Aa
Positive antibody test, negative HCV RNA test...
Hello all,
Two weeks ago I tested positive on a Hepatitis C antibody test during STD testing I requested through my doctor. A week after, I tested negative on an HCV RNA test.
I am in a low-risk group for HCV. Never used IV drugs, no blood transfusions, only a few sex partners. I have snorted cocaine a few times in my life, and shared the straw.
During the week I waited to know if I had HCV or not, I read all I could about HCV and what to expect. I'm aware that a single HCV RNA test cannot completely rule out an active infection because viral loads can vary and I should get an RIBA test to determine if I experienced a false-positive or if I had, at one time, suffered from an acute infection and managed to shake it.
My questions:
1) Taking into account my low risk status and the sensitivity of the HCV RNA test how worried should I be about this? What is the real possibility that a test like the RNA could read as negative when it's actually positive? Are there statistics available in regards to the RNA test and its accuracy?
2) I'm going to need to apply for health insurance soon, will a health insurance company requiring medical underwriting deny me because of a lack of absolute proof that I am not HCV positive?
Two weeks ago I tested positive on a Hepatitis C antibody test during STD testing I requested through my doctor. A week after, I tested negative on an HCV RNA test.
I am in a low-risk group for HCV. Never used IV drugs, no blood transfusions, only a few sex partners. I have snorted cocaine a few times in my life, and shared the straw.
During the week I waited to know if I had HCV or not, I read all I could about HCV and what to expect. I'm aware that a single HCV RNA test cannot completely rule out an active infection because viral loads can vary and I should get an RIBA test to determine if I experienced a false-positive or if I had, at one time, suffered from an acute infection and managed to shake it.
My questions:
1) Taking into account my low risk status and the sensitivity of the HCV RNA test how worried should I be about this? What is the real possibility that a test like the RNA could read as negative when it's actually positive? Are there statistics available in regards to the RNA test and its accuracy?
2) I'm going to need to apply for health insurance soon, will a health insurance company requiring medical underwriting deny me because of a lack of absolute proof that I am not HCV positive?
Hey guys,
Thank you so much for responding.
I'm not sure what my sc/o ratio was on my antibody test.
My liver functions were normal when tested.
Thank you so much for responding.
I'm not sure what my sc/o ratio was on my antibody test.
My liver functions were normal when tested.
Do you know your 'signal to cut off ratio' on the screening test? If your score was 'weakly reactive,' meaning between 1 and 3, there is a chance you had a cross reaction with other antibidies in your immune system. i would ask for the 'Riba' confirmation test. This is very specific for Hcv and if neg you do not have Hcv antibody in your blood stream.
you are in a 'low risk' category for hcv. No iv Drugs and no transfusions.
I have a feeling you had a 'weak reactive' score on the screening test and your riba test will be neg. At least, i hope so.
Ask your Pcp for a riba and hope for the best.
you are in a 'low risk' category for hcv. No iv Drugs and no transfusions.
I have a feeling you had a 'weak reactive' score on the screening test and your riba test will be neg. At least, i hope so.
Ask your Pcp for a riba and hope for the best.
Hello!
More than likely, you don't have hep c, just the antibodies...however...Get retested in 6 months and then again in a year, and the following year when you should have a full physical complete with liver function tests...I say this because, I had a "false positive" test (hep c antibodies, 1 RNA strand) two years prior to being diagnosed with hep c (antibodies +, 3 RNA strands present)...I had slightly elevated liver enzymes, but also had gall bladder problems at the time...I do hope you are one of the lucky ones...
~Melinda
More than likely, you don't have hep c, just the antibodies...however...Get retested in 6 months and then again in a year, and the following year when you should have a full physical complete with liver function tests...I say this because, I had a "false positive" test (hep c antibodies, 1 RNA strand) two years prior to being diagnosed with hep c (antibodies +, 3 RNA strands present)...I had slightly elevated liver enzymes, but also had gall bladder problems at the time...I do hope you are one of the lucky ones...
~Melinda
In a nutshell, it sounds as though you were exposed to HCV (leaving you with antibodies), but eventually cleared the virus with your own immune system. This occurs in 15 to 40% of patients; you can probably count yourself as one of the lucky ones. Another scenario could be a false positive EIA (antibody test).
I doubt your health care provider will order a RIBA test; the HCV RNA test will essentially “trump” the need to confirm antibody presence. Here is what the CDC has to say about HCV RNA testing:
http://www.cdc.gov/NCIDOD/DISEASES/HEPATITIS/c/faq.htm#1b1
“…A single positive PCR test indicates infection with HCV. A single negative test does not prove that a person is not infected. Virus may be present in the blood and just not found by PCR. Also, a person infected in the past who has recovered may have a negative test. When hepatitis C is suspected and PCR is negative, PCR should be repeated…”
Given your low risk of exposure, and presumably a lack of other corroborating factors such as high liver enzymes, etc, your doctor will probably either recommend you return in 6 months or a year for a final RNA test, or tell you to go on with your life and forget about this.
