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Hepatits C antibody positive, negative RNA (please help):
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Hepatits C antibody positive, negative RNA (please help):

Hello, this is for a dear friend. She tested positive for HCV antibody twice so it is correct. She had a RNA test done and it came back negative. 6 months later she had another RNA tets done and it is also negative.

-Her liver enzymes still remain slightly high. Could this be due to the HCV.

-I heard about occult HCV where it remains in the liver and such even though RNA is always undetectable. Could this small form of HCV affect the individual and may cause her enzymes to be high. Will this occult HCV cause her problems in the future that is similar to chronic HCV or not as bad since the RNA is undetectable.

-If she does have some occult HCV in her, can she pass it on to her partner or even a child when giving birth.


thank you all, I love my fiance so much and wnat everything to be alright. I believe people here are more knowledgable than the doctors and really would like your help.
22 Comments Post a Comment
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1280753_tn?1367761532
I googled it and found this:

Background

Occult Hepatitis C virus (HCV) infection is a new pathological entity characterized by presence of liver disease and absence or very low levels of detectable HCV-RNA in serum. Abnormal values of liver enzymes and presence of replicative HCV-RNA in peripheral blood mononuclear cells are also observed. Aim of the study was to evaluate occult HCV occurrence in a population unselected for hepatic disease.
Methodology/Principal Findings

We chose from previous epidemiological studies three series of subjects (n = 276, age range 40–65 years) unselected for hepatic disease. These subjects were tested for the presence of HCV antibodies and HCV-RNA in plasma and in the peripheral blood mononuclear cells (PBMCs) by using commercial systems. All subjects tested negative for HCV antibodies and plasma HCV-RNA and showed normal levels of liver enzymes; 9/276 patients (3.3%) were positive for HCV-RNA in PBMCs, identifying a subset of subjects with potential occult HCV infection. We could determine the HCV type for 8 of the 9 patients finding type 1a (3 patients), type 1b (2 patients), and type 2a (3 patients).
Conclusions

The results of this study show evidence that occult HCV infection may occur in a population unselected for hepatic disease. A potential risk of HCV infection spread by subjects harbouring occult HCV infection should be considered. Design of prospective studies focusing on the frequency of infection in the general population and on the clinical evolution of occult HCV infection will be needed to verify this unexpected finding.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0008128

read more:
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Avatar_m_tn
Well I see this is now the second thread on this in a few hours. Why?
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You were asking the same exact thing three and a half years ago??? I think its safe to assume she is fine.

http://www.medhelp.org/posts/Hepatitis-C/What-is-the-difference-between-SVR-and-undetectable/show/971785#post_4547581

http://www.medhelp.org/posts/Hepatitis-C/HCV-positive--RNA-negative--high-liver-enzymes/show/971795#post_4547623
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766573_tn?1365170066
You specifically stated "positive antibody and negative RNA"  yet Occult HCV is a rare phenomenon where the opposite is the case:

"....presence of HCV RNA in the liver ..... infection despite the absence of detectable serum HCV RNA and antibodies."
______
Occult HCV infection is a form of chronic HCV infection characterized by absence of detectable anti-HCV antibodies or plasma HCV-RNA but presence of HCV-RNA in liver biopsy and/or peripheral blood mononuclear cells (PBMCs).

http://www.ncbi.nlm.nih.gov/pubmed/21458706

http://www.antibodychain.com/content/prevalence_occult_hepatitis_c_virus_infection_iranian_patients_lymphoproliferative_disorders

http://www.wjgnet.com/1007-9327/12/6922.asp
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Avatar_n_tn
I understand, but why are her enzymes still elevated 3 years later. Perhaps the little hepatits c that is in her liver is causing damage.

Thats what I meant by Occult.

-Do you know what is the prognosis for someone with Negative RNA/Undetectable? Is it as long as someone who doesnt have it at all?

-I also read a study by I believe someone from Spain (I want to say Castillo) that talks about Occult HCV and how over a long period of time it was spread to family members. I thought if you have no RNA, you cant spread it to someone else?

Here is the article. It is long but I will post it:






Hepatitis C virus infection in the family setting of patients with occult hepatitis C."

