Hepatitis C Antibody

Hi All
A few days back went to doctor for flue and she asked for some tests and that ended up in following:
HEPATITIS C VIRUS ANTIBODY TOTAL (HCV AB TOTAL) 1.34 s/co
SGPT (ALT) 74 U/L
SGOT (AST) 35 U/L
CREATININE (ENZYMATIC) 0.9 mg/dL
HEPATITIS B SURFACE ANTIGEN QUALITATIVE (HBS AG QUALI) 0.14 s/co
URIC ACID (SERUM) 5.79 mg/dL
GLYCOSYLATED HEMOGLOBIN. 6.71066 %

Medicines
GALVUS 50MG TAB.56'S
LEGALON TAB 70MG.
URSOFALK 250MG CAP 50'S

Now she asked me for Hepatitis C PCR test (and they sent sample to Germany . . .  no test facility here)

I am very much worried . . . I  knew how to spell hepatitis correctly just yesterday :(  and when doctor told me Hepatitis C . . . fatty liver . . . . I was just unable to standup even.

How bad is my result?
Any chances to be hopeful in PCR Test what test results will ensure I am not hep c patient?

I had one time jaundice back in 2002

Please advise me where do I stand . . . . I am 42 years old male and really don't know what should I do?

Kaiser

[ActingBrandNew]

I will take my best shot at this and if I'm wrong...I'm sure someone will scold me LOL

The signal to cutoff ratio on your AB test was 1.34 If I understand correctly since it was less than 8.0 it is "not not predictive of the true HCV antibody status and additional testing is recommended to confirm anti-HCV status." Obviously that is what your doctor is doing with the HCV PCR test. Your AB test can mean many things and I posted some info for you that gives you an idea of what your test results mean. I don't think anyone can say whether you are likely or not likely to come back with an active HCV infection...you will just have to wait until your results come back. I hope they dont come back positive but if they do...stay plugged into this site because there is some great information here. Good luck.

Chemiluminescence Immunoassay:

Reactive hepatitis C virus (HCV) antibody screening results with signal-to-cutoff (S/CO) ratios of  or =8.0 are highly predictive (> or =95% probability) of the true anti-HCV status, but additional testing is needed to differentiate between past (resolved) and chronic hepatitis C.

A negative screening test result does not exclude the possibility of exposure to or infection with HCV. Negative screening test results in individuals with prior exposure to HCV may be due to low antibody levels that are below the limit of detection of this assay or lack of reactivity to the HCV antigens used in this assay. Patients with acute or recent HCV infections (<3 months from time of exposure) may have false-negative HCV antibody results due to the time needed for seroconversion (average of 8 to 9 weeks). Testing for HCV RNA (HCVQU/83142 Hepatitis C Virus [HCV] RNA Detection and Quantification by Real-Time Reverse Transcription-PCR [RT-PCR], Serum) is recommended for detection of HCV infection in such patients.

RT-PCR:

The quantification range of this test is 43 to 69,000,000 IU/mL.

Negative results indicate that HCV RNA is not detected in the serum.

A numerical result indicates the presence of HCV infection with active viral replication.

Positive results with the comment of "HCV RNA detected, but 69,000,000 IU/mL" indicate that the level of HCV RNA present is above the quantifiable upper limit of this assay.

A single negative HCV RNA result with positive anti-HCV antibody status (assay signal-to-cutoff ratio of > or =3.8 by EIA, or > or =8.0 by chemiluminescence immunoassay), does not necessarily indicate past or resolved HCV infection. Individuals with such results should be retested for HCV RNA in 1 to 2 months, to distinguish between patients with past or resolved HCV infection and those with chronic HCV infection having episodic HCV replication.

Presence of anti-HCV antibodies (assay signal-to-cutoff ratio of <3.8 by EIA or <8.0 by chemiluminescence immunoassay) in individuals with negative HCV RNA results may be confirmed by RIBA/80181 Hepatitis C Virus Antibody Confirmation by Recombinant Immunoblot Assay (RIBA), Serum.

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/60707

[pooh55811]

Just to add to what ActingBrandNew posted, it sound like you may have had some form of Hepatitis in 2002 if you became jaundiced in 2002. Or, you may have been jaundiced for another reason. As ActingBrandNew said, the only way you will know if you have chronic Hepatitis C is through the test that was sent to Germany. Hopefully, you will get that result soon.

