed no further damage to my liver. My trouble is, my 21 year old daughter just got blood work back which I assume shows elevated liver enzymes because they want her to in tomorrow for full hep work up. I had both my kids tested a few years ago and they were negative. I think I would die if I thought I made my kids sick. I don't know what the question is in all of that, but I am really freaking out. I haven't been on the forum website since 2004, so I am not sure what the etiquette is these days, but if any one has any color on this issue, would love to get it. Roostermom

[working dog]

i don't have the answer..but i wonder about that a lot...i had 7 kids..all tested negetive..but both myself and my xwife had hepc for years.....good luck...billy

[DoubleDose]

Your question is one which I am interested in seeing more information about.  I have concerns about the possibility of delayed development of HCV antibodies in family members.  I have only read personal accounts of individuals becoming HCV positive many years after an infected parent or spouse had passed away either from HCV, or hwo had had HCV.  I have concerns about a potential for 'silent' transmission that might only show up years later after initial transmission.  There are no real published accounts of this phenomenon, and I am only concerned because of anecdotal accounts that I have read, so do not take my concerns as any sort of evidence or cause for alarm.

My concerns were originally surfaced in noticing that some family members have slowly developed symptoms similar to my old (pre-SVR) HCV symptoms.  They have all tested negative on HCV antibody testing.  Most of the time I am assured that they are fine, but when I read anecdotal stories of people becoming HCV+ many years after close contact with an HCV infected house-mate, or spouse...then I begin to worry that some sort of slowly developing infection, or delayed antibody response could be happening.  If I did not see odd symptoms in several close contacts I would have no concerns at all.  But seeing chronic problems develop in close family members is unsettling, and always provoke a little anxiety about the odd stories I have read.

If I were you I would have my daughter get tested immediately for HCV, and other liver viruses, if her liver enzymes continue to show an elevated pattern.  Even if they don't, I think that an HCV antibody test would go a long way in easing your mind.  Also, you might ask your daughter is she has experienced any unusual physical changes or symptoms.  Have her monitor the LFT's with her doctor.  

Keep in touch with the forum here, if you have any further concerns or questions.  I have many of the same worries, but with less evidence for worry than you have with your daughter.  Enzymes can elevate for other reasons though, and drinking is one big one.

Good Luck.

DoubleDose

[IAmTheWalrus]

I sympathize. It would ne normal to feel terrible about passing this disease along to a loved one. But remember, you didn't do it knowingly. From my own experience, I can tell you that I was diagnosed with HCV about seven years ago. In all liklehood I have had this disease for 30+ years. I am married with five children (all grown now) and my wife and mother of my children tested negative as did my children. I don't know of any published studies that indicate that HCV is transmitted other than through direct blood contact (transfusions, shared needles, etc.), but if you are concerned about some kind of delayed development of the antibodies, perhaps the PCR-C test would help as it (I understand) detects actual HCV replication rather than the antibodies. Talk to your MD and maybe he can set your mind at ease.

Best luck!

[Susie2007]

My girls were both born soon after I got HCV. Of course I had no idea that I had it until my diagnosis when the girls were 22 and 25. Both are clear and I am sure they used my razor and other personal hygeine items over the years. We didn't know any better. My point is that while it can be transmitted by use of personal things in the home, it is not that common. I hope she doesn't have hep C but if she does I don't think you should feel any guilt. As the other poster said, it wouldn't be intentional. I'm wishing her the best of luck with her hep panel.

[Hepatitis Researcher]

Do you remember my description of the NIH research in which I was involved regarding the mucosal entry and class II T cell response/protection in sexual partners of HCV infected persons? Tiny amount of viral material, slowly entering through the lymphatic vessels of the mucosal surfaces are processed by local "sentinel" dendritic cells and monocytes, processing the class II epitopoes and initiate a T helper cell  ( "classII") response in the local lymphoid tissue, that leads to a protection from further transfer of viable virions by an early entry local antiviral cytokine and phagocytic response. The repeated stimulus leads to a substantial portion of memory T-cells, that caan be found in the peripheral blood of such partners in the absence of any antibodies or of course virons. No virus reaches the liver, not even the B cell system is activated enough to become positive. But if you stijulate the lymphocytes of such a person with HCB specific class II peptides - THEY LIGHT UP IN THE ELISPOT TEST AND PRODUCE GAMMA INTERFERON, proving that the HCV virus is known to the T cell system of this body. Exactly the same mechanisms have been reported in the HBV system, with much lesser protective efficacy however. Frank Chisaris characterisation of this : HBV is a stealth virus....

