Chronic or acute Hepatitis C?

[ralk]

27 year old male. I tested positive for HCV Ab around a year and a half ago. I was tested because I was looking to take PrEP (Truvada), which I'm on at the moment (HIV negative). The doctor at the moment told me to get the PCR test, which came back negative. Liver enzymes were fine, so the doctor said it could be a false positive (non- drug user, although MSM). I got tested for HCV three and six months after, the Ab came back positive all times, but the PCR was always negative. However, a year later, my AST got a bit above the upper limit, so the doctor decided to check the HCV PCR again, which this time came back positive, with a count of ~680. I got an ultrasound which found fat infiltration in the liver but nothing else. I saw a gastroenterologist a month later who suggested I needed to go on treatment, so ordered a bunch of liver tests and the genotype. All tests came back fine, except ASMA which gave a 1:20 result, which the doctor said it could be just from the HepC. However, the genotype test couldn't be done because the PCR was negative. I got tested 3 months later and the PCR was negative again. The specialist said that if I still test negative 3 months after, I would be considered to be in the clear.

From what I've read, this is an indication that I might have cleared the infection on my own (if this is the case, lucky me!). However, from what I've read, acute HCV usually clears in the first 6 months. How can I test positive a year after the Ab were detected if it's not a chronic infection? Should I keep testing every 3 or 6 months for the rest of my life or something? Could it be I got infected, cleared it, then go re-infected and cleared it again? Any suggestions, thoughts, advice?

[Clementine02]

My best guess would be that the positive PCR test was a false positive possibly due to contamination of the equipment. It was so low and you have had quite a few negative PCR's. I wouldn't worry about it. Test again in 6 months and if clear, I wouldn't worry at all.

[flyinlynn]

Well the positive antibodies could maybe have been from a prior infection you fought off in the past. I am not a medical person only a fellow patient so this is just a total wild guess.

My thinking is if you still test negative on the test for the virus the HCV RNA by PCR test in a year you don't have hep c.

Bear in mind you will likely always test positive for hep c antibodies.

But my best suggestion is to follow your doctors recommendations.