However, even if you did have Hepatitis C in 2002, you have about a 20% chance that your own immune system may have fought off the virus. IF your own immune system was able to fight off the Hepatitis C virus, then you will always have positive Hepatitis C antibodies but you will not have the actual disease.

However, if you did have Hepatitis C and your immune system could not successfully fight it off (as happens in 80% of people who contract Hep C), then you would have Chronic Hepatitis C.

So you do have a 20% chance that your immune system fought off the virus by itself. There is also a small possibility that the antibody test you had returned a false positive test. So you really just have to wait and see.

Your ALT is a little elevated but the rest of your lab is not bad.

I looked at the drugs you are on. You are on one for Type II Diabetes and one for Gallstones. The other drug is milk thistle.

If you do have Hepatitis C, the Hepatitis C MAY be causing the Type II Diabetes and the cholesterol problem which is causing your gallstones. You also mentioned fatty liver. There is a relationship between Hep C and fatty liver as well as a relationship between Diabetes and fatty liver.

http://www.hcvadvocate.org/hepatitis/Basics/steatosis.pdf

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Extrahepatic.pdf


"Galvus (Vildagliptin) is a relatively recently approved oral treatment for people with type 2 diabetes. Galvus is often taken in conjunction with other anti-diabetes medications such as metformin, sulphonylureas and thiazolidinediones.

Usually, Galvus is prescribed as a once-daily drug and may often be combined with other anti-diabetic drugs.

Galvus (vildagliptin) should not be taken by those type 2 diabetic patients that have liver problems, particularly liver impairment.

At the start of every Galvus course, people with diabetes should have their liver monitored regularly. Furthermore, patients with renal impairment or congestive heart failure should not take Galvus. "


"Ursodiol is used in the treatment of gallstone disease. It is taken by mouth to dissolve the gallstones.

Ursodiol is used in patients with gallstones who do not need to have their gallbladders removed or in those in whom surgery should be avoided because of other medical problems. However, ursodiol works only in those patients whose gallstones are made of cholesterol and works best when these stones are small and of the “floating” type.

Ursodiol is also used in patients with cirrhosis of the liver. Cirrhosis causes a patient's liver to have problems and not work properly."

http://www.drugs.com/cons/ursofalk.html


Hopefully you will not have Chronic Hepatitis C. However, if you do have Chronic Hepatitis C, keep in mind that it is treatable and it is curable. In addition, if you have Hep C and you are cured, there is a good chance that any of the conditions that it may have caused directly or indirectly, those conditions may improve or possibly even go away.

When you get your result back, if it states that you do have Chronic Hepatitis C, then you should be seen by a Hepatologist (liver specialist) who will do further testing and initiate treatment.

Let us know how your test comes out. Come to the forum with questions and people will respond. Best of luck.

[Kaiser2013]

Thanks a lot pooh55811 and ActingBrandNew . . .  honestly you are angels

I thought its end of story

Is it possible to improve results with medication and change in diet and bring that s/co <1 ?

[pooh55811]

IF you do have Hepatitis C, you can treat with medications. The medications are quite effective. But first you need to find out if you have Hep C. IF you have Hep C then you will need to find out which Genotype you have. Genotype 4 is the most common in Saudi Arabia and the second most common Genotype is Genotype 1. The treatments/medications are different depending on your Genotype. That is why we cannot really tell you much specific information until we know IF you actually have Chronic Hepatitis C and, if you have Hepatitis C, which Genotype it is. After you get the test back we can offer more specific information.

Diet will not affect that ratio.

If the antibody test is a false positive, then it may be negative at some point. But if you have had Hepatitis C at any time in the past, that antibody test will always be positive.

That antibody test only tests for antibodies. If you had Hep C and your immune system fought off the virus, then you will still have the antibodies, but you will not have the disease of Hep C. You will not be sick. You will not be able to give the disease to anyone.

However, if you had Hep C and developed Chronic Hep C, then you will need treatment/medications to cure the disease. Even after you cure the disease and get rid of it, you will still have those antibodies. But you will not be able to give anyone else the disease because you will not have the disease any more.

I don't know if that helps explain anything or not or if it answers your question.

[Kaiser2013]

Thanks a lot. I am really so impressed that you people are so kind and caring. May God keep you always happy and healthy.

Just 3 questions more for now.

Which Genotype is easy to treat?

Can I have any idea what I should expect (no alcohol history)?

