Hep C Discussion Forum

Cinnamon Girl wrote:

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Thanks again, Martin, for the additional information.  It looks very clear, you don`t have Hep C and your doctor is satisfied that no further tests are necessary.  You have nothing to worry about.  

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Hello.

Thanks for your answers.

What did came across my mind is that I have a girlfriend that is Chronic Hepatitis B inactive.

My vaccine for Hepatitis B worked and I dont have any Hepatitis B.

Im pretty sure B and C cant be somewhat related, meaning that someone with B could give you C and so on?

I also seen her test results and everything was good, and her virus is inactive and so is her RNA.

What I still dont understand is how these screening tests can show antibodies/reaction of antibodies in the screening test, how is this possible?

Let's say they are true antibodies, there is no way i could have aquired the virus ever before in my life, cant think of any way really. Never.

I did several blood tests one year ago, like i told you, for the PCR, the RNA, the RIBA, viral load etc.

I am guessing that the following scenario is not anything i should even think about:

Possible scenario?;

The screening tests are real and I do have antibodies for Hepatitis C, meaning i recieved false-positive, riba, rna and pcr test? But im guessing this is nearly not even possible and I can let this go?

Since i did indeed test myself with RIBA, PCR, and RNA, viral load and all were 100% negative and no viral load what so ever, 1 year ago, I shouldnt even worry about this one bit if i havent done anything after that that could have gotten me infected, which I ofcourse havent.

Therefore, I should just ignore these screening tests that shows reaction to antibodies?

I mean, reaction to antibodies doesnt even mean I do have the virus, and I did all the testing 1 year ago for the virus, and therefore i am just overly paranoid now with no real need for it?

I didnt have any virus, any viral load, with the pcr, rna and viral load test 1 year ago, and

the riba test was also negative, all 100% negative and no viral load at all.

Therefore, i could be 100% percent sure i  dont have it unless i should have done something after those tests, which i havent. 

-- Edited by markymark on Saturday 1st of February 2014 08:27:43 AM

Cinnamon Girl wrote:

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Yes I agree, it`s very confusing.  I`ve just read your post again.  So are you saying that the first and third test showed positive for antibodies, but not the second test?  It does seem very possible that you did have Hep C at some time but not now.  If you have had a Hep C infection then you would expect the antibodies to be present in every test but sometimes the tests aren`t accurate.

I agree with your doctor that you have nothing to worry about and that you are free from Hep C.

 

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Screening test done 1 year ago showed: antibodies reaction in screening test.

After this they decided to take more tests, and this was the results:

HCV-RNA:  Negative

HCV RIBA test: Negative

PCR test: Negative

Viral Load or Quantitative HCV tests: None

And after this the doctor said that since they couldnt find any antibodies in the confirming riba test the screening test is probably a false-positive.

Now a year later the same happens in the screening test; Reaction in the screening test showing antibodies for Hepatitis C. 

What the doctor tried to explain to me is that due to the fact that my  RNA, RIBA, PCR and viral load was all 100% negative, i shouldnt worry about these screening tests at all, if im not putting myself to any risk of getting hepatitis c, (drugs, injections etc) and I have never even done such a thing, not even close to that, and therefore they said that more tests is considered unnesseceary since i did the confirming tests a year ago, and that I shouldnt worry about the false-positive screening test. 

This is how the scenario has been today: 

The doctor that blood tested me 2 weeks ago called me today saying the following:

"You tested your blood to see if your Hepatitis B vaccine was working and we can confirm that the vaccination for Hepatitis B has worked and you have the antibodies for Hepatitis B now and you are not infected with Hepatitis B, so you shouldnt worry about that. 

However, we did find reactions in the screening test concerning Hepatitis C (note that we are talking about C now) and it shows that it looks like you have the antibodies for Hepatitis C, and therefore we want you to come in for confirming test."

My answer to him is the following:

"I had exactly the same reaction in the screening test last time i blood tested myself 1 year ago at another Hospital, and then they took confirming test, RIBA, RNA, PCR and viral load test and all was 100% negative and they couldnt find any antibodies either in those confirming tests, only in the screening test".

His answer to me is the following:

"Okay, we didnt know that you tested yourself 1 year ago and this is most likely then a false-positive test, and even if it isnt you still dont have to worry since you tested yourself with RIBA, RNA, PCR and viral load test 1 year ago and you had nothing, then you dont have to worry about these screening tests results. You would only have to worry about this if you have done anything after you took these tests that could have given you Hepatitis C"

Then I tell him that i have not even came close to doing anything that could have given me the virus in the past year (or before that either) and he tells me that its now up to me if I want to take more tests and that I shouldnt worry about this if the same happened in the last screening test.

A couple of hours later i get a phone call from the old hospital i visited 1 year ago (I requested them to call me): 

"Hello, you requested that we called you about your blood tests you took here. In the blood tests you took here you did indeed show for antibodies on the screening test, same as you did a couple of weeks ago recently, but when we tested you with the RIBA, PCR, RNA, and viral load testing you were negative on everything and you did not have any viral load at all in your body and nothing that showed that you have had any earlier infections either.