It is to be noted that such Tcell reactive partners have no clinical disease and do not develop antibodies or hepatitis or show any sign of viral entry beyond that short length mucosal contact.Only a research lab equipped with this T-cell tests can find the above reactivity.

[kittyface]

Hi, roostermom, there's many causes of elevated liver enzymes so please stop beating yourself up over this.  The chances that you passed it to your daughter in the past couple of years are almost nil assuming you didn't share personal hygiene items and even that is relatively low risk.

I lived with my boyfriend for 7 years before I knew I had HCV and did all the usual things cohabitants do:  had "relations," deep kisses, shared razors, toothbrushes, beverages, silverware, tended to wounds, etc.,and my boyfriend is HCV negative.  

Please take a deep breath and relax.
------------------------------------------------------
HR:
Thank you for explaining the immune system and the virus. Absolutely fascinating.  I appreciate all your work here.

Best to all,

KF

[DoubleDose]

Thank you very much for your description of the cellular immune response above.  Just reading how it works and what it actually represents is very reassuring to me.  As you are aware, I have wrestled with this issue of strangely similar symptoms developing over many years in several grown children, and in my spouse.  Also a former partner from several decades ago has developed a similar syndrome.  None have tested positive for HCV.  There may be coincidence at work here, or possibly they may have developed some sort of immune system reaction from this T-cell response  which has created a chronic low grade symptomatic sort of syndrome.  The symptoms include unusual bouts of fatigue, at any time of day, lots of yawning, even after eight hours sleep, joint and muscle pains (FM style), mucousal irritation in eyes, sinuses, throat, and in the females also irritations in the sexual tract.  Testing identifies nothing either infectious, or allergic.  Also, there are periodic skin reactions, and a development of very dry skin in the extremities. Oh yes, digestive issues, and a sort of IBS has also become apparent.  My spouse NEVER had these problems in her life until the past five or so years.  They are similar to the symptoms I experienced over the years.  

Your explanation of what really happens gives me a sense of relief, and hope....that there really is no active HCV infection taking place in my family members.  Thank you again.

DoubleDose

[merryBe]

my feelings exactly....giving it to children..the worst sinking sorrow...
but you've got to take a deep breath, they may be positive for antibody and negative for virus,
or they may have a different form, from restaurants etc.
or they may be drinking, lots of reasons...just be glad they are testing our kids now....far easier to head things off at the pass, what with new treatments coming, that to wait 40 years until liver is shot before they notice, oh, you've got hep c.

but don't over worry, Ask then do draw for RNA at the same time they draw for the prliminarise, that way if some genome does come up positive they can discover if the virus and not just the antibody is there. ergo, no waiting 2 weeks to know the whole story. Because, if she is pos. for antibodies she could still be negative for virus...and without the RNA test, you may wring hands needlessly.
anyway I insisted my family get both tests, and gave my reasons, and they went along.
hope that helps.

[roostermom]

Thank you all for your rapid responses. I will ask for the RNA test as well. Is that where they can tell you the genome type as well? I have 1b which is difficult to treat. I haven't been on the site for a while - any postive news on treating 1b? I am at Cornell Med center and my doc didn't want to retreat with peg combo because I didn't do well on it.

[mremeet]

There can be all kinds of reasons for elevated liver enzymes unrelated to the possibility you somehow infected her. Hepatitis B (HBV) is a sexually transmitted disease, is she sexually active and does she use a condom? (don't be so sure you know everything she's up to) Did she get any tattoos, especially from low rent tattoo shops with questionable sanitary conditions? (possibly exposing her to HBV and/or HCV etc) Tattoos are extremely popular with young people today, and sometimes they get them in concealed places on their bodies. Don't assume she doesn't have one just because you can't see it. Has she been taking relatively large amounts of pain relievers like acetaminophen? Has she been drinking alcohol, especially shortly before getting her blood sampled? Has she recently traveled to Mexico etc or perhaps has recently eaten raw foods that may have exposed her to hepatitis A? Etcetera, etcetera, etcetera...

As you can see there are all kinds of reasons why she may have elevated liver enzymes that are completely unrelated to casual contact with you. Unless some of kind of specific blood-to-blood contact has occurred between you and her since her last (negative) HCV test, the odds are overwhelmingly against her getting HCV from you.