If I am tested positive for some Hep c and later medicines cure me, it means I will not transfer this virus to anyone?

[ActingBrandNew]

"Which Genotype is easy to treat?"

"The standard of care (SOC) therapy for patients with chronic hepatitis C virus (HCV) infection has been the use of both peginterferon (PegIFN) and ribavirin (RBV). These drugs are administered for either 48 weeks (HCV genotypes 1, 4, 5, and 6) or for 24 weeks (HCV genotypes 2 and 3), inducing sustained virologic response (SVR) rates of 40%-50% in those with genotype 1 and of 80% or more in those with genotypes 2 and 3 infections.5-7"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229841/

When you have genotype 1 and treat with triple therapy, your SVR rate is much higher than double therapy.

"Boceprevir and telaprevir are the first two protease inhibitors available for the treatment of patients infected with hepatitis C virus (HCV) genotype 1. A sustained virological response (SVR) of 70-80% is observed when either of these protease inhibitors is utilized with pegylated interferon (PEG-IFN) and ribavirin (RBV) in treatment naïve patients. Both agents are also highly effective in patients who failed to achieve a SVR during previous treatment with PEG-IFN/RBV. A rapid virological response (RVR) is observed in 56-60% of treatment naïve patients. Patients who achieve a RVR can be treated with a shorter course of therapy (24-28 weeks) and still achieve a SVR rate of 90% or higher. Patients who do not achieve a RVR, those with cirrhosis and certain prior non-responders should be treated for 48 weeks. Although the SVR rates observed with boceprevir and telaprevir are quite similar both globally and within sub-populations, the treatment algorithms for the two agents are unique. The decision of which protease inhibitor to use should assess several factors including the treatment scheme, duration of therapy, adverse event profile, cost and the likelihood of achieving a RVR. The latter is highly dependent upon IFN sensitivity and the IL28B genotype."

"Can I have any idea what I should expect (no alcohol history)? "

"If you have hepatitis C and also drink — even moderately — you're more likely to develop cirrhosis than if you don't drink."

http://www.mayoclinic.com/health/alcoholic-hepatitis/DS00785/DSECTION=causes

"If I am tested positive for some Hep c and later medicines cure me, it means I will not transfer this virus to anyone? "

If you obtain a sustained virological response (cure) you cannot pass the virus to anybody else.

[pooh55811]

"Which Genotype is easy to treat?"
------------------------

Genotype 2 and Genotype 3 are considered easier to treat than Genotype1 and Genotype 4. Genotype 1 is considered the most difficult to treat. However, there are new drugs out now that have greatly improved the cure rate for Genotype 1. If your test is positive for Hepatitis C, hopefully they will also run the Genotype test so we can then tell you about the medications/treatment. While most of us on the forum have Genotype 1, there are people on the forum who have Genotypes 2, 3, and 4. Also, while many people on the forum are currently in treatment, there are also many who are getting ready to treat, and there are many who have successfully treated. Some forum members from each Genotype have stayed on the forum even though they are now cured. Someone will know the answer to just about any question you ask. One member in particular is quite knowledgeable about Genotype 4. I tell you this to reassure you that there is treatment, that Hep C is curable, and that the majority of people who are treated are cured.


"Can I have any idea what I should expect (no alcohol history)?"
-------------------------------------

I am not sure what you mean by this question. If you can explain what you mean by this question, what you would like to know, maybe I can answer it.


"f I am tested positive for some Hep c and later medicines cure me, it means I will not transfer this virus to anyone? "
--------------------------------------

That is correct. IF you do have Chronic Hepatitis C, and the medication cures you, then you cannot transfer the virus to anyone because, if you are cured, you will no longer have the virus. You cannot transfer a virus to anyone if you no longer have the virus.  

[pooh55811]

I am a slow typist. I see ActingBrandNew has responded while I was typing.

[Kaiser2013]

Many thanks

Alcohol question was just to check whether by not drinking I reduce HepC virus or not.

Can I get advice how to reduce ALT

I test my sugar 3 times a day. What risk my family carry if by chance some drop of my blood is on a cloth or on sugar testing machine and they touch the same.

Should they use same washing machine to wash their clothes that is used by me (if there is some drop of blood on my clothes) . . . . i.e. virus in my blood will how long out of my body to affect anyone else. . . . . I was just thinking that if a drop of my blood is on any place and after some hours (by chance) my family members touch at same place (so will he carry the virus with him/her that can be transferred when he gets a cut on his body)

I am sorry I don't have very good idea about virus and infections.