Family members of patients with chronic hepatitis C virus (HCV) infection are at increased risk of HCV infection but the prevalence of HCV among family members of patients with occult HCV infection is not known. Anti-HCV, serum HCV RNA and levels of liver enzymes were determined in 102 family members of 50 index patients with occult HCV infection and in 118 family members of 59 chronic hepatitis C index patients. HCV RNA and/or anti-HCV were detected in 10/102 (9.8%) relatives of patients with occult HCV infection and in 4/118 (3.4%) of patients with chronic hepatitis C. Fourteen additional family members (seven were relatives of index patients with occult HCV infection) had abnormal values of liver enzymes without serological markers of HCV infection. Two of these patients (who were relatives of two index patients with occult HCV infection) underwent a liver biopsy and were diagnosed with an occult HCV infection because HCV RNA was detected in the liver cells in the absence of serological HCV markers. In conclusion, the prevalence of HCV infection among family members of patients with occult HCV infection was similar to that found among family members of patients with chronic hepatitis C. This stresses the need to adopt strategies to prevent the transmission of HCV in the family setting of patients with occult HCV infection.

http://www.ncbi.nlm.nih.gov/pubmed/19475603?ordinalpos=2&itool=Email.EmailReport.Pubmed_ReportSelector.Pubmed_RVDocSum


The same group has another paper listed ahead of publication:

"Hepatitis C virus replication in patients with occult hepatitis C virus infection."

http://www.ncbi.nlm.nih.gov/pubmed/19475689?ordinalpos=1&itool=Email.EmailReport.Pubmed_ReportSelector.Pubmed_RVDocSum



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Avatar_n_tn
Guys and Girls in the community, I am sorry if I am bothering, but please see if you cna help me.

Basically if someone has no RNA, but positive HCV antibodies, with elevated liver enzymes:

-is damage being done in the liver the same as a chronic hcv with elevated enzymes

-is it just as bad as having chronic HCV

-Is it contagious as it was in the study.


thank you. I thought no RNA means it isnt affecting the perosn who has the posiitve hcv because there is nothing there to affetc them, and that they cant spread it since there is nothing there to spread.


Maybe I am wrong? Not sure please weigh in.
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1747881_tn?1358189534
Two of these patients (who were relatives of two index patients with occult HCV infection) underwent a liver biopsy and were diagnosed with an occult HCV infection

Has she had this done to confirm she has an occult HCV infection or are all the questions just about theory and what if's
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Avatar_n_tn
no, just basically posiitve hcv antibodies and negative RNA tests. But elevated liver enzymes.

I am scared she got this at birth or a younger age. She is 25 now. Maybe she has had this for like 20 years and now the liver is showing signs of the end.

Wouldnt she have some RNA if that was the case?

Thats why I ask if RNA is negative, for people on this board that have "cleared" it and are RNA negative for many many years, how has your prognosis bene like (liver enzymes, liver biopsy results, etc).
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1747881_tn?1358189534
"no, just basically posiitve hcv antibodies and negative RNA tests. But elevated liver enzymes."
--------------------------------------------------------------------------------------------------
Is it possible for someone to become infected with HCV and then spontaneously clear the infection?

Yes. Approximately 15%–25% of persons clear the virus from their bodies without treatment and do not develop chronic infection; the reasons for this are not well known.

http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c5

What to do if the Hepatitis C Antibody Test is Reactive
•If the Hepatitis C Antibody Test is reactive, an additional, follow-up test will be needed to see if the Hepatitis C virus is currently in the blood.
•If the additional blood test is:

Negative—this means a person was infected with Hepatitis C, but the virus has now been cleared from his or her body.
Positive—this means a person currently has the virus in his or her blood and is chronically infected.

http://www.cdc.gov/knowmorehepatitis/LearnMore.htm

Elevated liver enzymes

Causes
By Mayo Clinic staff
Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.

More common causes of elevated liver enzymes include:

Certain prescription medications, including statin drugs used to control cholesterol
Drinking alcohol
Heart failure
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Over-the-counter pain medications, including acetaminophen (Tylenol, others)

Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (liver inflammation caused by drinking alcohol)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cirrhosis (liver scarring)
Cytomegalovirus (CMV) infection
Dermatomyositis (inflammatory disease that causes muscle weakness and skin rash)
Epstein-Barr virus
Gallbladder inflammation (cholecystitis)
Heart attack
Hemochromatosis (too much iron stored in your body)
Hypothyroidism (underactive thyroid)
Liver cancer
Mononucleosis
Muscular dystrophy (inherited disease that causes progressive muscle weakness)
Pancreatitis (pancreas inflammation)
Polymyositis (inflammatory disease that causes muscle weakness)
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)

My advice is to take her to the doctor to figure out why she has elevated liver enzymes

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1280753_tn?1367761532
you either don't understand the answers that you have been given, or don't want to accept them....as hrsepwrguy suggested, seek the advice from a medical professional.
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Avatar_n_tn
I believe the doctors are tlaking along the lines of you guys where they are treating it as a fatty liver disease. They cant treat Hepatits C RNA if it isnt there. But the fact that she has high liver enYmes makes me believe it is affetcing her some way.

-Do you think a biopsy is in order to see how bad the liver is. I am very afraid it may be at a very advanced stage.

-If RNA levels are undetectable, cant harm still be done and is it at a same level as chronic type?

I pose the quetsion about HIV. If  a perosn has positive HIV antibodies, can they get their RNA undetectable after taking medications. Are they still contagious and will they eventually progress to a worse stage?
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1747881_tn?1358189534
"If RNA levels are undetectable, cant harm still be done and is it at a same level as chronic type?"

