HEP C questions

[Philwoods19]

Hi, I had protected vaginal intercourse at a massage parlor. Very embarrast. It has been 8 weeks and I paid for a hep c qualitative rna test and it came back negative. Is this accurate or do I need retesting. I did an antibody test at 8 weeks as well and that was negative as well. Thanks

[Lynn K]

You were not at risk in this situation

The HCV RNA by PCR test which it sounds like you had is definitive

[Philwoods19]

This was the test: HCV RNA NAA Qualitative
HCV RNA NAA Qualitative Negative NORMAL Negative: HCV RNA Not Detected

It was through healthlabs and done through labcorp. I read somewhere that rna can fluctuate and test may not be accurate. Is this true?

Thank you for taking time to answer
Very appreciatively

[Lynn K]

The RNA test is definitive in a few days post exposure.

Yes viral levels in those infected can and will fluctuate which is why there is no correlation between viral load and severity of infection. However, not detected means you don’t have hep c. You have no viral load to fluctuate.

The antibody test is normally performed first after waiting 12 weeks post a concerning exposure. In the Hep c antibody test is negative 12 weeks post exposure no additional testing would be needed. This is assuming you have a normal immune system and you don’t have a weakened immune system for example if you are undergoing chemotherapy, have had a transplant and are taking anti rejection drugs, if you have cancer or are infected with HIV.

Hep c is not considered by the CDC to be an STD it is a blood borne virus requiring hep c infected blood to enter the blood stream of an uninfected person. While there can be a small risk of hep c transmission for those with multiple sexual partners, those who engage in rough sexual practices like BDSM or blood sports, or in the presence of HIV. In fact the CDC does not recommend the use of barrier protection (ie condoms) for long term monogamous couples as there is essential no risk of transmission. For everyone else barrier protection is sufficient.

As you indicated you had protected sex you were not at risk.

[Philwoods19]

Thank you for the thoughtful reply. Would having hiv interfere with an rna test or only the antibody test?

[Lynn K]

If a person is infected with HIV because their immune system is compromised it will take longer for their body to develop sufficient antibodies to rise to detectable levels. Antibodies are not the virus they are formed by our bodies own immune system when it tries to fight off an invading virus. For people with HIV or otherwise immune compromised it may take up to six months for enough antibodies to form to rise to detectable levels.

The HCV RNA by PCR is a test for the virus itself. It is not affected by the patient having a compromised immune system. This test is normally done after a positive antibody test as the HCV RNA test is much more expensive and not needed if the hep c antibody test is negative 12 weeks post a suspected exposure.

Having hep c is not a medical emergency. Simply wait the appropriate amount of time and have the antibody test. If that test is negative at 12 weeks post if the patient is not immune compromised no further testing is needed. if the patient is immune compromised then wait 6 months post a concerning event and have the hep c antibody test.

[Lynn K]

But again, as you had protected sex unless there was a risk of hep c infected blood entering your blood stream like sharing of IV drug needles or engaging in rough sex practices where there could be bleeding occurring like in BDSM you were not at risk.

[Philwoods19]

I was asking because I had the RNA test at 8 weeks and was wondering if having hiv would extend window period for rna test or only the antibody test. I am trying to learn and I do appreciate it

[Lynn K]

The RNA test is looking for the presence of the actual virus. I’m assuming with a weakened immune system the virus would be able to replicate unchecked in any way and easily achieve detectable levels more quickly. I also assume you would know if you had HIV with a compromised immune system aka AIDS