Hep C false negative?

[FB__0]

  What is the false negative rate of the Hepatitis C blood test?
  I was tested at the mayo clinic, with lots of suspicion, but
  it came back negative.
  ALT, AST, and GGTP have been mildly elevated for 8 years.
  Not all symptoms seem to fit together but include continouslow grade
  fever, extreme fatigue, heart palpitations, vague neurological
  symptoms, pain in upper right quadrent, chest pressure, weight
  loss but no apetite loss.
  US doesn't turn up anything except a small hemiangioma. No sign
  of fatty liver. Autoimmune liver tests (e.g.ANA) negative, no
  iron overload, or copper problem. (thyroid normal also). I am
  female, 37, no alcohol intake, and very thin.
  Could this still be Hep C? Any advice greatly appreciated.

[HFHSM.D.-D.M.]

_
Dear FB:
Your question is really an excellent one and I appreciate the opportunity to address it.  
When most people talk about the hepatitis C “blood test”, they typically mean the hepatitis C antibody test.  This is really an excellent test and it is unusual for this test to be negative in an individual with hepatitis C.  There are a variety of situations in which it can happen and we try to be aware of these situations.  These include a person who has just become infected, a person who cannot mount an antibody or immune response (immuno-compromised individual, someone on dialysis), or someone with a condition called hepatitis C related cryoglobulinemia.
In individuals who have elevated liver enzymes with no obvious cause and a negative hepatitis C antibody, one helpful option is the hepatitis C PCR test or the HCV RNA.  These tests which looks directly for parts of the virus in the blood is usually very sensitive when done correctly.  If someone has a negative antibody and negative HCV RNA (done by a good laboratory), I am usually pretty comfortable that they do not have hepatitis C.  You might ask your physicians to do this test.  If nothing else, it should help lay the issue of hepatitis C to rest.  
I hope this information is helpful to you.  If you have any additional questions or concerns, you can post them through MEDHELP or contact us directly at Henry Ford.  The direct number to our liver clinic is: [phone].  At Henry Ford, we have a very active group of hepatologists with a strong interest in the care and research of hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question physician when you have a question pertaining to your health.

[flower123422]

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