EXTREMELY WORRIED ABOUT RISK- Tested positive on antibody test

[srk20]

I went in for routine HIV testing last week and my HIV test came back negative but I tested positive for the hepatitis C antibody test. I'm terrified and going through extreme anxiety right now. I am not sexually active in the sense that my boyfriend and I do not have any sexual intercourse. About four years ago I did have unprotected anal sex with my ex boyfriend; realized that it was the worst idea ever and stopped. Is there any way that I could have been infected by the virus 5 years ago and it would not show any symptoms until now? I have had all my liver enzymes tested because I have colon inflammation and all my liver enzymes (AST ALT) were well within range. My doctor said that it could be a false positive because I have hypothyroidism and sometimes the antibody test comes back false positive due to autoimmune diseases. I would really appreciate your help if you could give me any information on my risk and if I have put my current partner at risk if I am infected.

[willbb]

Positive antibody/ Negativa RIBA. It says further testing or evaluation is not needed, so can I rejoice
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correct....

[spectda]

You are one heck of a patient guy my friend!

[srk20]

So am I good to go? I've been looking at http://www.cdc.gov/hepatitis/hcv/PDFs/hcv_graph.pdf

and the 5th line down is my case: Positive antibody/ Negativa RIBA. It says further testing or evaluation is not needed, so can I rejoice even without my RNA results? Or should I still hold out for them?

[Bill1954]

HCV RIBA is considered specific for exposure; from the results you’re providing it appears you were never exposed, past or present. Or I should say at the time the RIBA samples were taken.

The upcoming PCR test results should corroborate this. Here’s an unofficial congratulations in advance of discussing this with your *qualified* medical doctor :o)

--Bll  

[srk20]

Hi Bill,
I still haven't gotten my RNA PCR test results back but I do have some others. The first time I had the HCV antibody test done it was at some random GP that I went to, which came back positive at 2.62. I then went to my Gasteroenterologist who I've been going to for a few months and I got the following test results:

Test results from GP (1st doc):
HCV Antibody 2.62 REACTIVE

Test results from Gasteroenterologist (quest labs):
HCV Antibody 0.12 NON REACTIVE
RIBA (recombinant immunoblot assay) NEGATIVE


So what does this mean? Is it safe to say that I am for sure negative, or should I still wait and hold out for the PCR before I rejoice?

[1oftheclub222]

Hi srk20,
I am in the same boat as you right now, just found out the day before Thanksgiving and waiting for the viral load test resuts and genotype results, I took those on Monday, hoping to know something by tomorrow one way or the other.  At least there are people here to talk to, so that helps with the anxiety.  They have all been where we are at right now, so who better to help and give advice.  Even if it turns out you do have it, it takes a very long time to do severe damage.  My mom got it when she was in her late 20's, she is now 78 and will probably go from one of the other many things she suffers from instead of the virus.  I know every minute seems like forever, but it's only because we are hyper-focused right now.  there is nothing you can do about this situation until you get your results back, so try to breath and do something you enjoy...btw, I am probably takling more to myself then you, ha, it's very theraputic, try it, go to my thread and give me advice...good luck...

[srk20]

I understand what you mean. I'm just confused as to how one test four days ago indicated positive and this new one indicated negative. Is that something that you have seen before? Still trying to hold strong to get the PCR back today.

[Bill1954]

Again, I’m not well versed on antibody testing. From time spent watching others come into this discussion group, patients that receive sc/o results of, say >13.0 usually end up being diagnosed with chronic infection, or they’ve cleared the virus with their immune response during the acute phase of disease.

I imagine you’ll soon find that you were never initially exposed. But there’s a reason doctors order follow up testing to confirm, so hang in there; it shouldn’t take much longer.

If they didn’t explain, the HCV RIBA result confirms *exposure* which suggests infection past or present; basically it rules out false positive antibody testing. However, HCV RNA by PCR results are still required for diagnosis.

--Bill

[srk20]

So I'm a little confused right now. When I went in for confirmatory testing to another dr on monday (my GI instead of my GP who reported my initial result) my GI said that along with the rna pcr and the RIBA test he wanted to just run the antibody assay again. I called back in today to see if any results had come in and the nurse told me that the antibody test came back and my value was 0.12 so negative. Now I'm SUPER confused- my first value was 2.63 and my second value is 0.12. I have one positive and one negative result. I'm still waiting on my pcr and RIBA. What does this all mean? Am I actually negative and was the first one a mistake?

