Positive HCV and RNA

[diane914]

My 18yold daughter recently donated blood and we just received a letter stating that she is positive for both the HCV RNA and Antibody tests.  Please help - My md is off for the weekend and I need some direction.  It is possible from my past that I am also positive - could she have gotten this during childbirth?  Does this definitely mean she has active disease? Please help

[jmjm530]

Missed the "RNA" part, so if true, then she has Hep C. Was not aware that blood banks tested for the virus itself, so it might be a good idea to get hold of the actual test results and double check that it indeed she was RNA positive but in any event I would do a confirming PCR with a private doc.

[willing]

as emphasized above, a positive RNA test implies active virus.

Between now and Tuesday you might want to look for any available old medical records and check for liver function panels ( AST/ALT levels)  as well as talk to your daughter about possible exposure. HCV infection is often, but not always, accompanied by out of range (high) AST/ALT values. If your daughter has been exposed to no other likely sources of infection, and if you are chronically infected, she may have acquired it at birth and would now also have a chronic infection.

On the other hand, if your daughter has recently contracted the virus her infection might still be in the acute stage.

Treatment strategies for chronic and acute are quite different so your Dr. will likely ask about this.

All the best - and remember that in either case her prospects of eliminating the virus are quite good.

[Isobella]

Just wanted to offer support.  My daughter was also recently diagnosed at 18.  (We had her tested after I was diagnosed) I also had to sit on the information for a few days before giving her the results...so I can relate to what you are going through right now. Ironically enough, when she tried to give blood at school, they wouldn't take it because she had recently had an ACL replacement...otherwise we would have gotten that same letter.

The best part of having some time to digest the information for yourself is that you can do your research and be better informed when you do have to break the news.

I am currently 37/48 in a Vertex trial.  My daughter had her biopsy over spring break---it was a breeze for her and she has decided to treat when the new drugs come on the market. (she is 1/1 with a viral load of 400,000)

Search the forum, the archives and the janus site.  Ask any questions you have.  We are all here willing to help you through this.  

I wish you and your family the best in this. And special (((((MOM HUGS))))) to you. It stinks when our kids are sick =(

Isobella

[Bill1954]

Hi Diane,

Unfortunately, the HCV RNA test is *extremely* specific for the active virus; there is really no chance that she doesn’t have the virus at this point, outside of a possible typo on the paperwork.

The liver specialist will be able to guide you through this, obviously; but in the mean time, you might want to research this a little further. A good site that offers basic Hep C (HCV) information is Janis and Friends:

http://janis7hepc.com/

You might start by clicking on “newly diagnosed” near the top of the page, as well as “other HCV information”, in the right-hand margin.

Be sure to discuss the HCV genotype with the specialist, as well as the new class of HCV treatment drugs known as ‘protease inhibitors’ that are now in late stage clinical trials. These drugs promise to reduce the patient exposure to interferon and ribavirin, as well as shorten the duration of treatment for select genotypes.

This is a lot to take in right now, I’m sure; but it’s all important. Bookmark Medhelp as well as Janis and Friends, and get back to us and let us know how things progress, OK?

Take care—

Bill

[diane914]

Thank you all so much for all your help.  I having gotten the name of a liver specialist who will see us next week, but this forum has helped me with the initial shock of receiving this news via the mail.  It is comforting to know that complete strangers are willing to take time out of their day to alleviate some of my fears...thank you again.

