Spontaneous Clearance of Hep C?

[HepC_false]

Hello,
At a recent gynecologic screening exam, my doctor included an HCV antibody test, much to my surprise, the test was positive.  I was surprised because I have never done any IV drugs, nor do I have tattoos or have received donated blood.  I was told that the result could have been contracted through sex (I have had vaginal sex while menstruating and anal sex without a condom), but that the risk for this was still very low.  Since the initial test over a year ago, I have had 3 PCR tests (all negative) and 3 liver panel tests (all normal except slightly elevated GGT).  Is it possible that the antibody test has been giving false positives? Even if I was exposed to Hep C, given my PCR and liver panel results, could my body have cleared the virus?  If my body has cleared the virus, is it possible for me to transmit the virus to anyone else (sexual partner or fetus should I become pregnant)?  Also, since my results appear to be normal now, if my body has cleared the virus, I am now immune to Hep C?  Lastly, is it possible to have 3 normal PCR and liver panel results and then for the virus to suddenly "re-appear?"  I have a new doctor and he wants me to repeat the liver panel every 6 months. Do I have to do this forever?

I know I've asked a lot of questions.  Thanks so much for taking the time to read and respond to them!

[ClippedWings]

To answer one of your questions, yes it is definitely possible to spontaneously clear the HEP C virus.  This is actually fairly common- years ago it was thought that around 15% of people exposed cleared the virus without medical intervention, these days many experts think that up to 40% of people exposed will spontaneously clear.  I would recommend you seek out a hepatologist or a gastroenterologist with significant HCV experience to answer your other questions.  It does sound like you dodged the bullet- congratulations.

[ajw543]

I am somebody who had Spontaneous Clearance of HCV.  So yes it can happen.  The odds are not great but it does happen.  As for you being immune, no the virus mutates so even though you have the antibodies you are not immune and can still be re-infected.  And as for passing HCV to somebody else, no if you cleared then you can not pass it just from carrying the antibodies.  So if you have been checked for a VL load and you don't have one then yes you cleared on your own.  

[meki]

OK - I'll answer as best as I can...

If I'm incorrect - someone PLEASE - jump in.

"At a recent gynecologic screening exam, my doctor included an HCV antibody test, much to my surprise, the test was positive.  I was surprised because I have never done any IV drugs, nor do I have tattoos or have received donated blood."

A LOT --- and I do mean a LOT of people do not know where they got HCV. I think it's easier for some folks here on this board to say they got it from IVDU - but even then --- it's possible it came from somewhere else.

Don't worry about where you got it though --- that can just drive you bonkers...

To me - the main step in responsible living - is ensuring no one else gets YOUR disease --- or diseases... This to me, includes colds, pink eye --- and of course HCV.



" I was told that the result could have been contracted through sex (I have had vaginal sex while menstruating and anal sex without a condom), but that the risk for this was still very low.  "

Extremely low





"Since the initial test over a year ago, I have had 3 PCR tests (all negative) and 3 liver panel tests (all normal except slightly elevated GGT).  Is it possible that the antibody test has been giving false positives?"


One test --- yes it is possible to have a false positive or a lab mess up... More than one test - NO.



" Even if I was exposed to Hep C, given my PCR and liver panel results, could my body have cleared the virus? "


Yes - there are a small percentage of people who clear the HCV on their own during the ACUTE phase, however they still retain HCV antibodies - they just do not have a detectable Viral load.


"If my body has cleared the virus, is it possible for me to transmit the virus to anyone else (sexual partner or fetus should I become pregnant)?"


This is an unknown ---- and there are MANY MANY opinions on this. I don't know the true answer - and I don't know if anyone else does.

Keep in mind sexual transmission is EXTREMELY low --- it requires BLOOD INTERACTION through open wounds or gaping holes --- or injection.

It's not a bodily fluid thing ---- ONLY blood.

Vertical Transmission happens in less than 5% of cases (from what I understand).

Whether or not you carry and infectious viral disease still ---- no one can tell you.. There are schools of thought that maintain that the virus lives within the tissue - and circulates within the blood in extremely small amounts.

There are others that say "YOU ARE CURED" --- therefore there is no chance of transmission.

I choose to believe that HCV may still be alive --- in minute, small amounts --- and can still infect others --- SO I USE EXTREME CAUTION now.. (universal precautions --- covering wounds if bleeding or open, etc. ---- however, I don't have protected sex with my hubby)



" Also, since my results appear to be normal now, if my body has cleared the virus, I am now immune to Hep C?  "

NO --- absolutely NOT... You can still catch HCV --- there is no antidote --- you can get another genotype --- you can get the same genotype --- if you become reinfected.




"Lastly, is it possible to have 3 normal PCR and liver panel results and then for the virus to suddenly "re-appear?""

Uhm --- I don't know.

I don't know if you can Lose SVR after a certain amount of time... I honestly don't know if anyone knows that answer.

I would say the chances appear to be very slim that you will get the virus reactivated after several years...

But then --- I don't know.

It's still a young disease - and the medical community is still learning about this disease.




" I have a new doctor and he wants me to repeat the liver panel every 6 months. Do I have to do this forever?"

I would suggest that you keep an eye on your liver panels for awhile. Just my thoughts on it --- I think we should all have that plug in that cars have --- diagnostics... LOL!

But hey --- if you can - keep an eye on it - you probably should...

That is --- if you have had more than ONE test that shows HCV pos antibodies....

If you have had elevated ALTs and ASTs --- it's a good idea to keep an eye on them, as well.



"I know I've asked a lot of questions.  Thanks so much for taking the time to read and respond to them! "


Not a problem - I only hope that I was correct in my opinions.

Much luck to you!

Meki

[merryBe]

what did your original test say?  was it antibody only, or did they look for and find a genotype?

a lot depends on the lab procedures and cleanliness when you llok for parts per million slide/machine contamination can be a factor....

do you still test positive for antibodies, and negative for virus on each of the 3 more tests?

mb

[Jakied]

I have a feeling your initial screening test was a false pos.  ask your doctor for a 'Riba' test.  It is VERY specific for Hcv antibody.  If that is neg, you do not have Hcv antibody.

For sure, you do not have the virus.  Three neg Pcr tests confirm that.

I believe your riba test will be neg.