[roostermom]

Parat one of her blood work came back today and was negative for Hep B which makes sense because she was vacinated for that. THe liver profile also came back normal, but there isn't an alt and alt on it. It could be in the next batch that wasn't done yet. sthe sgot and sgpt were normal. Can anyone reassure that this will all come out as a false postivie?? The very first blood work showed her positive for a, b and c, and not the B test is negative. Any thoughts on this and why they wouldn't have done an alt and ast in this batch?

[Hepatitis Researcher]

ALT is just another name for SGPT .   AST is just another name for SGOT. So both WERE done in this batch and they are normal.

rooster :
"The very first blood work showed her positive for a, b and c, and not (DO YOU MEAN NOW?) the B test is negative.".


I assume the antibody for A was pos - good.
Possibly the anti HBSAg was pos - good.  Now the HbSAg is NEG?? --good!


But what was pos about the c as ou write above?????????

[mremeet]

SGOT is another name for AST, and SGPT is another name for ALT. If those two parameters were normal, as far as I know her AST and ALT are also normal. And are you saying she tested positive for hepatitis A, B and C - all of those??? And then later tested negative for hep B?? Hmm, sounds confusing, seems highly unlikely she could have all of those strains of hepatitis simultaneously unless there's been some sort of extraordinary risk exposure somewhere along the line. She could test positive for hep A and B antibodies if she's been vaccinated for those two (antibodies are ok, the virus is not). But there is no vaccine for hep C. If she has antibodies to hep C, there's a good chance she has hep C. Only about 1 in 5 clear hep C on their own spontaneously, the rest go on to be chronically infected without treatment. Sounds like you need to really discuss this in detail with your daughter's doctor, some of the details you are providing sound mixed up. Your daughter's enzymes being normal and the rest of her liver panel being normal definitely strongly suggests she does not have hep A, B and C all together. Sometimes people with long term hep C can have normal enzymes, but usually the enzymes are elevated. So overall it sounds like your daughter is fine, but really you need to to sit down with her doctor and go over her labwork carefully with him/her until you truly understand what's going on. Right now I don't think you do based on what you've said. And we can only guess at what's going on unless you provide us with accurate information. Hope you get it sorted it out soon, take care.

[mremeet]

Oops crossed posts, glad to see you weighing in.

[roostermom]

Her doctor ordered the extra tests because she thought the first one was a bad test. Needless to say untill, you can prove that, your world is upside down! Thank you for telling me that the SGOT & SGPT are the same as the alt & ast. They were both normal, and the Hep B came back negative so i am feeling more and more like it was a bad first test. She was tested two & three years ago and was negative and she doesn't lead a drastically risky lifestyle. Thank you for this Thanksgiving gift ot info - I feel a lot more at ease. Hope you are well, and have a great day.

[Hepatitis Researcher]

you wrote:
The very first blood work showed her positive for a, b and c

I asked
But what was pos about the c as you write above?????????

mremeet asked the same thing, indirectly.

I therefore repeat:
Was there any pos finding re the "c" in her first test that you can specify? You had to have a reason that you wrote "pos for c".

The tests are all separate, so there is no global  "bad first test" but there were several first tests.

[roostermom]

Here are the results of the first test word for word:
hepatitis tests HBsAG (Automated)                            Negative

Hepatitis B Surface Ab                                               Positive

Hepatitis C Antibody                                                  Positive

Hepatitis B Core IgC Ab                                             Positive                                            

[Hepatitis Researcher]

This result means clearly that there was a past infection with the HBV virus, that has cleared, leaving behind a neutralizing antibody to the surface antigen and and an antibody against the HBV core antigen, that demonstrates beyond doubt ( other that the test was false, which is very unlikely since the anti HBS is pos) that a past infection with HBV has occured.  Not much to worry about, the body has managed to eliminate the virus with the exception of minute amounts. In the unlikely case of cancer chemotherapy  a prophylasctic HBV antiviral would have to be given - if ever necessary,  in the future -  to prevent a reoccurrence of acute  hepatitis B. The real problem with that is, that almost 50% of the chemotherapists are not aware of this, as a survey at the AASLD has shown. So she has to be educated with that, so that she can speak up, if ever necessary, for herself.

