recently tested pos hep C

[Javi1962]

I went to the doctors office and this is the results from lab, not sure how to read so I will post comments:

HCV lgG AB         Reactive*

HCV lgG AB S/CO Ratio     >11.0

S/CO Ratio
Nonreactive:    11.0

Specimen is highly reactive (S/CO ratio > or = to 11.0). Confirmatory test be RIBA is not indicated. This immunoassay test was performed on the Siemens Advia Centaur system using two HCV recombinant (c200 and N55) antigens and synthetic HCV core (c22) peptide. Assay performance characteristics have not been established when the Siemens Advia centaur HCV assay is used in conjunction with other manufacturers assays for specific HCV serological markers.

_____________________________________________________________________


AST / SGOT                 27
ALT / SGPT                 38

P6 - enzymes


comments: no liver problems, Regular report in 1 year



don't know what any of this means, please help me, not sure what I should do next, doctor said, since my liver is normal enzymes, I am not ACTIVE hep C and the insurance will not refer me to specialist, he said I don't need one at this point.

this is the only test I have taken, no viral count or geno type, idk.... :(

[Marcia2202]

Hi, you need to undergo further testing to determine if you have hep c or not. Since your doc doesn't seem to know what he's talking about, I would go to another doctor and ask him/her to check for Viral Load and genotype. If the Viral load and genotype come back negative, then you do NOT have hepatitis C. This is the only way of finding out.

The preliminary test for antibodies doesn't say anything else than that you have antibodies. You can have them if you have hep c or if you had hep c and cleared it yourself. If you test negative, doctors will usually test again in 6 months, just to be sure.

Low liver enzymes are not a marker for having the disease or not. Many people, like myself, have low liver enzymes for years without being diagnosed. I had it for over 25 years and my enzymes were always normal. Until last year.

Many people have low liver enzymes until actually diagnosed with cirrhosis.

Go to another doctor. It is great bullsh1it that he does not want to do further testing.

[RamsBaby]

17 years ago I was also told since I had no viral load that I had dormant Hep C. I'm now a Stage 2/Grade 1. My liver enzymes were also normal then. I'll be starting treatment next month.

Usually a RIBA test is performed as well as the antibody test, if thats positive you do have active HCV. Then a HCV RNA PCR is done to check for viral load.

I would get another opinion. Had I been diagnosed properly I could have treated before damage set in. But the norm seems to be damage first then diagnosis.

[Javi1962]

thanks for the advise guys, I am going to call my provider to see what I can do, in the long run if they dont help me to catch things early it's just going to cost them more to pay for it.

on my test it says "highly activate" do you know what that means?

[Marcia2202]

You see, that's the problem. They come up with expressions like 'dormant hep c'. I don't know where these docs get it from. Dormant hep c doesn't exist. Either you have it or you don't. These kind of docs don't know anything about hep c.

[RamsBaby]

I was diagnosed in '92. New doc seems to think that back then not much was known about HCV. At that time I had BW done, all normal. An MRI was also normal.
Between now and then I've developed the viral load, I've always tested positive for the antibodies, it wasn't until my LFTs came back abnormal that a doc cared.
Now I know there is no such thing as "dormant" HCV.

[Javi1962]

do you know what "highly reactive" means? that does not sound good! on my antibody test result

[Shehabi]

As far as i know reactive means negative so it means that you do have it, i really need you to download the following presentation file and take a close look at it, it will help you.

http://www.filefactory.com/file/a09g77h/n/HCV_Management_October2009_rar

also you need to look for a DR. in your area, maybe some here from your area can guide you with this but, if you start early you can get this sorted with no complications that you don't want to go through, im not really expert but i read, try to learn and help

check out the above file and then you'll know more about it.

[Isobella]

I posted this link on your other thread, but I think it may be why your doc is thinking you don't need any further testing....

http://www.turkjbiochem.com/2007/051-054.pdf

Bottom line...ask for a Quest Heptimax.  Straight and simple.  If insurance doesn't pay, it costs $440.00 here in Florida.

