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Do I Have Hep C?
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Do I Have Hep C?

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
Tags: hep c, test, HIV
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Dear EIowa,

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.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra
Also I have no other risk factors for either HIV or Hep C ... In a 20 year monogamous marriage (with only sex partner I have ever had) and no drug use of any kind.
So you do feel my HIV test is conclusive ... That I do not have HIV?  
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