1) As far as HCV RNA test performance characteristics, they are considered highly sensitive and specific, although not bulletproof. For more info regarding the accuracy of HCV RNA testing, this excerpt is from Pub Med:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=149605
Performance Evaluation of the VERSANT HCV RNA Qualitative Assay by Using Transcription-Mediated Amplification
“…A preclinical evaluation of a qualitative assay for the detection of hepatitis C virus (HCV) RNA by transcription-mediated amplification (TMA) was conducted according to the guidelines of the National Committee for Clinical Laboratory Standards and the U.S. Food and Drug Administration. Our results showed that this assay, HCV TMA, detected 95% of samples with HCV RNA concentrations of 5.3 IU/ml and 29 copies/ml. HCV TMA showed an overall specificity of 99.6% and was highly reproducible, detecting 99.3% of samples with HCV RNA concentrations of 50 copies/ml across seven different lots of reagents…”
2) Unfortunately, assuming you are indeed antibody positive, these antibodies will be durable and persist for many years, if not for life. You will probably find it difficult to obtain medical or life insurance, as well as donate blood or organs. You’ll want to investigate this though; I’ve heard anecdotal reports of patients overcoming this with the proper letters from their physicians.
This response should bump this post up to the top of the list; someone else might want to comment.
Best of luck to you,
Bill
I doubt your health care provider will order a RIBA test; the HCV RNA test will essentially “trump” the need to confirm antibody presence. Here is what the CDC has to say about HCV RNA testing:
http://www.cdc.gov/NCIDOD/DISEASES/HEPATITIS/c/faq.htm#1b1
“…A single positive PCR test indicates infection with HCV. A single negative test does not prove that a person is not infected. Virus may be present in the blood and just not found by PCR. Also, a person infected in the past who has recovered may have a negative test. When hepatitis C is suspected and PCR is negative, PCR should be repeated…”
Given your low risk of exposure, and presumably a lack of other corroborating factors such as high liver enzymes, etc, your doctor will probably either recommend you return in 6 months or a year for a final RNA test, or tell you to go on with your life and forget about this.
1) As far as HCV RNA test performance characteristics, they are considered highly sensitive and specific, although not bulletproof. For more info regarding the accuracy of HCV RNA testing, this excerpt is from Pub Med:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=149605
Performance Evaluation of the VERSANT HCV RNA Qualitative Assay by Using Transcription-Mediated Amplification
“…A preclinical evaluation of a qualitative assay for the detection of hepatitis C virus (HCV) RNA by transcription-mediated amplification (TMA) was conducted according to the guidelines of the National Committee for Clinical Laboratory Standards and the U.S. Food and Drug Administration. Our results showed that this assay, HCV TMA, detected 95% of samples with HCV RNA concentrations of 5.3 IU/ml and 29 copies/ml. HCV TMA showed an overall specificity of 99.6% and was highly reproducible, detecting 99.3% of samples with HCV RNA concentrations of 50 copies/ml across seven different lots of reagents…”
2) Unfortunately, assuming you are indeed antibody positive, these antibodies will be durable and persist for many years, if not for life. You will probably find it difficult to obtain medical or life insurance, as well as donate blood or organs. You’ll want to investigate this though; I’ve heard anecdotal reports of patients overcoming this with the proper letters from their physicians.
This response should bump this post up to the top of the list; someone else might want to comment.
Best of luck to you,
Bill
OK - here's my suggestion: Rescreen on the HEP Panel --- and if it pops positive again for HCV antibodies - then Rescreen on the PCR (GO HEPTIMAX ok? It's one of the better ones).
IF --- IF you screen UND on the Heptimax - then you probably had an acute infection that you naturally cleared on your own --- this can and does happen.
I don't know what the test results false pos percentages are... But they seem very unlikely to me.
CockSparrow is the better one with percentages and stuff.
The risk factors don't matter. I'm low - to no risk factors --- and I was HCV pos.
About health insurance...
I don't know which insurance company you are going with - each underwriter has different specifications. BUT -- if you are UND --- then you are considered HCV "cured" by a lot of doctors --- talk to your doctor --- or hepatologist regarding this factor...
And whatever doctor you're going to ---- because if you're CLEAR HCV - then they might not even report it.
Me - I'd go for the second round of tests.
Much luck to ya.
Meki
IF --- IF you screen UND on the Heptimax - then you probably had an acute infection that you naturally cleared on your own --- this can and does happen.
I don't know what the test results false pos percentages are... But they seem very unlikely to me.
CockSparrow is the better one with percentages and stuff.
The risk factors don't matter. I'm low - to no risk factors --- and I was HCV pos.
About health insurance...
I don't know which insurance company you are going with - each underwriter has different specifications. BUT -- if you are UND --- then you are considered HCV "cured" by a lot of doctors --- talk to your doctor --- or hepatologist regarding this factor...
And whatever doctor you're going to ---- because if you're CLEAR HCV - then they might not even report it.
Me - I'd go for the second round of tests.
Much luck to ya.
Meki
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