If there is no RNA there is no HCV to do any harm

"I believe the doctors are tlaking along the lines of you guys where they are treating it as a fatty liver disease"

Perhaps you should leave the diagnosing to the docs and if you are unable to do that I would suggest you get help for your anxiety because from reading your prior posts it would seem you are more worried that you may get HCV from this person, which by the way she doesn't have!!!

"I pose the quetsion about HIV. If  a perosn has positive HIV antibodies, can they get their RNA undetectable after taking medications. Are they still contagious and will they eventually progress to a worse stage?"

For your HIV concerns follow the link

http://www.medhelp.org/forums/HIV-Prevention/show/79
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Avatar_f_tn
If she is positive for Hep C antibodies, then she had Hep C at one time.  If she is negative for Hep C RNA, then she does not have Hep C.  However, if her liver enzymes are elevated, she should be seeking medical diagnosis and care for whatever may be causing her liver enzymes to be elevated.  She may have another type of viral hepatitis, she may have HIV,she may have Cirrhosis, she may have fatty liver, or many other diseases that can cause elevated liver enzymes.  It's important for her to get a diagnosis and be treated by a hepatologist or a gastroenterologist as soon as possible.  She won't know if she's contagious until she finds out what's causing the elevated liver enzymes, but it isn't Hep C from what you're telling us.  Other diseases that cause elevated liver enzymes can also be contagious and can cause liver damage as well, so it is important that she be seen by a qualified doctor.
Advocate1955
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Avatar_m_tn
Can i get ur gsm
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Avatar_n_tn
hello shesna

what is a gsm and why do you want it?
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Avatar_m_tn
i mean phone no ...i hav som doubt abt Anti HCV...HCV& RNA..
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Avatar_n_tn
sorry as I do not feeel comfortable talking by phone. But you can message me if you want by inbox or post here...

please let me know

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Avatar_m_tn
This question for One of my family friend during his gulf medical ,the result found he having anti HCV reactive--the count was it wil be 2.09 something like dat ...aftr 3 mnths it wil be 1.59 and 0.98 accordingly and  in Liver fuction test[LFT] the SGPT was around 45....

After couple weeks he sent some blood for  RNA test.the result was negetive..it was below 1

Wat these all report says..Is he HCV patient?
Wat is the diffrnce Anti HCV,Reactive ,HCV positive.RNA ??

If he have any problems, Is der any treatment??

Plz help us..........
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Avatar_n_tn
Hello Shesna

I understand your concern, but perhaps it is best for others on this forum to help you as they appear to have more knowledge

From my understanding your friend should have a repeat test for RNA in 6 months. If he is still undetectable perhaps he cleared the virus on his own. Your friend will probably test positive for antibody always, but negative for RNA.

From my understanding it is the RNA that is important. Whether or not at a lower level having just antibody and no RNA affects your friend's liver, I dont know. From my understanding the goal of treatment for someone with RNA is to decrease it to undetectable levels; so if he doesnt have any that is a good thing.

As for those numbers listed, it is best if someone else here can talk about those numbers as I am not sure what they represent.
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Avatar_m_tn
Tnxxxxxxxxx a lot
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Avatar_n_tn
Ok so I went to the Dr. with her for a scheudled appointment today. She actually had a blood test done in Sept of 2012, and the liver enzymes were in range

alkaline phosphatase: 67
ast: 17
alt: 25
bilirubin: .3

Her last RNA test was done in December of 2011 and was negative

She did have the results from an endoscopy from November 2012 and it said that her liver is mildly enlarged and homogenous at 19.0cm. The doctor feels that this is due to her weight issues since the enzymes were normal and such...

I wanted to ask

-what do you make of the mildly enlarged liver at 19.0cm. One doctor said that with hepatits c the liver anctually shrinks, but what do you think of it?

-Second, the doctor said that if we wanted an RNA tets we could have one since it has been a yera. At first he said quantitative; but then his supervisor said do qualitative with genotype? Is this the less better one and why would he aks for genotype of he says she doesnt have Hepatits C?
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1747881_tn?1358189534
"Is this the less better one and why would he aks for genotype of he says she doesnt have Hepatits C?"

Either will be just fine for a confirmation (+ or - result), the test they want to run is called RNA with reflex to genotype, meaning IF she is positive it will automatically do a genotyping, not because they think she is +

"Her last RNA test was done in December of 2011 and was negative"

Unless she has had some kind of risk exposure since that date there is no reason to test, it is a waste of time, money and worry, YOUR FRIEND DOES NOT HAVE HEP C, you could better serve her by realizing that and moving on
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Avatar_n_tn
Thanks for the answer

but what about her having a mildly enlarged liver at 19.0cm

any input regarding this and the measurement?
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