[Javi1962]

I went on a website where I can ask a question, I asked the same question I asked on this site, That i tested positive for hep c and showed DR test results, I asked if I could be positve for hep c antibody but not virus, he seems to say I have it and he later replied I should do the PCR test but only so I can measure viral load, but he said I have it from the first test, see below, what do you think?

Hi,
Welcome to JustAnswer!
You have chronic hepatitis C infection.
The liver enzymes are within normal limits which indicates that there is no active inflammation going on in the liver.
The S/C ratio is used for confirmation in low positive cases.
If it is less than 3.8 additional confirmatory test should be done to confirm HCV infection.
Since your S/C is more than that you do not need any additional confirmatory test.

[Marcia2202]

I replied to your pm.

No matter what, get a PCR done. Your doctor should agree to it. Especially if he thinks he is so sure that you have hep C. You will need to know your genotype and viral load. If they come back negative, you will know that you don't have hep C.

[Javi1962]

this is a physician online that answers questons, this is my reply queston:

Don't I want a PCR test to confirm virus? Someone had told me that Elisa test just means that at one point I had been infected with hep c but that my immune system could have naturally got rid of it, and that many people have the antibody but not the virus, only the PCR test can confirm for sure that i have actual virus, is this true? also my doctor said I was positive Hep C but was not active? I asked to see specialist so I can start treatment if I do have hep C, is this not what I should do?

this is Dr. answer:
There is no need for any confirmatory test as your S/C ratio is quite high.
The next step is to quantitive assay of RNA ( with PCR). This estimates the viral load.
Based on the levl treatment with Peg interferon and ribavirin will have to be started.
Consult a gastroenterologist/hepatologist for further workup.

[Marcia2202]

Okay, I'm not 100% sure on those numbers and the S/C ratio, but he gives the same advice as we did.

Get a PCR to determine the viral load and do the genotyping. They usually do it at the same time with the same vial of blood.

Then you will know for sure.

And please don't panic. We have all gone through this here and we will be here to help you.

[nygirl7]

Between now and then I've developed the viral load,"

Probably you have always had that viral load just back then the tests were not nearly as sensitive as they are now so they did not see it in the results.

and Javi again - get the PCR test then you will know for sure one way or the other. If you test positive for the antibodies the healthcare provider really cant refuse you to take it, it's the first of many steps that should be followed.

[Javi1962]

I have an appt to see the GI doctor on Tues 17th, I will keep you posted.

thanks, Everyone!

[Marcia2202]

Good luck with your appointment.

I suggest you write down all the questions you have prior to your appointment. Most of us tend to forget stuff by the time we're in their office. Try and read up as much as you can digest, so you are a a bit more prepared and understand what the doc is saying.

I also took notes of what the doc replied on my first visit.

[Javi1962]

today is my doctors appt. I am going to tell him I want the PCR test to see if I have the virus, they seem to be very convinced I do because of my anitbody test >10 count is highly activate, any other questions you think I should ask? i am drawing a blank

[Bill1954]

If they’re going to draw for a PCR, they might as well order the test to ‘reflex to genotype’. This will instruct the lab to run genotyping if, and only if, the sample tests positive for HCV RNA (active virus). The genotyping will be necessary anyway, if you are truly infected; if you aren’t infected, then there’s nothing to lose by ordering the test this way.

Be sure to request copies of all the lb results; these will help you communicate more effectively here, as well as with other specialists that you might come across.

You can try to discuss treatment options, but it’s still a bit early in the game for that. You might also discuss transmission; I think you had questions about sexual activity in a prior post? This is an opportunity to get authoritative info.

You might also discuss whether this doc prefers biopsy on RNA positive patients; this will be another pertinent question if positive.

