Test results for HCV really not sure what they all mean. Too many Names etc..

[Personified82]

i had 2 Elisa tests done they both came back equivicol. With the Second Equivicol result they also tested with both EIA ORTHO and BIORAD ACCESS which both came back low positve. Ratios of 1.828 (ortho) and 2.003 (Biorad). Again at the same time because they were low reactive they tested via PCR which came back negative...
When i went to get these results they explained i was low reactive and to make sure they wanted to test for antibodies 1 more time using the same EIA tests kits Ortho and Biorad. Ratios were lower this time, at 1.574 ortho and 1.653 biorad, I am still waiting on the final PCR test which they also ran with the last two tests to come back...
I am not sure where i really stand at the minute and it all seems to be dragging on..Can anybody make any sense of it all?Neg/pos?
The NHS in the UK seem to do a lot of tests.. I only went in for a routine sexual health check etc....I'm not complaining they are doing all these tests (there is no cost to me) just as long as they give me my answer. hopefully soon it will be resolved.
Any comments would be much appreciated....

[Dennisdrl1]

A negative PCR and a positive RIBA test can have two interpretations:  one: the virus spontaneously cleared or therapy was successfully administered.  Two: the level of virus is below the lower limit of detection of the PCR assay. Consequently, it would need to be rechecked periodically as the viral level can wax and wane.  Thus, a negative PCR doesn't translate to 100% assurance that the virus is not detectable.  The most likely route with which you acquired the HCV was with intra-nasal cocaine with straw sharing which is a documented route of infection.  Also, if you continue to do drug most of us who treat HCV would exclude you from treatment as it raises compliance issues.  In addition, should you successfully clear the virus and once again share a straw or dollar bill you can be re-infected with a different strain of HCV.  Although you do not describe yourself as a drug addict you are engaging in addictive behavior which can have serious physical and social consequences.  Ideally, you should be drug free for at least six months before beginning treatment.  Also, you need to be alcohol free as well.  The swine flu had nothing to do with the result of the HCV test.  Also, with a history of risk factors for HCV if the antibody test was positive a RIBA test is usually not obtained.  Rather a PCR, either qualitiative (which is more sensitive) or a quantitative test is ordered and typically would be positive.

[Jakied]

A low + screening test is usually retested with the Riba.  this is VERY specific for

Hcv antibody.  the sceening test is VERY sensitive and may pick up some other

antibodies which are not Hcv.  ask for a Riba.  If that is neg, then you have never been

exposed to Hcv.  If Riba is pos, you had a prior exposure  but cleared without

treatment.  In this case, you will test pos for Hcv antibody for a LONG time, maybe

the rest of your life.  But your neg pcr says you do not have the virus.  the Pos riba

says you have the antibody to Hcv only, not the virus itself.

[Dennisdrl1]

Some questions: do you have any of the risk factors for acquiring HCV?  If the Elisa test is positive but the PCR is negative and you lack risk factors then it may represent a false positive test.  A qualitative PCR is more sensitive than a quantitative test.  Also, a RIBA test could be done. If this is negative then it confirms that the initial antibody test was a false positive.  If it positive then it implies you had an infection that cleared or the viral titer is too low to detect and will need to be serially tested.

[Personified82]

Thanks for the quick response, it really does help. it's all been a little messed up. i went in yesterday and spoke to one of the councilors who essentially told me i was positive (she didn't have half my notes) so i panicked etc and made and appoitment to see the infectious disease consultant today only to be told she had made some errors and wasn't reflective of all results, he has told me to wait 2 weeks for this final PCR test to be conclusive on wether or not i have the virus...

I will be honest i have been an IDU and used snorted coke with shared notes... I have only ever shared a needle once but that was a long time ago and it was cleaned, how well? i don't know. (not clever i know). i am not addict but do use every so often (now always with my own pan and needle cotton etc)...

Before the tests were carried out i had contracted H1N1 (swine) Flu maybe 10-14days earlier, could this have an effect on antibodies maybe?

Again your comments are really appreciated..

[Bill1954]

Hi there,

I think you’ll be fine after the dust settles. The only test that really matters at this point is the PCR result. The EIA testing is all antibody stuff; and your results there aren’t suggestive of exposure. I’m a bit surprised they even ran PCR testing; once that comes back, the results are very conclusive. For more on antibody test results:

http://www.cdc.gov/hepatitis/hcv/LabTesting.htm

Good luck and take care-

--Bill