Anti HCV positive RNA RCR negative- technical HCV antibody questions

[bp9191]

I was born in 1948, healthy until a transfusion in 1975 which infected me with several pathogens, none of which I found out about untill 2001 to present , although I've been plenty MISDIAGNOSED with other maladies due to these infections.  In 1976 I presented with acute hepatitis ( non A & B ) so I know I had acute Hepatitis in 1976.

In July of 2014 I tested "reactive" on a anti-HCV ( IgG antibodies), and subsequent RNA PCR on the same blood draw was negative ( reference range down to 15 Iu).
I was negative for Heb A & B.
   I am not a health care worker, nor do I have tatoos, or have I ever used IV drugs, so pretty sure the 1975 was the exposure to Hep C.

My Genral GP thinks I'm one of the young females who sucessfully cleared the virus, and thinks I  am "cured"  becuase of the neg PCR.

I on the other hand- know that antibodies don't live for 38 years or 40 years.

 I cannot find any references about a HCV antibody living for longer than 20 years. It is thought that a memory T cells may live longer (and maybe that confers immunity), but the Anti-HCV test is measuring IgG antibodies, not T cells.

On page 11, bottom left paragraph, this 2014 paper states not much is known about the protective life long immunity following spontaneous clearance of HCV . It looks like the memory T cells live longer than the antibodies (which die out over time).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058636/pdf/fimmu-05-00274.pdf


So. I guess...   
If I assume my Anti-HCV is not a false positive, then with this 2014 paper, my mind is not at ease with a Neg RNA PCR and I should probably be retested again periodically.

But what's the wisdom on this site- should I have a consultation with a Liver specialist?

bp9191

[Mike]

To my understanding, there is no life long immunity to the Hep-C virus. A person can clear the virus with treatment, and be reinfected with the virus at anytime thereafter.

This can happen through all ways one gets an initial infection (i.e., blood-to-blood exposure and so forth).

As far as seeing a specialist, there are several tests that can be completed, including a liver panel (looks at overall liver function, enyzimes and so on), an ultrasound, fibroscan and/or biopsy which will determine any liver disease/damage.

It sounds as though you've already dodged the bullet with a negative viral load, however, which means you don't have an active Hep-C infection.

Talk with your doctor and discuss your concerns.

Best wishes, Mike

[lporterrn]

Dear Bp9191,
I agree with your doc. Some people retain HCV antibody for life. The study that comes to mind is the Irish Women Cohort - a group of women who were infected in 1977 via contaminated immunoglobulin. Of those who spontaneously cleared HCV, there are still some who have HCV-antibody, according to a talk I heard recently - I could not find recent research.

[bp9191]

Thanks so much!.
Based on the replies, I found the paper referenced ( Irish women cohort) in PubMed.
Here's the link:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728443/pdf/v049p00423.pdf

Maybe I *was* one of the lucky ones who's body cleared the infection when
I was transfused.

My Dr. said I am the only person ( in her practice)  who's ever been RNA PCR negative after a reactive Anti-HCV.

As she suggest though, I will do 2 more PCRs, each 6 months apart. ( for a total of 3.) 

Thanks again!
bp9191

[lporterrn]

That she knows of. It's surprisingly common - 40% of women under age 40 clear HCV spontaneously.

[Molloy]

Hi,
I know this is kind of an old thread, but I'm very interested in this point--can you perhaps direct me to the source of this statistic (40% of women under 40 clear HCV)?  Thanks very much!
best wishes,
Molloy

[bp9191]

I just received my second Negative RNA PCR test for Hep C, although I test positive for the anitbody to Hep C.

I know for a fact I had non- A non B Hepatitis in 1978 ( so  that had to be Hep C ) from a blood transfusion.

But I am having a hard time understanding how I can test positive for the actual antibody and be Neg for the virus.

As far as I know, the Anti-HVC test tests for actual antibodies... not memory B cells.

With my limited understanding of life-long immunity:  I thought it was the memory B cells that persisted for life  ( not antibodies). 

Antibodies are only produced when the memory B cell finds the antigen then presents it to another cell- (which then produces the actual antibody.)

If any one can explain this to me, I'd appreciate it.
Maybe the Anti-HVC antibody test is cross reactive with some other virus?

bpeck9191

[Lynn K]

Antibodies are produced by your body in an attempt to fight off the hep c virus while the HVC RNA tests for the virus itself.
About 20% of people infected with hep  c will spontaneously clear the virus. However they will always test positive for the anti-bodies to the virus. Having antibodies to hep c however provides no immunity to later reinfection.

As an example, if you either had measles or the vaccine for the measles you will have measles antibodies but when tested for the measles virus you would test negative

Hope that helps