The case with the Hepatitis c antibody is more serious, since it also means past contact - infection with HCV, unless false pos - maybe needs repeat. It  could also mean that acute clearance of the HCV virus was achieved.  This can only be ascertained by testing with a sensitive test for HCV by PCR or TMA.   Many cases of  chronic HCV have LFTs in the "normal ranges". How high were the actual values for the SGPT and SGOT?

[DoubleDose]

Roostermom:
Now I am even more curious about this case than ever.  As I mentioned in my post at the top of the thread, I have read numerous anecdotal accounts of people in close relationships to someone with HCV who were negative for years on HCV antibody tests, and then somewhere down the road, often after no contact with the infected person, they became POSITIVE for the virus.  Quite a coincidence I would think!  Especially if they were fully aware of the virus, and surrounding issues, and had the motivation to be tested regularly for the virus.  One would have to really doubt a separate, and new infection, having no connection to the prior close contact.  

If your daughter turns out to be truly positive for the HCV antibody test, as the first test indicated, and then proves to have a viral load on PCR testing...then I think you need to get the past records of her negative HCV antibody tests.  If there are multiple negative HCV tests from her past few years, then I would really wonder about the issue that I raised above...a delayed positive antibody reaction.  The virus might have been there all along, and only provoked the antibody reaction recently.

How could this happen???  I have NO clue...but , again, as I stated, I have read of this sort of puzzling viral behavior in a number of other accounts.  I am sure doctors would just discount the whole thing, and assume that the prior negative tests were not valid, or that the person just became infected.  I am not sure that they would be correct in their assumptions!  They don't usually challenge their own preconceptions, nor think out of the box.

Please insist on follow up HCV antibody tests, and very sensitive PCR/ viral load tests as soon as possible for your daughter.  This would be very puzzling indeed, and is something I constantly dread regarding my spouse and children....given their odd symptoms over the years.  Of course they too were negative on HCV antibody tests....but this kind of situation makes me really anxious about the future.  Could there be a tissue based infection that takes years to overcome blood infection immune barriers?  

HR:  What do you make of this situation?  Especially if the infection is verified?  How could prior tests have come back negative?  Multiple tests?  I am back to the innocuous, invisible infection theory, which leaves room for down road manifestation of a newly provoked positive antibody response.  

Why in some longitudinal studies in other countries, do close contacts have a much higher HCV positivity after two or three decades from initial household contact?  I remember studies where close contacts seem to have less than 2%-5% HCV positivity during their first ten to twenty years in an infected family setting.  I believe the rate of positivity climbed into the 25% plus range after 25-30 years beyond earlier exposure.  I think the studies were middle eastern, and maybe Greek.

This is a very curious situation if it proves to be true.

DoubleDose

[mremeet]

Don't you think you're jumping the gun just a bit there by implying or otherwise being suggestive that roostermom may have infected her daugher via casual contact? C'mon, that's highly unlikely based on what is widely and commonly known about HCV (and how it's not communicated via casual contact like you often suggest or imply/postulate). Roostermom has not given us any further information about her daughter's possible risk factors (at least in this thread). But if her daughter's been definitively exposed to both hep B and hep C, something's going on here - more than what's being discussed. Please don't oversimplify the situation by attempting to force the square "casual contact infection" peg into the "hey, that's how she got HCV and HBV" hole. I really don't think it fits, do you?

[jmjm530]

I think its more than jumping the gun. the kids have tested negative in the past and the new test will tell if thereshould be any concern re the elevated enzymes. if they test negative, I say the case is closed and all this speculation is bestl left to our theoretical discussions and not to get someone all worked up over what may be nothing.

[DoubleDose]

Hey, I asked some questions, and stated the obvious!  What's with the intolerance on your part?  You seem to jump to your own conclusions, by the way.  I am stating a concern, based on observations, and accounts that I am aware of.  I did not make any definitive conclusions regarding this situation, but asked pointed questions, and recommended follow up tests.  I think the facts will make themselves apparent.  If there end up being questions that have no obvious answers, then it would make sense to investigate further.  Some things are not fully understood, or 'black and white'.

I am not trying to 'force' anything, but am leaving open the possibility that something 'atypical' could possibly also be one of the avenues to explore.  I know you already have all the answers...but some of us are just not as smart as you.  All I ask for is an open mind.  You seem to get agitated over anything that does not fit your preconceptions.  I am sorry about that, but I will continue to make unpopular observations, and look for reasons for HCV behaviors that we are not fully clear about.  