Good luck, and let us know how things go—

Bill

[Javi1962]

Just got back from my appt with GI doctor, he was like 100 years old, well maybe like 70, after asking my questions he said that there is no such thing as testing positve for antibody and negative for virus, he said if your + for antibody you are for virus, he said that only applies to hep B you can have antibody but not virus not C.

then he set me up for Viral load and geno type test, I should get those results back in 5 days.

[Bill1954]

Congratulations! I thought you said your referral was to an internist; not a GI?

I think there’s some confusion somewhere; I can’t imagine a medical doctor stating that we cannot be HCV antibody positive, RNA negative. This describes  the status of anyone that has successfully treated the virus; not to mention the hundreds of thousands that clear the virus spontaneously in the acute phase.

Regardless, you should have a better idea very shortly where you stand. Good luck with the results; you might be surprised when the results arrive.

Best of luck to you; keep us informed,

Bill

[Javi1962]

yes the referral said internal medicine but when I got to the office it said gastroenterology, he said 50% of his patience are hep c, and I asked him if I could be hep c positive for antibody and not for virus, he said that only applies to B not to hcv, he said if you have the antibody you have the virus, I told him how do you know if my immune system did not kill the virus naturally, dr. said if that was the case i would not show positive for the antibody. I told him everything i researched including being a part of this blog said the opposite, he basically told me to just listen to him.
I don't know about that answer, I just want the RNA test to come back clean!

thanks for your help, i will keep you posted.

[Marcia2202]

Your doctor is misinformed. I will always have antibodies, even though I cleared the virus with treatment. One of my daughters has antibodies, but not the virus. She must have fought it off as an infant, after contracting it from me through birth.

One will always have antibodies.

These are the most simple facts about HCV. If he doesn't know this, I would not trust him with treatment. If I was you, I would change doctors.

[Bill1954]

Marcia; thanks for weighing in… sometimes I miss some very fundamental issues; it’s nice that you stepped in and agree as well.

Javi—

Regardless of info your doc provided, you will soon have sufficient info to know where you stand. I’d definitely request copies of the results, given the questionable interpretation given recently. With those results, someone in here can help; it’ll make it easy for other specialists to way in if you have copies too.

Good luck; perhaps you’ll have a diagnosis to work with prior to Thanksgiving holidays.

Bill

[Javi1962]

hello everyone, doctor gave me results for blood test 1.5 million viral load and gen type 1A, so I guess i have hep c for sure now, the doctor said I should start treatment right away, I asked him if i should wait for new drugs he said that they recommend treatment any count over 500.000 and that I should get it done, not sure what to do, my enzyme levels are normal, he ordered a ultra sound of my stomach? not sure why? im confused not sure what to do should I start the treatment or wait?

[jdwithhcv]

The decision to treat should be based on the condition of your liver, not your viral load.  You should have a biopsy before you or your doctor make any treatment decision.  Ask him about a biopsy and if he does not order one find a doctor who will.  Wait til you have that result, it will tell you if you need to treat immediately or if you have time to wait.  Best of luck, and let us know how it goes.

jd

[Javi1962]

he is sending me for a stomach ultrasound not sure what this does.

[Javi1962]

ultrasound referral said to "Rule out Hepatoma and Hep C" not sure how it does this

[Marcia2202]

That is common procedure. The first test they do is ultrasound. It will be able to show if the size of your liver, spleen, etc are normal. It can also show fatty liver to some degree and usually should be able to rule out cirrhosis. It cannot show the grade of inflammation nor the stage of fibrosis. Thus you should preferably have a biopsy.

Depending on the stage of fibrosis, if I was in your shoes having genotype 1, I would consider waiting for the new drugs to hit the market. You would have a far higher chance of beating the virus than with the current SOC. Also you would be able to treat for 24 weeks instead of 48 weeks.

Another option would be to try get into a trial with the new drugs.