[Trinity4]

As Info:

HCV RNA Tests

Unlike antibody tests, HCV RNA tests directly measure for the presence of the hepatitis C virus. HCV RNA tests may be qualitative or quantitative. Qualitative HCV RNA tests are used to diagnose hepatitis C. Your doctor might choose to perform an HCV RNA test instead of the ELISA, especially if you are at high-risk for hepatitis C. The HCV RNA test will be positive in as little as 1 to 2 weeks after exposure. A positive HCV RNA test means a person has hepatitis C infection.
Quantitative HCV RNA tests allow your doctor to determine exactly how much virus is in the blood. This is referred to as the viral load. The viral load is usually expressed as units per milliliter or copies per milliliter. In patients with chronic hepatitis C infection, viral loads vary widely from 50,000 to 5 million copies per milliliter. A higher viral load may not necessarily be a sign of more severe or more advanced disease but it does correlate with likelihood to respond to treatment. HCV RNA tests can also be used to monitor response to hepatitis C treatment. For example, if the viral load decreases during treatment, this suggests that treatment is working and should be continued. Conversely, if the viral load remains the same, it suggests that the patient is not responding to treatment.

[jdwithhcv]

If she tested positive on the antibody test she has been exposed to Hep C.  Either she cleared the virus (on her own as happens in a small percentage of cases, of through treatment)  or she is infected.  There is really no such thing as "inactive" disease when it comes to HCV.  

[Trinity4]

It's my understanding a postive RNA means active virus but there seems to be a difference of opinion or maybe I'm not understanding what the blood bank meant when they said both antibody and RNA test.  They may have a different terminology.  The RNA test determines what amount of virus is present in the blood.  I don't know the protocol for blood banks so don't know if a donor tests positive for antibodies they automatically do an RNA too.  HCV RNA PCR is the only test to determine if active virus is present.  They should have a viral load number too if indeed they did perform that test.
Sorry, I'm as confused as you are but if it were my child I would definately have her tested again to confirm the postive RNA and call the blood bank asking them to provide you with complete information.

[diane914]

The only information the I was given is that bothe the HCV RNA and Antibody test were positive. It says this means that she has been infected at some time in the past and carries the virus and may transmit it to others.  My question is that does the positive RNA test mean she has active disease.  She is away until Tuesday so I have not told her.  

[Trinity4]

Jim,

Diane stated her daughter tested postive for HCV RNA and antibody?  Don't understand what you mean?

[jmjm530]

No, there's at least a 40% chance she does not have the virus.

Ask your doctor to run what is called a "viral load test" sometimes referrred to as an "HCV RNA PCR" test.

Assuming she has Hepatitis C, there is a very small chance she could have gotten it during childbirth, assuming you have it. Ask your doctor for the same HCV RNA PCR test and put all questions to rest.

-- Jim

[Trinity4]

When you have time to view zaza posted this link which is very informative and will answer all of your questions.

Just to answer a few of your questions:  If you had hepc while your daughter was in utero there is approx a 5 percent chance of passing it to your unborn.

If you feel you may have been exposed to the virus from your past as you stated then you should get tested.

Positve antibody test and postive HCV RNA test you have the virus but make sure you are given a viral load and genotype.

http://www.uctv.tv/search-details.aspx?showID=16056&subject=health

[Trinity4]

HCV RNA PCR is the test for active virus and she was positive. It is very accurate. There is no other test to confirm.  Did they do a genotype and viral load along with HCV RNA PCR?   Did they provide that information as well?

[mar148]

I think she needs additional testing to confirm she has the active disease, some people naturally clear the disease but the antibodies remain.   She needs get tested for the active virus.  You and your family should get tested.  I found out I had the disease the same way as your daughter and did not know how I contracted it.  My family was tested and everyone was ok, so while it is nerve wracking to wait to determine who does or doesn't have the disease you should be tested.

I treated for the disease for six months and luckily have been cured.  So there is options.

mar

[SandDragon]

I got my news the same way I donated blood and recieved a letter in the mail. worst day of my life, or so I thought it was. She being so young, would probably be able to get clear of it with less trouble than most of us older folks. At least that was what i was told by a doctor, but it might be something to do some research on, Age+peginrol/ribavirin maybe theres a report on the positive effects on younger patients. Calm down and dont loose your cool like I did and then found out I had done all the freaking out for nothing. (feel sheepish) a clear head is a more productive head. Good luck and I'll pray for her speedy recovery from this disease.