[Bill1954]

No, as I mentioned above I think as the dust settles on this you’ll find you were never initially exposed/infected. Odds are odds though; that’s why we confirm with additional testing.

From my perspective I also realize HCV ain’t the end of the world; if I were somehow reinfected I know I’d  just have to deal with the consequences and treat again for it. Life goes on, eh :o)?

--Bill

[srk20]

While I wait for the results- do you think I should worry, Bill?

[Bill1954]

No, I wasn’t keeping labs then; I was diagnosed in 2004 and didn’t start tracking stuff until later when infection was confirmed.

My liver enzymes had been elevated since the mid-eighties but I didn’t regularly participate in medical care then. When I did, we attributed my elevated liver enzymes to drinking alcoholically at the time.

Yes, we see false positive HCV antibody tests in the forum quite frequently. Again, these tests are designed to screen large segments of population; if someone pops up positive by one of these tests it prevents them from donating blood; further testing sorts out false positives at a later date. Obviously it’s critical to keep this and other infectious diseases out of the blood supply.

Good luck, and try not to obsess over this; the PCR test will be conclusive for active infection.

--Bill  

[srk20]

Bill, when you found out that you were infected- do you remember what your antibody score was? And how long were you infected for? Had the disease affect your liver enzymes by that point? Just trying to understand where I stand because I truly want to believe that I have a high likelihood of getting a false positive.

One more question, in your experience- do false positives commonly happen? Especially with someone who has an sco score less than 3 (2.63 for me) ?

[Bill1954]

Further interpretation of antibody testing is skirting the periphery of my knowledge. If I had to venture a guess I’d agree that based on your results you have a low likelihood of exposure/infection past or present. Again, the PCR test should yield relevant, definitive information for you.

From a personal perspective I was reactive for HCV antibodies and shortly afterward my PCR results indicated positive for active, RNA virus. I engaged in high risk behavior many years ago though, so it wasn’t particularly surprising to me.

I imagine when the dust settles you’ll find you were never exposed, although the PCR testing will settle this shortly.

Best of luck to you, and let us know what you discover-

--Bill

[srk20]

Thanks for the information, Bill. I do have a question though. I read through the material and although I don't know who manufactured the antibody test which was used on me, all I know is that my result is 2.64. I had a look at the chart at the bottom of the page and noticed that all the signal to cut off ratios were treated than 2.64 . Does this therefore mean that I have a strong likelihood of getting a false positive and not actually being infected with the virus? I'm a little confused on how to interpret the cut off ratio values and how to compare them with my value so if you could give me some guidance on that, I would really appreciate it.

Thanks!

[Bill1954]

Here's a link (scroll down to locate the table) to the CDC and it's explanation of the HCV antibody tests and signal to cut off ratios; they vary according to mfgr:

http://www.cdc.gov/hepatitis/HCV/labtesting.htm

Sorry, I can't comment on how autoimmune issues might affect these results. Even if it turns out you were indeed exposed to the virus keep in mind that approximately 25% of patients will clear the virus spontaneously via their own immune response.

The HCV RNA by PCR results will be specific for active infection. Sorry to hear you're dealing with this, and good luck-

--Bill

[srk20]

I spoke to my dr this morning and he told me that my antibody level was 2.63 with greater than 0.8 testing as positive. I've noticed a few places on this forum which say that if a result is <3, it means that it is a weak positive and it could be a false positive. Is this information up to date or is the idea of a "weak positive" old. I'm not sure if there have been advancements with the assays. Please let me know your thoughts. I'll be going in to get a PCR/RIBA test done today but I need to some how hope for the best so that I can get through the next couple of days. Also, I want to mention again that I have two autoimmune diseases and I have heard that the presence of autoimmune diseases can sometimes make the EIA react as a false positive. Does anyone have any experience with that?

