Diagonsed HCV antibodies as +VE; does it confirm Hepatitis C?

Hi,

I am diagonsed Hepatitis C yesterday at hospital as they did HCV antibodies test beng positive. Does it confirm I have Hepatitis C. Please advise as I am very worried.
thanks

[copyman]

No it does not mean you have Hepatitis C. You will need further testing to confirm, a test called a PCR will confirm.

The chances of the antibody test being a false positive is only 5%

Some people clear the virus on their own and have only the antibodies. Hopefully this is the case with you.

Best of luck

[Bill1954]

A positive HCV antibody test requires confirmation with ‘HVC RNA by PCR’ test.

Approximately 15-20% of patients that are exposed to the virus will clear it spontaneously in the first six months of infection, so follow up testing is necessary. Until then do not drink alcohol.

Good luck—

Bill

[Trinity4]

No, the antibody test does not confirm you have the active virus.  It means at some point in your life you were exposed to the virus and occasionally the test will show a false positive.  Around 15% of those who test positive for antibodies will not have active hepc because their own immune system will have killed the virus, however, they will always test positive for antibodies.  You will need an HCV RNA by PCR to confirm the presence of active virus.

Trinity

[Bill1954]

:o)

[Koolman88]

So bill ... what do you mean by spomtaneously.. Do you mean it will sent off with out any drugs.. should I test ALT /ASL?

[Koolman88]

One more thing... what is HCV anitibodes test ( 3rd generation) as it was the test sent for confirmation by the hospital to external lab. it was also positive..thanks

[Bill1954]

Yes, in about 15% of patients, the virus clears, or disappears on it’s own, without the use of drugs. This only occurs in the first 6 months; this is called the ‘acute’ phase of disease. Once the disease reaches the ‘chronic phase” (>6 months) then it will nearly always require medication to resolve.

ALT/AST (liver enzymes) can help to some point, but remember that some chronic patients will not have elevated ALT/AST; that test can give false information and false hope. Always best to check with HCV RNA by PCR.

--Bill

[Anne1717]

I apparently did clear the virus during the acute stage and am waiting for the confirmation test 12/1.  

Just so you have my numbers for a reference -from July 23rd to September 1  - if it helps

July 23 - ALT 327  AST  162  Viral Load was not given but qualitative was negative
Aug 18 - ALT 124   AST   55       Viral Load 41,700
Sept 1 -  ALT and AST normal     Viral Load 1400

Everything decreased rapidly and I did have symptoms late spring.  

Good luck

[copyman]

Hi,

Although your Viral load & LFT's did decrease you still show a viral load of 1400. As of 9/1 you did not clear the virus. Hopefully your next test will be 0 viral load.

Do you know of an exposure that you would have contracted HCV.

Personally I would see a Hepatologist and test sooner then 12/1

If you dont clear a Hepatologist may have a plan in place to treat right away if you dont clear at 6 months.

best of luck

[Anne1717]

Thanks - I am seeing a hepatologist in an excellent teaching hospital and am not even near the 6 month mark - It has been 3 months at the most.  He is optimistic that I am definitely clearing given the way everything came down so quickly.

I don't know the exposure - possibly a tetanus shot - NO risks whatsoever,  but I do have a very clear time line since I did have symptoms and give blood every 6 months. I also have LFT'S often because of  hypothyroidism.

Here's hoping

[portann]

Hi Anne,

Did the doc explain why he's going to wait until December 1st?  I'm very unfamiliar with acute HCV, by the way, so this is just curiosity.

You had three PCR's, and waited 4 weeks between the 1st and 2nd tests and then 2 weeks between the 2nd and 3rd. Why a 12/13 week wait for the next one?

I'd be tempted to ask for one sooner than that but as I said, I know diddly-squat about how acute HCV is managed.

Regards,
Susan

[Anne1717]

Hi Susan,
Yes he did - he is really sure I have almost cleared.  I am definitely acute since most likely early June. Three tests were done by my internist and the last by the hep guy.  I guess I didn't put down the earliest one that was 400,000.  He says because of the rapid and drastic decline of all the levels without treatment, in such a short period of time, indicates my immune system is clearing the virus. From 7/23 to 9/1, the levels went from 400,000 to 1403, and ALT 327 back to normal. This is typical of clearing - high LFT levels that decrease quickly.
As an added measure, I have an appt with a gastro guy 10/1 who undoubtedly will also run tests.  The hep guy though hails from a well respected treatment center in a teaching hospital so has experience with acute hcv.  December 1 st will be 6 months and from what I have read, it  is the point where the tests would be run again.  It is important to say that I have no other compromising factors that would inhibit my immune system - no drugs, drinking, smoking, bad diet, obesity - my liver is great,  so in that light, it seems best to me to take a chance to clear completely.  
I have read everything I can find on spontaneous clearing and have no problem being proactive if I felt he was wrong in waiting.  And for some reason all goes to hell by then, well we will treat right away.  
Thank you for asking and I will keep the information flowing since this doesn't happen often.  It would be nice to have an acute history on the web site just in case  another odd ball comes along.  
Best to you

[portann]

Hi Anne,

Thanks very much for that.

It's an eye-opener for me, never having been in the middle of watching (in cyberspace, anyway) the spontaneous resolution of HCV.

Even though it's rare, I'd like to see it in the Health Pages as a reference for us if it turns up again. I'm not sure where it would go, as it's an infrequent situation. Maybe testimonials?

Here's the link, if you want to eventually do this (see 'create new health page'):

http://www.medhelp.org/health_pages/list?cid=64

Hope you keep this info flowing. What an unexpected trip for you.

