Confused about Hep. C testing

[melya18]

A  couple of years ago I was tested for Hep. C. The antibody test came out positive and I was informed I had hep. C and referred to a specialist. I told my primary care doctor I wanted retested but she said it was not necessary, she was sorry but I had it. Surprisingly, the specialist ran tests and said I did not have hep. C currently.  I believe the EIA and RIBA tests were positive, but I had no viral load. Of course, I was thrilled.

Now, the nightmare is coming alive again.

I was tested for hep. A, B, C, D because my liver enzymes are abnormal. The hep. C test came back positive. I told the doctor I tested positive before, but she said that the antibody levels were so high, she had no doubt I had it. She wants me to undergo genotype and quantitative testing, but she says I definitely have it.

Does anyone have any experience with it? Could I not have hep. C, but still have high levels of antibodies? No one seems to know anything and I am sick of all of the emotions. I had my whole family tested and I guess I should do it again.

NOTE: I am considered "low risk" for the virus, too. I have not done drugs, had blood transfusions, or any risky sexual contact.

[Bill1954]

Very cool! Good for you…

Bill

[Marcia2202]

A big congratulations!!!

[melya18]

I just wanted to give everyone an update. I had a "quantitative load" and "genotype test" done. Plus, a CT Scan of my liver.

To my doctor's surprise, I have no virus in my system! And, my liver is fine. It must be the medications I take making my liver enzymes elevated.

I am so thrilled! I never have to go through this terrible process again.

Thank you to everyone who helped.

[Jakied]

Melya,

      Did you have a second 'Riba' test?  This would confirm the second + screening test.

If I were you, I would ask for a Riba test to confirm or nullify the + screening test and

a qualitative Pcr to check for actual virus.

[copyman]

not sure of the exact # but if your antibodies are high then there is only a 5% chance you don't have HCV. Your doctor is on the right track to do further testing to confirm. I hope it comes back Neg for you. Best of luck

[Bill1954]

Wow; what an ordeal!

Ok, lets go step by step.

If you tested positive via antibodies previously for the virus, there are a couple of scenarios.

Antibody tests are notoriously inaccurate. They are designed to inexpensively screen large populations, but they have a fairly high rate of false positive results. However, the supplemental test ‘RIBA’ was reportedly positive; this accurately confirms exposure with a high rate of confidence.

If this was the case, at one time you were exposed and infected with HCV. However, roughly 20% of patients that are infected will experience an immune response strong enough to destroy the virus spontaneously; this will occur in the first six months of infection only. After the initial six months, the disease moves from the ‘acute’ phase to the ‘chronic’ phase; at this time, it’s highly unlikely for the disease to resolve itself without treatment.

From what you describe, it sounds as if that was the case originally; your enzyme test was positive, and the RIBA test confirmed exposure and subsequent acute infection. The lack of viral load at that point suggests that your own immune response was sufficient to resolve the virus, leaving you RNA negative (no viral load).

If you now have a viral load, you have either somehow managed to become reinfected, or there was an error with one of the previous lab results. The lack of life style risk suggests the latter.

If you presently have a high sc/o ratio with your antibody results, along with elevated liver enzymes, it’s highly probable that you are indeed actively infected. The HCV RNA test results will confirm this, however. Allow 7 to 10 days for the lab to return those results.

The risk that you might have inadvertently transmitted virus to your family is extremely low; even vertical transmission (mother-to-child) is thought to be less than 5%.

If your HCV RNA test results are positive, then you might reconsider retesting family members, but this is precautionary only; one would not expect them to be infected as well.

Do let us know how things go; and a big welcome to the discussion group as well—

Bill