HCV Test Question

During a routine physical, I had elevated ALT and AST results.  The Hepatitis test done at the same time was negative.  We retested and the hepatitis test has come back with low levels of anitibodies present, and the ALT and AST results have dropped significantly but are still elevated.  I do take lipitor and the initial thought was that the elevated liver enzymes were attributable to the lipitor.  

My doctor wants to do a viral load and genotype test to confirm what we are dealing with, and said it's possible we are getting a false positive result.  

Can someone address the the probability of whether or not there is a reasonable chance that this is a false positive?  

[PSP-n-Me]

my husband takes Lipitor and his enzymes are checked every three months - they have never fluxuated - normal range always...

I hope it is a false positive
Beth

[kjbwea]

I don't want to get your hopes up but let me tell you my story!  I tested positive for HCV and had an Elisa score of 1.9.   This was followed by a negative riba so it was presumed a false positive and the information was never relayed to me because of this.    One year later I had an Ortho Assay done and that was positve with a 5.9 S/CO.   That test was followed by an interdeterminate Riba.   I was devastated.   I did an HCV Quant PCR and that was undetectable but I was still scared.    I went for my 6 month follow up and have tested negative on Both the Elisa and Ortho and also on the Riba.   TWO False positive antibodies.   I still come here - I need to - this board was so helpful for me and I came here everyday to read.   I feel like it's part of my life now.   I'm thankful that I no longer test positive and my Dr's think that I had some other virus at the time that interfered with the the test.   It's possible!

[Jakied]

I have a similar story.  Three reactive screening tests with a 1.0 score, which is the lowest reactive score you can have or the highest non reactive score.  Each time the Riba has been neg, thankfully, plus a neg pcr qualitative.  This is a neg outcome but waiting out these tests is MURDER!

FWIW.  false + tests do happen.

[Jakied]

What is the level of your alt/ast?  Normal alt for a man is <50.  Normal ast is <40.

Do you know the signal to cutoff ratio on the elisa test?  hopefully, it is <3.  If so, there is a good chance it is a false pos.  

ask for a Riba test to clarify, VERY specific for Hcv antibody.

[Texan in Dallas]

My original AST/ALT at time of negative hep test was 843/1058, so very, very high.
At time of retest with Anti-HCV, my positive hep test comes back 4.2 and AST/ALT is now 62/341 in  a period of a couple of weeks.  

We are running a viral load to get a definitive answer, but as I gather a 4.2 and high AST/ALT isn't a good sign to hope for a false positive.  Also getting a abdomen sonogram next week

I feel fine, overall -- no problems that are at this point detectable.  

How do they determine, if I am positive, if I'm one of the lucky 20% or so that seem to beat it off and have what I guess is referred to as acute hepatitis?  Do you have to let the 6 months run and see what happens and that is what defines this?  And, does that mean it's wise to delay treatment until this period of time runs it's course to see if you are acute?  Last, I seem to gather from reading that really high AST/ALT scores are sometimes indicative of acute hepatitis development vrs. chronic hepatitis which seems to be associated with a more modest enzyme elevation.  Any truth to that?

[Jakied]

With a 4.2 signal, the chance of a neg riba is small.  I won't lie about that.  However, The screening test and Riba confirmatory test check your system for antibody to Hcv NOT the virus itself.  You need a pcr test for that.

When patients with Hcv complete treatment successfully, they are virus free but NOT antibody free.  The HCV antibody stays in your blood stream for a LONG time, maybe the rest of your life.

There is a possibility you are antibody pos but virus neg.  This is NOT a health concern but you cannot donate blood or organs, etc.

Acute hepatitis is your blood test showing virus but no antibody.  Your immune sysytem has not yet produced enough antibody to be detected.  The virus is detected through the PCR test (polymaraise chain reaction).  Alt/ast number are usually very high in acute hepatitis and come down after your immune sysytem has made enough antibody to fight back against the virus.  In chronic hepatitis, alt/ast are usually slightly elevated.  Alt is between 60 and 100 or so and ast is between 50 and 100 or so.

Your doctor will probably schedule you for pcr test to check for the virus.  there is a chance that will be neg and you are left with pos antibody and neg virus.  If the pcr is pos, you will be diagnosed with chronic hepatitis and will make a decision to treat or wait a few years for better drugs.

