On September 2, 2011 I received a tattoo. I watched artist open a new needle and fill a single use ink cup. The shop was clean and the artist had his state certification posted as well as blood born pathogen certificate. Even so afterwards I got worried about HIV and Hep C. I tested at 10 weeks, 3 months and 6 months for HIV and all were negative.
My HCV test was non reactive at 10 weeks but then REACTIVE at 6 months (just a week ago)? For some recall reason RIBA test was not available to confirm so an HCV RNA PCR test was done with results negative and non detected.
1 Why did the HCV antibody test change from negative to positive?
2. Do I have Hep C? Or could the second antibody test be a false positive?
3. Is my 6 month negative HIV test conclusive or if I contracted HCV would that effect the test window?
4. Dr. wants to retest HCV RNA PCR in six months and says don't worry but I'm worried
Thanks for writing in. I do understand your predicament. I would first like to clarify the role of the tests in detecting a HCV infection.
In the tests that are done for HCV, anti HCV tells us about the exposure to HCV (either present or past) and HCV RNA confirms the on-going infection. Anti HCV usually takes around 6-12 weeks to appear after an infection and HCV RNA can be detected by 1 week after conception.
1) Reasons for a positive anti HCV with an undetectable HCV RNA are
a) HCV RNA is very low and it may not be detected and anti HCV may be positive
b) A patient recovering from an infection where HCV has been eradicated and the antibody is a telltale evidence of prior infection
c) A false positive report. This is less common nowadays with the third generation ELISA tests but can be seen in people with autoimmune disorders. HIV co -infection causes more of false negative anti HCV antibody with a detectable HCV RNA.
2) Whether you have HCV or not can be confirmed when you get yourself retested by RIBA and repeat the RNA testing after 3 months or so and clear the confusion. As I explained, the second antibody test could be a false positive.
3) If you are sure that you had no more exposure after the one stated then I don't think there is any merit in repeating a test for HIV. Also, HIV co-infection can cause an increased likelihood of a false negative anti-HCV antibody.
4) I would suggest you repeat a RIBA and get tested for HCV RNA after 3 months. Meanwhile, follow every measure possible to prevent any risk of acquisition.
I hope I have addressed your concerns. I will be available for follow ups.
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