If you havent done anything that could have infected you with Hepatitis C after you took the tests here your new screening test that you recently took is either a false-positive or showing that you may have had infection of hepatitis C earlier, but you are now fully healthy from it. You can however take more tests if it makes you feel even safer about this and maybe that will help you to not go around and worry about this, but when we did the blood tests with you (RIBA, PCR, RNA, viral load) they were all negative and you didnt have any virus in your blood) so you dont really need to do further testing.

Thank you for your comment.

But, what I dont understand, is how 2 different screening tests can show antibodies?

According to the doctor it will probably stay this way in the screening test, but that this doesnt mean anything since the HCV RNA PCR was all 100% negative. 

It's the thing that it shows positive for antibodies on the screening test multiple times that makes me think, but the doctor said the same thing as you did so probably its nothing to think about then.

But, could you or someone else here try to explain me in a way I can understand, how the screening test can show antibodies, but its false positive multiple times?

The only thing the doctor asked me was if i had in this past year after i did the last rna, riba and pcr test, if i have done anything that could meant i would have gotten hepatitis c this last year, and i have never been in contact with anything that may have given that.

Im just curious how multiple screening tests can show antibodies when its not true.

 I asked the doctor if i should do more test for RIBA, RNA, and PCR, but they said that its not needed since i did the test a year ago and had negative on everything, and that these screening tests will probably keep showing as false-positives, which means i shouldnt worry about it at all. 

-- Edited by markymark on Friday 31st of January 2014 07:05:56 PM

I have updated this thread with an answer. 

I thought since we're discussing tests right now, it may be a good time to describe each of the current procedures.

Anti-HCV tests detect the presence of antibodies to the virus, indicating exposure to HCV. These tests cannot tell if you still have an active viral infection, only that you were exposed to the virus in the past. Usually, the test is reported as positive or negative. There is some evidence that, if your test is weakly positive, it may not mean that you have been exposed to the HCV virus. The Centers for Disease Control and Prevention (CDC) revised its guidelines in 2003 and suggests that weakly positive tests be confirmed with the next test before being reported. 

HCV RIBA test is an additional test to confirm the presence of antibodies to the virus. In most cases, it can tell if the positive anti-HCV test was due to exposure to HCV (positive RIBA) or represents a false signal (negative RIBA). In a few cases, the results cannot answer this question (indeterminate RIBA). Like the anti-HCV test, the RIBA test cannot tell if you are currently infected, only that you have been exposed to the virus. 

HCV-RNA test identifies whether the virus is in your blood, indicating that you have an active infection with HCV. In the past, it was usually performed by a test called a qualitative HCV. Qualitative HCV RNA is reported as a positive or detected if any HCV viral RNA is found; otherwise, the report will be negative or not detected. The test may also be used after treatment to see if the virus has been eliminated from the body. 

Viral Load or Quantitative HCV tests measure the number of viral RNA particles in your blood. Viral load tests are often used before and during treatment to help determine response to treatment by comparing the amount of virus before and after treatment (usually after 3 months); successful treatment causes a decrease of 99% or more (2 logs) in viral load soon after starting treatment (as early as 4-12 weeks), and usually leads to viral load being not detected. Some newer viral load tests can detect very low amounts of viral RNA, and some laboratories no longer do qualitative HCV RNA tests if they use one of these versions of viral load testing. 

Viral genotyping is used to determine the kind, or genotype, of the virus present. There are 6 major types of HCV; the most common (genotype 1) is less likely to respond to treatment than genotypes 2 or 3 and usually requires longer therapy (48 weeks, versus 24 weeks for genotype 2 or 3). Genotyping is often ordered before treatment is started to give an idea of the likelihood of success and how long treatment may be needed.

When is it ordered?

Hepatitis C infection is the most common cause of chronic liver disease in North America; about 2% of all adults in the United States have been exposed to the virus, and 75-85% of those are chronically infected. The CDC recommends HCV testing in the following cases:

 If you have ever injected illegal drugs 

 If you received a blood transfusion or organ transplant before July 1992* 

 If you have received clotting factor concentrates produced before 1987 

 If you were ever on long-term dialysis 

 For children born to HCV-positive women For health care, emergency medicine, and public safety workers after needlesticks, sharps, or mucosal exposure to HCV-positive blood 

 For people with evidence of chronic liver disease

* The blood supply has been monitored in the U.S. since 1990, and any units of blood that test positive for HCV are rejected for use in another person. The current risk of HCV infection from transfused blood is about 1 case per two million transfused units. 

A positive anti-HCV test may be confirmed with an HCV RIBA test, especially if the test is weakly positive. Qualitative HCV-RNA is often used when the antibody test is positive to see if the infection is still present. HCV viral load and genotyping may be done to plan treatment; viral load and qualitative HCV RNA are also used to monitor response to treatment.

What does the test result mean?

If the antibody test result is positive, you have probably been infected with hepatitis C, even if it was so mild you did not realize you had it.

A positive RIBA confirms that you had been exposed to the virus, while a negative RIBA indicates that your first test was probably a false positive and you have never been infected by HCV.

A positive (or detectable) HCV RNA means that you are currently infected by HCV.

Is there anything else I should know?

HCV antibodies usually do not appear until several months into an infection but will always be present in the later stages of the disease.

Sources
National Institutes of Health and Department of Health & Human Services

Seems like I read somewhere that 20% of people clear Hep C on their own - sounds like you may have done this but will defer to the guru's here that really know this stuff!