Congratulations and warm regards,

Susan

[Anne1717]

Hi Susan, HOPEFULLY it's congratulations !!! I will do that if I am am clear in December.  I would like to be able to post a success with spontaneous clearance and not just another disappointment.

I just wish you all didn't have to face a life long illness but am inspired by the ferocity in which you have gone after this disease.  I guess you have to eh?

Be in touch and I wish you good health and the best of luck.

Anne

[FlGuy]

Just wondering out loud here.  If docs watch what they believe is a spontaneous response, I suppose it's waiting for the immune response to do it's thing.  And, if that's the case, why wouldn't they "inspire" the response with some flavor of interferon?

[Anne1717]

Ok - I'll wonder out loud too.  Being in the position of most likely clearing, and because I am otherwise very healthy and have no liver issues or compromising factors,  I would rather give myself the chance to fight this off on my own.  If in three months I was not successful or am losing ground, then I really have lost nothing and can start interferon.  

Don't forget - many people have cleared it on their own and never will know they had acute  HCV until they pop up with the antibodies at some point in their lives. I would not have know if I were not a regular blood donor.  Without more widespread testing, we really have no idea of the extent of exposure.  And again - I've said it many times, if I have it with  no risks other than a tetanus shot, then anyone can have it.

I think we have no idea of the scope of HCV.  Eye opening and frightening experience.

Probably every individual case needs to be assessed but in my situation, it's probably best to wait and see.

[FlGuy]

Sure is a lot of watching and waiting with hcv.  Not a good disease for an impatient patient.

[Koolman88]

Dear All,

Yesterday, I sent Qualitative PCR test to the lab. I again did HCV antibody test and it has the following figures. My PCR result will come on 22nd of this month.

HCV antibody using 3rd generation ECLIA
REACTIVE (36.06)
CUTEOFF rate is 1.00

Please explain as I am very worried.

[Koolman88]

Can anybody explain above figures plZz

[Bill1954]

http://www.cdc.gov/hepatitis/HCV/LabTesting.htm

[Koolman88]

Hi bill,

I got the HCV PCR Qualitative report. Here is the result but I couldn't understand if it is ositve or not?

Qualitative HCV  PCR
Hepatitis C Virus (RNA) Detected.
NOTES:
1. For the diagnosis of viral hepatitis, a sngle positive HCV RNA test in the absence of other diagnostic parameters must be carefully interpreted.
2. Patients tested positive for HCV RNA may have their viral load quantified.

Please elaborate?
regards,

[Koolman88]

Can anybody elaborate the above result. I am very worried.

regards,

[Koolman88]

I got the HCV PCR Qualitative report. Here is the result but I couldn't understand if it is ositve or not?

Qualitative HCV  PCR
Hepatitis C Virus (RNA) Detected.
NOTES:
1. For the diagnosis of viral hepatitis, a sngle positive HCV RNA test in the absence of other diagnostic parameters must be carefully interpreted.
2. Patients tested positive for HCV RNA may have their viral load quantified.

Please elaborate?
regards,

[Marcia2202]

Hi, unfortunately it means that you do have hepatitis C.

The next step would be to determine what genotype you have.

Then the next step would be to have a biopsy, to see how much damage your liver has suffered from the hepatitis C.

Please do not panic. We have all gone through this and you have come to the right place. It is very important that you read and inform yourself about this disease and it's treatment. Knowledge is power. The more you know, the more you will relax about it.

Wishing you all the best.

[Marcia2202]

This is a very good site to read about hepatitis C


http://www.hepctrust.org.uk/

[Koolman88]

Dear Marcia,
One more thing.. does it effect very fast or I can start treatment after 10 15 days as my Doctor is out of country.

[Marcia2202]

Hep c progresses slowly. I had it for 25 years before I found out and had hardly any liver damage. I treated and am now cured.

Relax... there is no hurry to start treating. Go step by step. You will need to find out what genotype you have first, as the length of treatment is different for the different genotypes. Genotypes 1 and 4 treat for 48 weeks and genotypes 2 and 3 for 24 weeks.

Please read up on hep c and treatment on the link I gave you. You will get a lot of basic information there. It will put you at ease.

[Bill1954]

It might not be necessary to undergo treatment for years, so yes, delaying treatment for several days, weeks or even months isn’t normally a problem.

HCV disease progression is measured in years and decades (10’s of years); often, a liver biopsy can determine the amount of fibrosis, or scarring that might have occurred in the past. The biopsy results can help determine the urgency for HCV therapy.

Sorry to hear of your diagnosis; as Marcia said, test for HCV genotype to determine both the duration and the effectiveness to interferon. The predominant genotype in Pakistan is genotype 3, although other strains are present there. Genotype 2 and 3 typically require 24 weeks of treatment; genotype 1 and 4 require 48 weeks minimum.

You’re doctor should discuss all this with you prior to any treatment.

Good luck,

--Bill

[Koolman88]

Bill, one thing why test didn't said positive; it is only detected...

[Bill1954]

ANY detectable HCV RNA implies infection; detectable = positive. You should discuss all this with your doctor for a formal diagnosis, of course.

Good luck, my friend—

Bill

[Koolman88]

Dear bill, I got the Quantitative PCR today viral load is 632762. Is it too much. my alt is 24.

regards,

[Koolman88]

I got the Quantitative PCR today viral load is 632762. Is it too much. my alt is 24.

regards,

[Bill1954]

Yes, any virus is too much; you have active RNA infection. You will next want to determine the genotype of HCV; this establishes the duration of treatment required, as well as how well the treatment drugs will perform.

Has your doctor discussed treatment options with you yet?

Bill

[Koolman88]

it is genotype 3 which requires 24 weeks of treatment but Doctor says as I have approx. .6 million copies and it is below the dangerous line I can be cured very fast.