Do you have a risk factor for hep?  Blood transfusion/organ transplant/drug use are the main methods of hepc transmission.  Sexual transmission is possible but not common.  Blood to blood is how hep c is transmitted.

Good luck with all this.  I hope your Pcr is neg and that is possible.  If you have a any questions, leave them on this post and I will help you any way I can.

[Texan in Dallas]

Thanks Jakied.  

No risk factors here -- I did have a cyscoscopy and lithotrypsy (twice) about 4-5 months ago.  The Cystoscopy worried me at the time because I got a raging infection immediately thereafter.  Guess chasing the cause is secondary at this point, doens't really matter but can't help but wonder.  

So, I guess my remaining question is really whether or not there is any way to know at this point, if I am positive, what the chances are that I can hold out hope that I will be PCR negative and one of the lucky ones that for some reason is able to fight it off.  It seems that if I am positive, I have just aquired the infection recently as all tests (enzyme and Hep) until just recently have always been negative or within normal range.  

If your body is able to fight it off with it's own defenses, is that a gradual thing where the virus load drops to zero or does the body inhibit it's development altogether?  Don't even know if I'm asking a question that can be answered, but I guess trying to understand if there is anything in my numbers that might give me an idea of the chances that I will or won't be part of the 20%  

[Jakied]

In all honesty, Hep C is a 'stealth' virus, very sneaky.  To confirm active infection, a Pcr test is necessary.

Let me ask you this.  Do you have any symptoms of Hcv?  Dark urine and light colored stools(Just the opposite of normal), stomach pain, joint pain, brain fog are common symptoms.

Good luck with everything.  Don't give up hope for a neg Pcr.  ask for a qualitative NOT quantitative.

the qualitative is more sensitive and will check for the presence or absence of HCV.  The quantitative checks for the amount of hcv.  This test is used to measure the effectiveness of treatment in confirmed hcv cases.

[kjbwea]

[kjbwea]

Which antibody test did you get because there is a difference.    My first antibody test was the Elisa 3.0 and signal cut off ratio for that was 3 and I had tested 1.9.     A different Dr. ran my second screening and my test came back at 5.9 so he said my level has increased and I have HEP C and no need for confirmation.   PERIOD!      Come to find out through someone more educated on the subject that the test the second Dr. ran was a completely different test called an Ortho  Vitros Assay and that test has an s/co ration of 8 so anything less than 8 could very well be a false positve---and in my case they were false positives but I had to wait 6 month to know for sure.    

I know this is very stressful and I hope you get your confirmation soon.   The one thing I did learn when I thought I had HCV was that there are many options and hope for clearance.   I was ready to fight it with everything I got...I thank god everyday that I ended up being negative.   You came to the right place- during my 6 months of hell I looked forward to coming here and reading what others were feeling and going through.   It's a good group of people   .

[Texan in Dallas]

I'll check -- thanks for the tip.  I'm learning how much I don't know about all of this but I'll check. This site is very helpful.  What I can say is that I'm learning patience and learning to take it day by day and to not sweat the things I can't control.  My doc is pretty well versed in this stuff but I've also learned you really do have to pry with them to get information, otherwise they just move through the process and assume you are letting them guide the ship solo.  

[Texan in Dallas]

Found out my test was the Immuno Assay test, not the Elisa Test -- so perhaps the 4.2 score is reason to hope for a false positive after all ?  They are running a viral load so from what I can find out that should give me a definitive answer along with the geno type  as to whether or not I really have contracted HCV.  Thanks for prompting me to ask the question --- much appreciated.  

[kjbwea]

My pleasure- my Assay was 5.9 (higher than yours) and I was a false positve.   Keep good thoughts.   Sounds like you are and that is so important.   I was a complete basket case.   Keep us posted!   I'm hoping the best for you!   And yes, this site in my opinion and the people on it are a great help!

[Jakied]

texan, put an end to your worrying.  Ask for the 'riba' confirmatory test.  it is VERY specific for Hcv antibody and is used to confirm a reactive screening test or give assurance of a 'false +.'

I have a feeling your 'riba' will be neg.