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Author Topic: False-positive HCV RNA QN RT PCR  (Read 9944 times)

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Offline Ton_1216

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  • Posts: 6
False-positive HCV RNA QN RT PCR
« on: January 17, 2016, 01:38:01 pm »
So here is my story. I went in to get tested for a investigational study. They drew blood and I had no worries. They finally call me a few days later and tell me to come in. I go in and they advise me that I have tested positive for hep c. She shows me my test results and let's me know that the good thing is all of my other blood results show my liver functions seem to be fine. She gave me my results which say 27h IU/ml and 1.43 log IU/ml. She tells me that it's such a low count so it may be a new virus. Well I'm confused because I haven't done anything in such a long time as far as risk factors go and I had just gotten done with one of their studies in October with nothing on my blood results then. No contact with blood either. Well I've been reading A LOT about it on the Internet and I notice that usually the first test they do is antibody test and THEN the rna to confirm current infection. Also i haven't seen people with such a low level as I have. I went back in to get tested again because it didn't sit well with me. And they told me that a lot of people have tested false positive sometimes and that I can have the test where they test the amount of the virus (assuming they only do antibody testing from this remark) anyways I had my tests done by quest diagnostics. Now I'm just waiting for results but does anyone aside from those on tx have such low numbers as these? Has anyone heard of a false positive rna test? Or gotten a RNA test as the first test without high risk behavior. My research has shown its expensive and unless it's asked for then it's usually the antibody test first.

Offline gnatcatcher

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Re: False-positive HCV RNA QN RT PCR
« Reply #1 on: January 17, 2016, 04:22:18 pm »
Hi, Ton_1216. Yes, a viral load of just 27 (1.43 log) is incredibly low. The only time I've seen such low numbers on these forums is when someone is part-way through treatment, so a medicine such as Harvoni has brought the initially much higher viral load down to almost undetectable.

I wonder if your blood sample somehow got contaminated. I'm basing that on this journal article: http://www.jci.org/articles/view/115815 which contains the following sentence: "HCV RNA PCR is subject to false-positive reactions through contamination and is inherently difficult to standardize and quantitate."

It's also possible the woman who thinks it may be a new virus is correct, in which case a later HCV RNA PCR test would confirm it. But how you got exposed is a puzzle unless the person who drew your blood in October did not use hygienic practices, so that some HCV entered your bloodstream then. I sure hope that's not the case.

You are correct that usually a person is tested for the HCV antibody, then only if that is positive does the person get the more expensive HCV RNA PCR test. But since you say this test was for an investigational study, perhaps they had the money to do the HCV RNA PCR test right away in order to save time.

I'm glad you went back to get tested again. Please let us know what you learn.

Gnatty
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Ton_1216

  • Member
  • Posts: 6
Re: False-positive HCV RNA QN RT PCR
« Reply #2 on: January 17, 2016, 05:43:19 pm »
Thank you gnatcatcher for your response! I'm thinking they only do antibody tests because she said I could "get a test that tests the little viruses that I would have" in her own words. either they don't know their stuff or they thought I had gotten the antibody. I'm crossing my fingers while I wait. I'm just hoping its some weird mixup because of this mercury Retrograde  :-[ I will let you all know what happens and hopefully I get a result tomorrow or Tuesday.  :-\

Thanks again for your input. I've been staying up all night the last few nights reading everything I can about the virus and possibilities. As well as questioning my every past move ugh.

Offline gnatcatcher

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  • Posts: 1,372
Re: False-positive HCV RNA QN RT PCR
« Reply #3 on: January 17, 2016, 08:14:37 pm »
Ton_1216, with the antibody test, people test Positive if they have ever had Hep C (even if they managed to get rid of it without treatment) or if the result was a false positive. I don't know whether an antibody test would be reported with a result that includes a log value; the antibody test that diagnosed my Hep C in 2002 just indicated Positive and recommended further testing. It's because your result included a log value that I thought that 27 "little viruses" were found. Do you have a printout of the test? If so, what was the name of the test that resulted in 27 IU/ml and 1.43 log IU/ml? If it's the same as in your Subject: line (HCV RNA QN RT PCR), then that's not the antibody test but the one that measures viral load, which means either that there is Hep C virus in you or the test sample was contaminated. Even if it's the worst-case scenario, there are very effective treatments now that most people find very easy to tolerate.

Gnatty
« Last Edit: January 17, 2016, 09:04:21 pm by gnatcatcher »
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Ton_1216

  • Member
  • Posts: 6
Re: False-positive HCV RNA QN RT PCR
« Reply #4 on: January 18, 2016, 07:11:51 pm »
Gnatcatcher I'm only assuming that they think I got an antibody test and don't know what They're reading. Another odd thing is that they did both hiv and hcv and the hiv test was the antibody test which read nonreactive. Which to me means they both should have had that same type of reading. Maybe somehow I got someone else's RNA or it was cross contaminated which resulted in false positive. As anyone would hope I'm leaning towards the better outcome but I'm fully prepared to face the possibility of me being positive. Still haven't received any update but tomorrow should be the day or else I'll start pulling my hair out waiting. I already scheduled a visit with my PCP to go over what might happen if it's positive but also get a THIRD test with both antibody and RNA if that's possible.