I personally do not think we know everything about the virus yet, and that there are lots of areas to continue exploring.  Apparently you do not agree.  Sorry about that.

DoubleDose

[jmjm530]

Just went over the thread again, and it appears a viral load (PCR) test is needed to tell if your daughter has hep c, or just the antibodies. Cornell is an excellent medical center and if you're seeing a liver specialist there (hepatologist) I'm sure they will run the correct tests. If you're not seein g a liver specialist, then ask for a referral. Dr. Afdhal, or anyone in his group are excellent.

All the best,

-- Jim

[jmjm530]

sorry...meantt to say Dr. Ira Jacobsen or anyone in his group at Cornel. Afdhal is in Boston at beth israel.

[DoubleDose]

You may have missed the post where roostermom indicated that her daughter tested 'positive' on the recent HCV antibody test.  That sure adds some additional force to the elevated enzymes.  I would not think that a HCV+ test result is a benign event, especially when the mother is HCV+.

DD

[jmjm530]

I missed that, on hte first pass , yes. but still, a PCR will tell the story. no need to get somone very new in this all upset with familial transmission issue. Its one thing to discuss this in a theortical contesxt, very good in fact, but i think another to bring someone new to the discussion with a specific concern who may not uderstand that this is not established medical knowledge. anyway, havingtrouble with coputer as you can see, so im going to sto. hope you had a happy turkey.

[DoubleDose]

Happy Thanksgiving to you as well.  I over-ate, and feel like a turkey.

I am not trying to get roostermom worked up, she is already upset, on her own.  She is very familiar with HCV already, and has been having her daughter tested.  I am being straight-forward about the need to confirm the antibody test with a PCR immediately.  I do believe that 'familial' transmission is noted in ALL the literature as a low percentage possibility, and it is often unexplained when it does happen.  I am just looking for explanations...IF the result comes back positive on PCR.

I would definitely hope and pray that the HCV antibody test is a false positive...or that if there was a prior infection..it has resolved.  But then the prior HCV negative antibody results come into question as well.

The only reason I responded to this situation is that I have been hearing about too many of these odd cases to not closely scrutinize this one, since it is on the forum.  I hope there is no infection, AND no connection to the mother's infection.  If there happens to be a surprising result, and a positive PCR, then the case warrants lots of further scrutiny.

Best wishes and enjoy the holiday.

DD

[jmjm530]

In re-reading the post again, a lot is unlcear , as is often the case when we get r fractured info. for exmple, what tests were actually given in the past? Is it possible that ,if daughter ends up testing pcr positivem ,it was actually from birth? Or could it even be a new infection, unrelated? all that was stated was that kids were tested a few years ago and were neg, whatever that means. in any event, i thik we both agree that if the pcr is negative for hep c, then all is good. if not, i suppose lots of thin  possiblities. i also overate, really like a pig, with three-four helpings of turkey stuffing, postaties, actually two kinds of potatoes and then triples on desert -- cake, pie and ice cream. i rarely eat like this but every thanksgiiving it happens. no control whatsover.

[mremeet]

DDquote: “Hey, I asked some questions, and stated the obvious!  What's with the intolerance on your part?”

The “obvious?” There’s nothing really obvious, or obviously true about your theory that people are casually contact infected with HCV all the time. And I have no intolerance to your speculations on the matter, like I said before I often enjoy discussing all sorts of various possibilities when it comes to HCV. But in this case clearly it’s an inappropriate leap without knowing a whole lot more about what’s really going on here. Plus it’s inappropriate to imply to roostermom she may have had something to do with infecting her daughter, when based on what she has said so far, she probably did no such thing.

DDquote: “I am stating a concern, based on observations, and accounts that I am aware of.  I did not make any definitive conclusions regarding this situation, but asked pointed questions, and recommended follow up tests.”

I never said you did make definitive conclusions. I said you were “…implying or otherwise being suggestive that roostermom may have infected her daugher via casual contact.” And that’s exactly what you were, and are, doing.

DDquote: “I think the facts will make themselves apparent.  If there end up being questions that have no obvious answers, then it would make sense to investigate further.  Some things are not fully understood, or 'black and white.”

Well sure things will make themselves apparent. Roostermom’s daughter will get an HCV PCR to see if she has an active infection or not. But if you think in the event she does test positive, then THAT constitutes some sort of “aha!” moment that verifies or otherwise lends credence to your casual contact infection theory, think again.

