Tested "Reactive" for HCV following a recent STD blood test.

[ledman]

Had unprotected sex during a random encounter with a complete stranger (female - I'm male) about 4 weeks ago. Got an STD test at the 2 week mark, including rapid HIV RNA. I recall a small amount of teeth scraping during oral sex before vaginal intercourse. Tests all came back negative (I did them all) except for Hepatitis C which is listed as "abnormal" in the report.

Would anyone be willing to possibly help me understand these results before I'm able to go see a doctor? I'm pretty nervous about this.




The notes alleviate a bit of my worry, but why would I have 0.07 over the signal to cut-off ratio? Is it possible this is an old infection I've already fought off naturally and just never had any symptoms and so no reason to test for HCV? Is it possible it's a false positive altogether? Is it possible the infection is too recent to detect Quantitative Real Time PCR (whatever that is), but was able to detect antibodies alone?

I went through an anonymous online service for STD testing that sent me directly to a Quest Diagnostics for blood to be drawn. I only spoke with a doctor over the phone and was emailed the report for my blood work. I've cropped the portion pertaining to the HCV test to remove any personal identifiers. If I missed anything, please let me know. The doctor recommended I speak with my primary care physician and schedule an appointment with a doctor of infectious diseases.

I have my liver function/enzymes checked with every physical each year. Even through heavy drinking (which has since ceased altogether as of several months ago) my function has always been normal. I did have one doctor a few years ago suggest I might have fatty liver (I'm a bit overweight) from drinking. She seemed to determine that possibility by simply feeling my liver through my abdomen

Beyond this recent fling, I can't think of any other scenarios for which I might have contracted HCV beyond a few instances of sharing toothbrushes and nail clippers over the years with friends. I've had sex with a few women, but nothing extreme and mostly in monogamous circumstances.

Any assistance is greatly appreciated. I've been kicking myself for weeks now.

[Lynn K]

The antibody test indicates you may have been exposed to hepatitis c at sometime in the past.  About 25% of people who test positive for hepatitis C antibody's were able to beat the virus on their own without medical help you appear to be one of those lucky people especially since your test for the hepatitis c virus the HCV RNA test indicates the virus is not present in your blood.

 Hepatitis C is not generally considered to be an STD.  In fact the CDC does not even recommend using barrier protection for long-term monogamous couples.  There is an increased risk of transmission for those who engage in rough sexual practices in the presence of the HIV virus or in person to engage in sex with multiple partners.

Hepatitis C is a blood borne virus it requires blood to blood contact in order to be transmitted from one person to another hepatitis C infected blood must enter the bloodstream of an uninfected individual.

However, as your HCV RNA test is negative you do not have hepatitis C and therefore have nothing to worry about.

However I am just lay person I am a patient who had hepatitis C for 37 years and I am no type of medical professional. For a proper interpretation of any and all medical questions you should always ask your doctor.

I am only reading your test results which states the patient is not currently actively infected with HCV either because they had a past resolved infection or had a false positive antibody test and was never infected with HCV.

[Lynn K]

 Just to add anti-bodies are not the virus they are made by your body when it tries to defend itself against a virus. for example if you either ever had the measles or were immunized against the measles virus you carry measles anti-bodies. anti-bodies are made by your own body they are a part of you.

[Mugwump]

A great many people test positive for HCV antibodies and do not have the virus. It is beginning to look very much like more than 25% who are exposed in some fashion clear the virus naturally. HOWEVER! The most common result is actually a first test that is a false positive response. Most times the test is then repeated before going on to test for a viral load which is a completely different test and much more expensive and accurate.

The samples for HCV rna testing are collected in a container that works completely differently than the sample taken for HCV antibody test. All blood that is donated goes through hcv antibody testing before being passed on into the blood donor bank systems because the test for HCV antibodies is very inexpensive in relation to HCV RNA viral load testing.

I have answered this question very many times over the years when I was infected with HCV. Unfortunately most frequently to those who I told about my infection and were afraid that they might have HCV. MANY TIMES IT WAS JUST their unfounded fears of somehow being exposed to HCV just because they were exposed to me. One of the most reassuring moments of my life came when my wife and children tested negative for this disease and I realized that I had a long road of truth to walk with this disease.

Even a very close relative of mine tested positive once for HCV antibodies and then called me in a bit of a panic because he knew that I had almost been hospitalized during my first interferon treatment in 2004. He was convinced that he had HCV and his doctor had not filled him in on the specifics of the disease diagnosis process or what to do next, perhaps the doctor just thought that the individual knew about HCV and how to go about dealing with a positive antibody test. OR WORSE just perhaps the doctor himself did not yet know the diagnosis process for HCV.

So what Lynn has explained is essential to know, if you do not have HCV rna in your system then request another antibody test to confirm a history of exposure. Because sexual activity type of (link to info)  transmission that you believe may have infected you is not at all a known path to infection. But the sexual transmission of HCV can occur in some circumstances that are becoming better documented. It is important to read the entire cdc document to understand better how HCV is known to be transmitted.

This little tale of mine is personal but many who have HCV go through this and find dealing with the lack of public and even professional knowledge about this disease has been one of the biggest hurdles to overcome. This fear and ignorance caused the death of a friend who could not tolerate the stress after being diagnosed with HCV, it is in the memory of him and the others out there who have taken their own lives after being diagnosed with HCV that I write these words.
 
The Mugwump