Offline Mugwump

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  • Posts: 778
  • My number of posts means nothing, piscor ergo sum!
Re: False-positive HCV RNA QN RT PCR
« Reply #5 on: January 19, 2016, 03:57:44 am »
PCR testing is usually not done unless there has previously been a positive antibody test result. And usually the antibody positive result is double checked because that is the test that frequently returns false positives.


There is a possibility that you have had a very recent exposure and you are just now either clearing the virus naturally or it is just starting to infect. Either way insist upon more PCR testing over a 3 month period to confirm or rule out an infection!


If you are infected the virus is very fast to replicate and the VL load count can go into the millions in a hurry so if you have another test and it shows the same results I would ask your doctor to change labs! Because there is no way that the result could be accurate unless the lab is messing up the tests.


When I was first treated for HCV with interferon and ribaviron in 2004 I had a very low VL count lab result near end of treatment. A retest two weeks later and my viral load was 11 million!


Take care and be proactive about testing. If you do have HCV do not wait until you start seeing high AST and ALT levels before getting treatment. Scream yell kick and give your paid elected officials HELL rather than put up with pencil pushers making you wait till you have cirrhosis before they condescend to allowing you to get treated!


I truly hope that your positive pcr result was only bad lab technique and you are not really infected.


All the best
Eric
Caution shameless self promotion below :-)
https://www.hepmag.com/article/eric-reesor-27742-782589663
DING DONG MY DRAGON (HCV) IS FINALLY DEAD!

Offline Ton_1216

  • Member
  • Posts: 6
Re: False-positive HCV RNA QN RT PCR
« Reply #6 on: January 19, 2016, 11:01:55 pm »
Thank you for the advice mugwump. I still haven't heard anything back yet but still keeping an optimistic attitude about it all. Also thank you for the information you've shared.

Offline Ton_1216

  • Member
  • Posts: 6
Re: False-positive HCV RNA QN RT PCR
« Reply #7 on: January 20, 2016, 03:37:22 pm »
Results came back as negative from what they're telling me over the phone. Not sure which test they performed but they're ruling it out as a false positive and will be getting back to me when the doctor reviews them more. Whatever the case, looking at this as a good thing.

Offline Ton_1216

  • Member
  • Posts: 6
Re: False-positive HCV RNA QN RT PCR
« Reply #8 on: January 20, 2016, 03:38:06 pm »
Ruling out the first test as false positive.

Offline gnatcatcher

  • Member
  • Posts: 1,372
Re: False-positive HCV RNA QN RT PCR
« Reply #9 on: January 20, 2016, 06:14:11 pm »
WONDERFUL news! (horrible to have to go through those days of worry, though. I hope you managed NOT to pull your hair out.)

Gnatty
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Mugwump

  • Member
  • Posts: 778
  • My number of posts means nothing, piscor ergo sum!
Re: False-positive HCV RNA QN RT PCR
« Reply #10 on: January 21, 2016, 01:04:57 am »
FYI the test that is conducted for antibodies is the same test used to screen blood bank samples so it is cheap. It is called an immune assay hepatitis serum antibody test. Please read the info down the first page of the link and the difference in tests will become clear.
http://www.cdc.gov/knowmorehepatitis/learnmore.htm





The test that confirms the presence of HCV is different and if the virus is detected the software goes on to do a count. Provided the lab tech does not botch the sample. It is not a simple test and requires more advanced clean room technique. Which is part of the reason why it is more expensive.


http://www.mayomedicallaboratories.com/interpretive-guide/?alpha=H&unit_code=83142



Sounds like you had the genetic PCR test done and it returned a non specific result the first time. If you are antibody positive then you cannot give blood because all blood that is given and found to have HCV antibodies in it cannot be used.


If I were you I would make absolutely sure that you do not have HCV antibodies and insist upon knowing the results of a cheap simple antibody test and grill the doctor that is what he is being paid to know! Either that or go to a lab that lets you see the test results online.


This is silly, because the "gold standard" PCR test is still ridiculously expensive one and is not at all necessary unless you have had repeated positive antibody test result happen. You know cart and horse, chicken and egg debate type logic. But it sounds like a good way for the labs and the pharmacos that hold the test software, equipment and kit patents to clean up in the land of medicine for profit!


BTW YAHOO another human who does not have this disease!


All the best
Eric
Caution shameless self promotion below :-)
https://www.hepmag.com/article/eric-reesor-27742-782589663
DING DONG MY DRAGON (HCV) IS FINALLY DEAD!

 


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