DDquote: “I am not trying to 'force' anything, but am leaving open the possibility that something 'atypical' could possibly also be one of the avenues to explore.  I know you already have all the answers...but some of us are just not as smart as you.”

So I’m an arrogant know-it-all because I question the veracity of your casual contact theory? Especially within the context of this thread and especially as you’re rather awkwardly attempting to apply it to roostermom’s daughter without knowing anything more about this situation? C’mon, get real. If you’re going for an ad-hom, you’re gonna have to be better than that.

DDquote: “All I ask for is an open mind.  You seem to get agitated over anything that does not fit your preconceptions.  I am sorry about that, but I will continue to make unpopular observations, and look for reasons for HCV behaviors that we are not fully clear about.”

I’m not agitated over what you said, I’m just reminding you that your casual contact theory is often over the top. You take it well outside of the realm of speculation sometimes, you obviously feel it has more scientific merit than the evidence supports at this point in time. That’s you’re right to do so, but then so it is my right to question your theory and to do so in a frank and forthright manner. Besides, there are many people who agree with my skepticism, it’s just they’re too polite to openly disagree with you (mostly because you’re a nice person and it’s not worth disagreeing over).

DDquote: “I personally do not think we know everything about the virus yet, and that there are lots of areas to continue exploring.  Apparently you do”

Oh. So you’re telling me that I believe that we know everything about the virus and that there are no further areas to explore? That’s funny I don’t remember saying that nor implying that. Well, you wouldn’t be the first person to tell me what I believe and what I’ve said without me actually doing so. Good luck with that.

DDquote: “I am not trying to get roostermom worked up, she is already upset, on her own…I am being straight-forward about the need to confirm the antibody test…I do believe that 'familial' transmission is noted in ALL the literature as a low percentage possibility, and it is often unexplained when it does happen.  I am just looking for explanations...IF the result comes back positive on PCR.”

How do you explain roostermom’s daughter having being exposed to HBV in addition to HCV? According to HR her test results indicate an actual exposure to HBV, not just vaccination antibodies. Roostermom has not mentioned that she has/had HBV, only HCV. Did she also give HBV to her daughter too? And if not, how did her daughter become infected by HBV? Considering how HBV is often transmitted, doesn’t that open up a reasonable possibility of HCV exposure too? Isn’t that a viable possibility for getting HCV other than the very unlikely casual contact theory that you seem so heavily vested in?

DDquote: “I would definitely hope and pray that the HCV antibody test is a false positive...The only reason I responded to this situation is that I have been hearing about too many of these odd cases to not closely scrutinize this one, since it is on the forum.  I hope there is no infection, AND no connection to the mother's infection.  If there happens to be a surprising result, and a positive PCR, then the case warrants lots of further scrutiny.”

Here’s what I think: I think you carry a guilt complex DD. I think you carry around a catholic sized cross thinking you infected your wife and your children (even though they all test negative and you’ve been SVR for years now). I think you’re worried that they will someday spontaneously develop a full-blown HCV infection and they will have become infected by being casually exposed (and sexually in the case of your wife) to you. In your darkest fears you worry that you have planted a time bomb within all of them, people you love deeply with all your heart. And when you read threads like this it taps right into that fear and guilt (misplaced as it is) and you end up reading too much into it for that very reason. You’re a good person DD, a decent man, that much is obvious. But you didn’t give your kids hep C. And the odds they’re going to spontaneously develop hep C anytime soon from some kind of latent casual exposure from you, is in all likelihood, infinitesimally small.

THE END

[roostermom]

Here are some clarifications. The first time I had my daughters tested, I asked them for liver function tests where the alt and ast came back normal, along with the rest of the panel. The second time my daughter was tested, was while in college and she asked for a full std panel which includes the hep tests. alll normal. This time she asked for another std check and the above readings showed up. We them had a liver panel done where she showed negative for B, and the Liver Func Profile all came back normal. We are still waiting for another test for the C to come back, should be monday. The first part showed SGOT at 18 (normal range = 9-36) and the SGPT at 21 (normal range 5-40).
While I agree with the fact that you never really know for sure about a persons lifestyle, I believe it to be true that she is not a drug user, and has the STD tests because she is a responsible young adult who was having relations with her boyfriend.

[Hepatitis Researcher]

Her SGPT is borderline - according to the new AASLD gudielines 20 is the new upper limit of norm for women, 25 for men. So it does not give the clarification it could have contained.

