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Indeterminate Test Result
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Indeterminate Test Result

Hello - First off, I decided to get a Hep C test done a month ago under the impression that Hep C is an STD.  I had had an unprotected sexual experience six months prior to doing the test (and no sexual activity at all in that period).  Now, it appears that whether or not it is an STD is still up for debate.  Or is it?  Or is it not?  Or is it?  Anyways, I found out I am LOW RISK for Hep C.  All of the standard groups of people that should be concerned.....well, I fit absolutely none of those.  Secondly, the person I was with had tested negative to Hep C three years prior to our experience (but he has lots of blood issues - not infectious - that's why he had the test) and he, as well, fits none of the at-risk groups.  So, where I stand at risk is the possibility that he were infected somehow in that 3 year period and that somehow i could have gotten it sexually from him.  

NOW:  My test came back indeterminate.  EIA was reactive (under 4.2).  This was a huge shock for me, as I was expecting a negative.  The RIBA was indeterminate.  This got me freaked out and so, without the consultation of an infectious disease specialist, started going test-crazy.  I went through a tortuous six months after that initial experience worried I had any and everything (HIV came back negative after five months).....so when I get the indeterminate it makes that already paranoid anxiety level get higher.  In turn, this makes me want to just get done with all of it.  I was informed that "indeterminates" can continue in multiple tests until you find out what's "going on" with your blood.  I was also informed of the HCV RNA (or is it PCR?  is there a difference?)  I was told this would be the sure shot in giving me a definitive, quick, and EXPENSIVE answer.  I am told my results should all come in tomorrow.

my question:  i have been reading various internet info. on this RNA/PCR stuff and that it is very possible for these to come back as false-positives (especially for low-risk people?)  This is disconcerting now.....for one, this test is supposed to be conclusive, right?  Second, how could a test which measures a viral load give a false-positive?  0 would mean negative, right?

In my mind, it seems even less likely that I could have gotten Hep C in any way in the past six months and in my whole life.......there seemed more possibility for the HIV despite the sexual partner being recently tested for HIV (negative).....so now that the HIV came back negative, this HEP C seems the LEAST possible.  yet, it's that mysterious "INDETERMINATE" which is almost worse......it leads to other questions.  Does anyone else out there go back and forth in their minds where they know they have it/know they don't have it?

Sorry for my long message - wanted to let anyone informed know the situation fully if you have any input.  I have a feeling now that the RNA would not have been recommended for me from a professional, mainly because I am at such low-risk.  I have a feeling I should have done a second antibody test after a while.  

So if you can retrieve all my questions from all of this, I would greatly appreciate any feedback.......

thanks!
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10 Comments Post a Comment
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Avatar_m_tn
if that test comes back negative then you do NOT have HCV. move forward and start enjoying life again.
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717272_tn?1277594380
The initial screening test for antibodies can come back with unclear results or as a false positive.  Retest to put your mind at ease.  There is a second test called RIBA that can confirm or set aside a poor antibody test.  Don't move on to the expensive PCR test if the others come back negative.  A negative test means they looked and did not find any antibodies that your body made in response to the virus, so you are in the clear.
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Avatar_n_tn
yeah, the EIA was "reactive" and the RIBA was "indeterminate".  But it was a very low reaction level for the EIA.....
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971268_tn?1253204399
Hepatitis C is very unlikely to be sexually transmitted, unless there is exchange of blood.
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96938_tn?1189803458
For a little definition, HCV RNA is what is being seached for.  The PCR is the test. More accurately PCR is a test methodology; 'Polymerease Chain Reaction'.  The HCV test result could be quantatative (a count of the little buggers in a crazy internationl unit -based result) or qualatative (positive or negative).  There are a whole gaggle of different PCR tests (different labs).    This should be the last one one that will tell the tale.
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Avatar_f_tn
How often does indeterminate become positive?  I ask because I got the same news as the person who wrote this (EIA reactive, RIBA indeterminate) and am currently waiting an agonizing 3 weeks for the results of another test.
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Avatar_m_tn
perhaps i can shed some light on this.  when the screening test is 'reactive' (meaning a

signal to cutoff ratio>1),  a confirmatory Riba test is used.  the screening test is VERY

sensitive, so it can pick up antibodies which are not antibodies to Hcv.  there is

always the chance a reactive screening test will be false pos (Enzyme linked screening

tests have this problem).   the Riba confirmatory test is VERY SPECIFIC for Hcv.

It 'looks' for the 5 markers of Hcv.  findng none of the markers is a neg riba, finding

any one of the 5 is indeterminate riba and finding any 2 of the 5 is positive riba.

A positive riba is certain proof of a prior infection with Hcv.  A pos Riba does NOT

mean a person has HCV.  It does mean you have the antibodies for Hcv.  patients who

'clear' Hcv, either through teatment or  by their own immune system ( a few lucky

people clear on their own) will retain the hcv antibody for a LONG time, probably the

rest of their life.

sexual transmission of Hcv is rare but is possible.

Indeterminate Riba puts you in Limbo.  For sure, you need another test, either Riba

or Pcr qualitative.  If I were you, i would contact an internist who can tell you what needs

to be done now.

Do you know which of the 5 markers your riba tested positive?  Depending on which

one is positive, that can predict your Pcr result with fairly good accuracy.

If you can find that out, let me know.  i have the riba info about the 5 markers at home

and i will be glad to help you.  call the testing laboratory and ask about that.

There is a good chance you are not infected so hope for the best.
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Avatar_m_tn
your 5 month neg Hiv test is golden .  NO worries there.  BTW
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Avatar_m_tn
'An indeterminate Riba may represent a true Hcv infection, depending on the pattern

of the Riba.'

20% to 50% of indeterminate Riba tests with pos C22 OR C33 marker are hcv pos

by Pcr.

Almost no indeterminate Riba tests with pos C100-3 OR 5-1-1 marker are

hcv pos by Pcr.

Remember, an indeterminate Riba is positive on ONLY one of the markers.

Pos riba is positive on ANY combination of 2.

Pos riba means you have Hcv antibodies in your blood stream.  So you have a present

OR past infection.  Pos Riba does NOT mean you have Hep c virus.  Only a Pcr test

can confirm presence of the virus.
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