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HCV antibody negative, PCR RNA positive
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HCV antibody negative, PCR RNA positive

Posted By Mario Almeida on June 28, 1999 at 18:03:24
(Please kindly find below the copy of all previous messages on the subject).
The present situation (5 months after the exposure) is as follows:
- HIV1 antibody negative
- HIV2 antibody negative
- HCV  antibody negative
- HCV RNA PCR negative     (it was positive 51 days after the exposure)
- ALT/GPT=44 (upper limit 40)
- A significant increase in Albumin (70.7, upper limit 65)
- A slight decrease in Alfa 2, Beta and Gamma Globulins
- The "special blood test" (T- lymphocytes?) supplied the following result:
Cellular reactivity present in respect of  NS 5-4        2.73
                                 and in respect of  NS 5-12    10.72
According to my doctor the result of the this test confirmed that there was an exposure to the virus and the virus was cleared.
I'm not so convinced. Especially because from time to time I feel a sensation of inflammation like pricks inside in the upper right quadrant of the abdomen. My doctor told me that this may be due to the fatty liver and advised me to maintain my weight because five months ago my weight was 85 kg and now is 71 Kg  (almost immediately after the exposure I started a severe diet, almost vegetarian and no alcohol).
I would appreciate very much your opinion about the clearance of the virus. Is this possible to happen without the appearance of antibodies?
Particularly I would like to know something about whether or not HCV may delay the appearance of HIV antibodies in the same way as HIV delays the appearance of HCV antibodies. And what about any influence of HIV on HCV PCR RNA?
I would also like to know what do you think about the pricks sensation.
I'm willing to travel to the USA for a deep study of my case in some good hospital should it be convenient and you advise me to do so.
Thank you very much for your so valuable support.
Mario Almeida
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Posted By Mario Almeida on May 09, 1999 at 11:13:38
Thank you so much for your kind reply. I want to keep you informed about my situation for your benefit and the benefit of the Forum. Therefore, I'm copying my previous question and your reply in order to facilitate the understanding of the situation. My doctor, also finds the situation very peculiar and is very interested in further investigating it. By the way I must say that I'm Portuguese, 50 years old and live in Portugal. Please apologize me for my bad English.
The recent news are:
At 107 days after the exposure
- the HCV antibody and the PCR tests still are negative (PCR was positive 51 days after the exposure)
- ALT still is aprox. 2.5 times the upper limit
- there is a decrease in lymphocytes (12.7; lower limit: 20.0)
- there is an increase in neutrophils (82.6; upper limit: 70.0)
My doctor decided to arrange for some very advanced blood tests which I' m not able to describe: something related with the behavior of certain types of lymphocytes in presence of some different agents. This is expected to provide information on my immunity system as well as about any possible clearance of the virus which may have occurred (he told me that this happens with babies, without developing antibodies. Anyway it seems very unlikely).
I'm still very concerned about co-infection with HIV, because in an imunno- compromised situation the appearance of HCV antibodies will be delayed. On the other hand I still fear that HCV may also delay the positivity of HIV tests. For these reasons within one month I will repeat the HIV test, let's say 5 months after the exposure (this test was negative 3 months after the exposure) and will also repeat the antibody and RNA PCR tests. Then I hope to have some more firm results to report, including the immunity tests.
Should you have any comment or advice, I would appreciate very much. Many, many thanks for your so kind and useful support.
Mario Almeida
Posted By Mario Almeida on April 25, 1999 at 15:29:46
51 days after the risk situation I get for the HCV antibody test the following result: 0.12 < 1.1 (does this means negative?)
and a positive HCV RNA PCR (cut-off index 8.45).
3 months after the risk situation I get a negative HCV antibody test and a negative HCV RNA PCR in a different laboratory. Also HIV1 (antibody, antigen and PCR) and HIV2 (antibody) are both negative.
1 week after the risk situation ALT = 151 (upper limit 40)
3 months after the risk situation ALT = 97 (upper limit 40)
Fatty liver is known from 1995
HBs Ag negative
HBe Ag negative
HBe Ab positive
Hbs Ab positive
HBc Ab positive
Is it possible to be in the window period for HCV, or any other explanation? Is it possible the HCV infection to delay the positivity of HIV testings?
Thanking you in antecipation,
Mario Almeida
Posted By HFHSM.D.-D.M. on May 02, 1999 at 15:45:57
Dear Mario Almeida:
I appreciate your questions. Diagnosing hepatitis C early after an exposure can require a little extra effort and I appreciate the opportunity to make some comments.
There is a window period after exposure to hepatitis C in which it can take awhile for the antibody test to become positive. With some of the early tests for hepatitis C, it could take many months for the antibody test to become positive. The newer test are improved but it can still take over a month for many individuals to become positive. However, the HCV RNA or PCR test should be positive within several weeks of the exposure. In fact, the HCV RNA levels can be very high with an acute infection and this test is especially valuable in this setting. By three months, both the current antibody tests and the PCR tests should have enough time to become positive. I am encouraged that these tests are negative in your case.
I have, however, continually stressed to MedHelp participants that the HCV RNA or PCR test is a complicated test and not all labs are equal in their ability to perform the test or in their quality control. One of the best laboratories performing hepatitis C PCR is National Genetics Institute in Culver City, California. They specialize in this test and perform it reliably. If there is some doubt as to what is going on, you could have done your PCR test performed by them.
To answer your final question, I know of no reason why an acute hepatitis C infection would interfere with any of the HIV assays though I do not know if this has been looked at in any detail.
I hope this information is helpful to you. Good luck with your situation. If you have any additional questions or concerns, you can post them through MEDHELP or contact us directly at Henry Ford. The direct number to our liver clinic is: (313) 916-8865. At Henry Ford, we have an active group of hepatologists with an interest in the care and research of hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question physician when you have a question pertaining to your health.

Posted By HFHSM.D.-D.M. on May 19, 1999 at 11:06:30
Dear Mario Almeida:
I appreciate the extra information. I agree if there remains concern that you have either hepatitis C or HIV that the simplest thing is to repeat the HIV and the hepatitis C antibody and PCR tests. If these remain negative and your liver tests remain elevated you may need additional evaluation for other causes of elevated liver enzymes.
I hope this information is helpful to you. Again good luck with your situation. let us know if anything comes of your evaluation or if you have additional questions.

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Re: HCV antibody negative, PCR RNA positive HFHSM.D.-D.M. 7/03/1999

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