Can I get a piece of advice as to how much I avoid contact with others to avoid spread of virus.

[rivll]

The only thing you need to be concerned with is blood to blood contact. If a family member simply touches your blood there is no risk unless s/he has an open wound on the area that touched your blood.

Don't share razors or toothbrushes but other than that it really isn't easy to give it to another person.
I had the virus for about 40 years, was married and gave birth to 4 children. At the time I was unaware that I had HCV and as a result, I took no precautions.
It is unlikely you will give it to your family.
Just remember your blood has to be in contact with another persons open wound. Blood to blood.

[pooh55811]

Alcohol appears to increase the replication of the Hep C virus. Therefore, by abstaining from drinking, the Hep C viral replication would be slower than if you were drinking.


"Impact of alcohol on hepatitis C virus replication and interferon signaling"
From World Journal of Gastroenterology

"ALCOHOL CONSUMPTION ACCELERATES HCV RELATED LIVER DISEASE" .....
"Poynard et al[4] extended this study, showing that the consumption of 50 g/d of alcohol increased the rate at which fibrosis progresses in HCV infected individuals. ... At the virological level, Pessione et al[8] found a direct dose dependent correlation between increasing HCV RNA levels and increasing levels of alcohol consumption." ..........

"ALCOHOL MODULATES HCV REPLICATION" .....
"As previously outlined, there is clinical evidence to suggest that alcohol metabolism increases HCV replication and modulates the host response to HCV"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842525/

[pooh55811]

"Can I get advice how to reduce ALT"
---------------------------------
I am not sure how to reduce the ALT, but things that could make it rise, other than Hep C virus, would be alcohol, some drugs, toxic substances.
Therefore, avoiding alcohol, limiting intake of drugs such as Tylenol and some other drugs that may cause liver damage would help. Avoiding toxic substances would help.


"What risk my family carry if by chance some drop of my blood is on a cloth or on sugar testing machine and they touch the same."
---------------------------------
The family member would need to have an open cut and then get your blood into that open cut. My recommendation would be to tell family members not to handle your blood glucose testing equipment. If you have small children, keep your blood glucose testing machine and equipment in a high place where they cannot reach it. Dispose of all needles and sharps in a container that they cannot get into. Also, avoid sharing razors, nail clippers, toothbrushes.


"Should they use same washing machine to wash their clothes that is used by me .....?
---------------------------------
Using the same washing machine is perfectly okay. They are not going to get Hep C by washing their cloths with yours or by washing their clothes in the same washing machine.


"Can I get a piece of advice as to how much I avoid contact with others to avoid spread of virus. "
---------------------------------
You do not have to avoid contact with others. Just don't share razors, toothbrushes, nail clippers with others. If you cut yourself, wash it and cover it with a bandage. Avoid any rituals that share blood. (In the US sometimes young people may cut themselves and touch blood to open cuts in some type of blood brother ritual. Most people do not do this, but I mention it as an example.)

I had Hepatitis C for 36 or 37 years before I knew I had it. To my knowledge, no one ever got Hepatitis C from me. Even after I was diagnosed in 2011 I really did not change anything I was doing. I washed my hands frequently, but I had always done that. I covered any cuts. I just continued my life as I had always lived it.

Hepatitis C is spread blood to blood so you would have to get your blood into someone else's bloodstream in order for anyone else to catch it from you.

[Kaiser2013]

Just moments back received a call from my Doctor that PCR (RNA) Quantitative test is NEGATIVE, then she SMS me too as under
"I got the results (HCV-RNA Quantitative) and its negative - Marilyn"

Scanned Report is on its way but I though it my responsibility to share this news with you all (before reading report in detail.)

Honestly, these 2 weeks have really changed my life . . . .  having worked in consultancy for 20+ years (where every minute is charged) . . . .  I met a lot of so kind people who spent their valuable time to share with me their knowledge . . .  without even knowing who I am.

Just to say . . . . thank you all and May God bless you all with everlasting happiness and health

[Kaiser2013]

Extracts from Report

Specimen: EDTA blood
Infectious Serology
HCV-RNA quantitative (TaqMan-PCR)

negative IU/ml      negative

HCV-RNA not detectable, there is no indication of hepatitis c viraemia

[pooh55811]

This is very good news and I am very happy for you and your family.