[liavera]

Do not worry so much. Have hepatitis C is not a death sentence. If you have, will have to deal with and move on. Not the end of the world. I found out in February and I'm already at an advanced stage. At first I was very worried. But now I'm quiet and early treatment in January. Have faith and always expect the best. If you have, be thankful you have discovered in time to treat
best regards
Lia

[Bill1954]

The HCV EIA antibody test is not considered particularly specific for exposure to the virus. It’s designed to screen large segments of the population in a cost effective manner and relies heavily on follow up testing to confirm the presence of active, RNA virus.

Yes, it’s very possible to  be totally asymptomatic for infection for years, and even decades. Many, if not most of us were unaware we were infected until testing demonstrated otherwise. Approximately 20-30% of patients will develop chronic HCV and their liver enzymes and other lab values will continue in the normal range for many years.

Like everyone else you’ll need to wait for a while to rule out infection via confirmatory testing. It takes 10-14 days to process the ‘HCV RNA by PCR’ test. As Hector SF pointed out, it’s unlikely to contract HCV in the manner you describe. If, in the outside chance you are infected, the disease is now curable in the majority of cases.

Good luck and take care-

--Bill

[srk20]

Thank you so much for your advice, Hector. Now that I really reflect, I've realized that my partner and I did not have anal sex just once we had it a few times and then decided to stop all together. I do not however remember him ever bleeding from his penis before we engaged in those activities. I got the news about testing positive on the Hep C antibody test this morning and my dr did not tell me if it was a hard positive or a week positive. He told me to go into the office tomorrow morning to test with more definitive tests like the viral load. At this point I'm extremely worried and trying to think of all of the events where I could have contracted the disease. I know that the EIA antibody assay is known to react false positive with people who have autoimmune disorders such as hypothyroidism. Do you know anything about this or any statistics? I've never had the possibility of a false positive ever in my life before so I'm extremely worrisome as to whether people really do have false positives on these screening tests, or not. By "would not show symptoms by now" I basically meant that if I did in fact contract the virus about 4-5 years ago, wouldn't it have reflected in my blood results by elevating my liver enzymes or causing liver pain? Or is it possible to go asymptomatic for years and not have any liver damage altogether? I basically have to find a way to get through the next week before I get my viral load tests back and at this point I'm extremely worried and would like some help.

[HectorSF]

I am sorry that you are so worried but I think you are over estimating the chances being infected through sexual relations.

I am not sure what you mean by "would not show any symptoms until now? ". Most people with hepatitis C have no symptoms of being infected until it destroys the liver many decades after being first infected.

First, having antibodies for hepatitis C does not automatically mean you are infected by the virus. It only means you were exposed to the virus sometime in your life. Your doctor should have told you this and had your viral load tested so that you didn't jump to conclusions and worry that you are infected if you are not. You need to be tested to see if you have a viral load. The HCV RNA test. That is the true test of whether you are chronically infected or not.

Hepatitis C is very rarely transmitted via sex relations.That hepatitis C is a sexually transmitted disease is a misunderstanding of the disease. Is is a blood to blood virus.The most efficient way to become infected is through the transfer of blood from an infected person to a non-infected person. Common means such as the following - being stuck by an infected needle as a healthcare worker, via IV drug use, receiving body piercing or tattoos done with non-sterile instruments, being a child of a mother with hepatitis C.

Having had anal sex, once, the odds of being infected by hepatitis C are extremely low.
Firstly: Do you know for a fact that your ex-partner had hepatitis C? There are about 3-4 million persons in the US that are infected. So the chances of your ex-partner even having hepatitis C are very low.
Secondly: Though is is common for the colon blood vessel to rupture during anal sex your partner would have to be bleeding from his penis at the same time. Not a comfortable way to enjoy sex even for people that enjoy hard sex.

If you and your partners practiced "hard sex" where each person is bleeding or blood letting that of course would increase the chances of transmission. But again, both of you would have to be bleeding and there would have to be an exchange of blood through the open cuts.

In the future to prevent yourself from worrying about being infected by HIV, hepatitis B (which is transmitted through sex, hepatitis C, STDs etc. it might be a good idea to think about learning about and practicing "safer sex" which can prevent most cases of sexually transmitted diseases. And has the added benefit of allowing you to enjoy sex without being in constant fear of disease.

Best of luck. Have your doctor perform the correct test so you will know whether or not you are infected. Even if you are. Treatments are available to cure hep C. AS so many on this forum have done ad are doing.
I hope you are not infected after all.

Hector