You will have to wait for the HCV RNA test to come back neg to be perfectly sure that it was a case of

silent acutely cleared HCV, which is what it looks like at this point

if we believe all the lab tests to be true. Lab tests of this sort are rarely false - and sample switches are also extremely rare.

I assume that I clarified   what the sum of the HBV serological tests mean in her case.It is the positivity of the IGG-anti-HBVcore test that proves that real replicating virus, not just the vaccine, has been encountered.

[jmjm530]

It's unclear from the post -- or maybe from too much Turkey -- if "rooster" had the ElISA or RIBA. If only the ELISA, then doesn't the very real possiblity of a false postive exist, i.e. no "silent acutely cleared HCV" in the past? In any event, I think everyone agrees that a PCR is needed to determine if indeed she has Hep C.

-- Jim

[roostermom]

i will give a post on Monday when we get the rest of the results. I did ask them to do an RNA test, and they (ObGyn) said we had to go to a heoptolgist. BTW, my Doc is Ira Jacobson at Cornell, so if this comes back this any further noise, that is the first place I will be taking her.

[Hepatitis Researcher]

One would hope, that they use an advanced HCV Ab detection method.  It can always be repeated  ( the AB test) , if PCR is NEG, to evaluate if " acutely cleared HCV " existed, not totally unimportant to know that.

Here is to the bewildering array of HCv antibody tests:


OBJECTIVES: To evaluate the efficacy of second-generation ELISA (ELISA-2), third-generation ELISA (ELISA-3) and third-generation recombinant immunoblot assay (RIBA 3.0) for detection of antibodies to hepatitis C virus (anti-HCV) in comparison with reverse transcriptase-polymerase chain reaction (RT-PCR) to detect HCV RNA for the diagnosis of hepatitis C. METHODS: Sera of 108 patients with chronic liver disease (CLD) were analyzed by ELISA-2, ELISA-3, RIBA 3.0 and RT-PCR in the first part of the study; in the second part, sera of 105 patients with non-chronic liver disease were evaluated with ELISA-3, RIBA 3.0 and RT-PCR. RESULTS: In the CLD group, anti-HCV was positive in 4.6%, 14.8% and 16.6% by ELISA-2, ELISA-3 and RIBA 3.0, respectively. Among these anti-HCV positive cases, HCV RNA was positive in 100%, 58.9% and 64%, respectively. ELISA-2 did not give false-positive results, but missed substantial number of anti-HCV positive cases (p < 0.001). In the second group, anti-HCV was positive in 76.3% by ELISA-3 and 68.6% by RIBA 3.0 (p:ns). HCV-RNA was positive in 88.7% of ELISA- and RIBA-positive cases; in 60% of ELISA-positive, RIBA-indeterminate cases; and in 46.4% of ELISA-negative, RIBA-negative cases. CONCLUSIONS: ELISA-2 is not a suitable assay for routine screening. ELISA-3 was at par with RIBA 3.0 and it can be recommended for routine screening for anti-HCV. RT-PCR for HCV is of value in detecting early viremic, anti-HCV negative cases; this may be of importance in the treatment of hepatitis C

[jmjm530]

I'm a bit confused. If your doc is Dr. J at Cornell -- hes one of the best in the country-- then why aren't you addressing all these concerns with him as opposed to your other doc? Maybe I'm reading this all wrong, but Dr. J knows what tests to run and should be able to sort this out lickity split. At this point you really need clarity and closure, so do make an appointment with him now, regardless of what tests are being run -- unless you fully understand all these tests. I'm still unclear what tests have been done and have a feeling so are you.

All the best,

-- Jim

[roostermom]

Considering we brought her back to the doctor at 8:30 a.m. on tuesday after hearing about the issue at 3:30 monday, and considering that yesterday was a holiday, I think I am moving as quickly as possible to address the issues. Believe me, if this next batch of blood work comes back with anything out of the ordinary, the next call I make is to Dr. J.

[jmjm530]

Sorry, I thought the Hep C (positive) blood work preceded the recent one that showed elevated enzymes. As HR suggested, so many tests involved with diagnosing Hep C, that even doctors get confused, not to mention patients. Hope it all works out.

- Jim

[Hepatitis Researcher]

The testing history for rostermoms daughter that you requested to see, in her new thread, is already given here in some detail.