Initial test was positive but second test was negative

[confused_extremely]

Hi,

Just a background about myself. 29 years old male. Never had any drug (not even once), no smoking (not even once), no sexual activity and no blood transfusion ever.

For a totally different scenario, I was asked to take some blood tests and one of that test was for Hep c. Again this test was not taken because of any symptoms or because of any physical problem.

When that test results came, my doctor told Hep C was reactive. The test results were

HEPATITIS C AB W/REFL TO HCV RNA, QN, PCR

HEPATITIS C ANTIBODY - REACTIVE

SIGNAL TO CUT-OFF - 3.32 H

 

HCV RNA, QUANTITATIVE REAL TIME PCR

HCV RNA, QUANTITATIVE REAL TIME PCR - 1290 H

HCV RNA, QUANTITATIVE REAL TIME PCR - 3.11 H

Seeing this result, the doctor who ordered the test told I have Hep C and asked to follow up with my primary care physician.

 

After that, I went to the Primary Care Physician to do a complete physical checkup and during that time I asked to do the Hep C test again to confirm there was no lab error (because I was not exposed to any Hep c causes and I never had any symptoms). This was exactly after 20 days, after my initial test.

In the physical check up, everything turned out normal including liver enzymes which was very well within normal numbers. And the doctor also told my Hep C results were negative and she was not sure what was going on and referred to a specialist.

The second Hep C result were:

HCV RT-PCR, Quant (Non-Graph)

Hepatitis C Quantitation - HCV Not Detected

 

What does this mean? Why was my initial result positive and the second result was negative (without any medication)? Do I have Hep C or can I confirm that the first result was because of some lab error? Then why is my physician still asking to follow up with the specialist?

My appointment with the specialist is after 2 months from now (unfortunately that was the earliest appointment I could get). I am really worried and will be confused with this till I meet the specialist. In the meantime if any of you could through some light on my situation, it will be greatly appreciated.

 

[gnatcatcher]

confused_extremely, the more recent lab results are very encouraging. Either the first results were a lab error* or somehow your body came into contact with Hep C but your immune system got rid of it. (Some people do clear Hep C on their own without any medicine.)

It's emotionally difficult to wait 2 months to see a specialist, but you are not in any danger. Even if the first labs are correct, the fact that your liver enzymes are well within the normal range means your liver is in excellent shape. Hep C takes a long time to significantly damage a liver. Also, in the unlikely event that you actually have Hep C, finally there are good medicines to cure Hep C.

The 3.11 is the logarithm of 1290 (viral loads can jump around a lot from one lab test to the next, so the logarithmic number makes it easier to spot significant changes). I don't know what the "H" signifies, because the labs I have gone to measure viral load in IU/mL (international units per milliliter). Not knowing what the "H" stands for means I can't tell you whether the first lab result is a little or a lot. But  the odds are that the newer lab results are correct, either because the first ones were wrong or because the Hep C was recent and small enough that your immune system got rid of it. (People who are cured still have positive antibody tests.)

I hope reading this post gives you some relief.

Gnatty

*This journal article: http://www.jci.org/articles/view/115815 contains the following sentence: "HCV RNA PCR is subject to false-positive reactions through contamination and is inherently difficult to standardize and quantitate."

[confused_extremely]

Gnatty,

Thanks a lot for your response.

My doctor told the 1290 count is IU/mL only. The H stands for High (anything above 15 is considered as above limit and that is why it is marked as high)

[gnatcatcher]

confused_extremely, thanks for explaining the "H" and that the 1290 is IU/mL. 1290 is a low viral load, so in the unlikely case that it is correct, the two months you have to wait are not going to harm your liver much if at all. My guess is that the specialist will either decide that the newer result is the definitive one or will order a third test to be certain. I'm not a doctor, though, so I'm just basing my guess on what I mentioned in my earlier post. -Gnatty

[Lynn K]

Hep c seldom has symptoms which is why it is called a silent illness.

My best guess is you were somehow exposed and may have cleared hep c on your own. About 25% of people do clear hep c and do not go on to develop chronic illness. From when I was likely infected in 1978 I had a liver function test in 1988 that showed normal ALT and ALT.

Hope you are good to go