[Marcia2202]

If your doctor is not up-to-date with all this information about the PI's etc, PLEASE; PLEASE change doctors. You really need a hepatologist who is knowledgeable about current treatment options. You do NOT want to do this twice. You want to have the best possible chances of beating this virus.

[Javi1962]

thanks for the advice, most defenitly don't want to do more then once, I did call on a trial I found in Orange County but they are full but put me on there waiting list.

how long after ultrasound should I see results of exam?: i would imaging just a day or two? right? my ultrasound is set for this Monday, I will let you know.

my enzymes are still normal, so this is the only hope I am hanging on to right now that I don't have to much inflamation (inflammation), or damage. im pretty scared right now, I have 4 boys and I want to see them all grow and get married, can't imagine not being here for them:(

[Bill1954]

Hey Javi!

Are you getting all your questions answered? Marcia’s a good hand at all this; listen to her words. Also, feel free to get in touch if I can help more,

Bill

[Marcia2202]

Bill   :-)

Javi
The doctor doing it should be talking to you while he does it. You can talk to him and ask him to explain what he is looking at. Usually they type it into the computer there and then, it is probably just a matter of when they do the print out. I got mine right away, as I was running around the hospital (with my file) for all the different tests on one day and brought the results back to the hepa department. But I'm in Denmark and had treatment at the main teaching hospital. They schedule you for 1 day and take all tests including chest xray, blood, urine.

[Vic1967]

Hey Javi,
Hey you are going to be o.k!   I have the same geno as you, am 42 years old and found out 17 years ago. I never viewed it as a death sentence.  I waited that long for treatment to raise my babies and tried to stay healthy. I kept an eye on it every 6 months for that long. If you are, and have been, kind to your liver don't worry to much, it's not an overnight kind of virus. But you have to check things out like you are to see where you are and if and how much damage you have. Everyone is different.
I didn't know ANYTHING about treatment other than that it didn't always work and made you sick, .  I learned it all here after I started (ignorance is bliss in my case).
The ultrasound is easy and even the Biopsy is not bad.
I am in my 34 th week of treatment and I am o.k.
Good luck to you.
Vic

[Javi1962]

I quit drinking when I was 23 and picked it up again for some dumb reason when I was 40 mostly a weekend beer drinker and Monday night football, I quit drinking when I found about I may be hep c with the first antibody test I got, now i quit cold turkey, I am so concerned with my health right now, was told in 96 that I had psoriatic arthiritis been dealing with that for 13 years, then in June this year got a high fever wich caused pnemonia (pneumonia) and lung scarring, was hospitalized for 30 days, while there was tested positive for the hep c virus, I was like God what else?? did i **** you off that much? I am just so confused and am turning to him right now and whatever he wants i will do, i just felt like death is knocking, but on the positive side at least the flu led me to know about the "silent killer" and now I need to get rid of it as soon as possible, and I will never take life for granted again.
keep me and my family in prayer, I am so blessed that I found this site you guys are all awesome, Bill thanks for talking with me on the phone the other day, you are defenitly a champion on this side, you have a great testimony that you share and even though your cured of disease you still stay around to help us newbies out, your awesome guy! I look forward to the day I also can pay it forward and help others out as well.
so thanks to all who have cleared the virus and your still around to help out it means alot!

[Javi1962]

went for my ultrasound today, technician could  not tell me anything, she said doctor will have to go over results with me possibly tomorrow.

why is it everytime i ask for a hepatologist the pcp keeps referring me to a gastro doc?

[njlady365]

Hepatologists are GI doctors first, then they take the speciality up afterwards. Its like a specialty within a speciality.

Hepatologists are normally not listed in searches, but if you do find them, they usually will be listed at larger teaching hospitals and transplant centers. And if your insurance carrier is like mine, you'll only find them listed as GI drs. It's weird, I know. I've made about 200 phone calls in trying to find my own Dr.

You're going to be fine, just focus on one thing at a time. This is the BEST forum so you're doing good staying connected. These people are the finest and have so much to teach us newbies!