Inconsistent Test Result Past the 6 Month Mark - Please Help

I have had some really unsual test regarding Hep C and I am suffering a lot of anxiety:
Below is the chronology.

July 5 2007 -  Possible exposure
Jan 2008 - Reactive Hep C anitbody test
Jan 2008 - Negative RNA PRC test
March 2008 - Non-reactive Hep C anitbody test
August 2008 -  Reactive Hep C anitbody test

My doctor thought my first positive antibody test was a false positive since it unlikely the RNA PRC test would come up negative at 25 weeks, the time when infection is usually chronic.

The subsequent non-reactive anitbody test at 36 weeks confirmed his false postives suspicion...
or so we thought. Now over a year later from any possible risk, i once again get a reactive antibody test.

Any ideas?  I had a Hep A and B vaccine in April 2008...could this be causing the reactive antibody test?  Could it be a lab error? False Positives?   Could I have cleared the virus?  I find it very odd I would get a neg antibody and RNA PRC test months 3 months apart if I was indeed positive for hep C.

Any thoughts are greatly appreciated!

[Trinity4]

If you had all the tests done at the same lab -  I would switch labs.  Don't know about the possible effect  A & B vaccine would have on the hepc test.  If you tested positive for antibodies in 2008 and the same month negative for active virus -  you would have more than likely spontaneously cleared between July 07 (or before cause you really don't know) and Jan 08.  But then to have a negative antibody in March 08 and postive in Aug 08 is very confusing.  I would indeed find another lab.
Trin

[Bill1954]

Assuming you’re under the care of a primary care doctor at this point, you might suggest he consult with a hepatologist for further test result interpretation.

I’m not very familiar with HCV antibody results, but the s/co ratios (signal to cut-off ratios)  might be of some help, and the average PCP  is probably incapable of interpreting this data. A little more on this subject:

http://www.cdc.gov/ncidod/diseases/hepatitis/c/sc_ratios.htm

Hopefully, others will chime in with some thoughts as well. PCR results are considered very specific; and should be accurate in the absence of test contamination. You most probably don’t have active virus at this time… a substantial percentage of those infected go on to clear the virus in the first six months via their own immune response.

Best of luck to you sorting this out, and let us know—

Bill

[jmjm530]

Sounds like you need another viral load test. I'd ask for a very sensitive one such as Quest's "HCV RNA QUALITATIVE TMA". It's sensitive down to 5 IU/ml.  An UND should put the matter to rest,  but as Bill suggests, consulting with a liver specialist (hepatologist) is always a good idea.

[jh240]

Thanks to those who responded.  This brings me some level of comfort until I can get more definitive testing. Based on all my reading, my results are hopeful yet confusing.  I was theorizing that either:

(A) I cleared the virus (but that doesnt explain the non-reactive antibody at week 36)

OR

(B) The two reactive antibody tests at 6 months and 15 months were false postives.

My liver enymze have shown no elevation ever, so I am told that is a good sign.

My big fear is that the lab messed up my tests and I ended up with false negatives but how likely is that to happen to the same person twice in a row?

Thanks,
JH

[jmjm530]

Given no enzyme elevation, my money is on "B", but why guess when you can test for the virus. But as long as we are guessing, do you want to share what type of exposure you had? You do understand that HCV is blood-to-blood and not via causual contact.

[jh240]

The exposure was unprotected intercourse with someone I was dating..lots of regret.

[Trinity4]

Very Very low possibility of contracting the disease sexually unless it was very rough unprotected sex with vaginal bleeding.  No usually the way this disease is transmitted.
Trin

[jh240]

Yeah, there was bleeding :(

[Trinity4]

Typically, an open wound or sore would have to have been present for the blood to enter your system.  

[dynamo17]

theres no way you have it if you had a negative PCR at that time frame