Blood results after treatment - could someone please explain RNA- Antibodies+

[Aussie]

I just got my post treatment (week 12) results over the phone:

HCV RNA not detected but positive for HCV antibodies. Pathologist Note: have test repeated in 12 months

What does this mean?

[Lynn K]

Once exposed to the hepatitis c virus and tested positive on a hep c antibody test you will test positive for hepatitis c antibodies likely for the rest of your life. 

Anti-bodies are not the hepatitis C virus they were made by your body in response to being exposed to the hepatitis C virus. They are part of your body's natural defense system that were created by your own body in an attempt to fight the hepatitis C virus.

Most consider a not detected result done 12 weeks after treatment has ended to be  tantamount to a cure. I suspect your doctor is just being cautious and wants to test you again for the virus at 1 year post treatment to be 100% sure you are cured. But really once you achieve SVR12 (a sustained viral response at 12 weeks post treatment) your odds of remaining not detected are about 99.8% and really the most common way to test positive for the virus would not be a relapse and rather a new infection.

But again there is no point in testing for hep c antibodies as you will always test positive for antibodies to the hep c virus because you were once infected with hepatitis c.

Just to be sure did you finish your treatment 12 weeks before this test was taken?

Or was this the test done at the end of your treatment when you had just in the last day or few days had taken your last dose of medication?

If this was your EOT (end of treatment) test your doctor will likely want to test you at the 12 week post treatment point. That is a test done 12 weeks after you took your last dose of medicine to make sure you have not relapsed and are cured.

[gnatcatcher]

Hi, Aussie --

I was still typing when Lynn beat me to it, but there may be some value in reading a "second opinion" worded a bit differently.

It means you ARE cured ("HCV RNA not detected" 12 weeks after the end of tx is officially a cure). You will most likely continue to be positive for antibodies -- there are some very rare individuals who eventually test negative for antibodies, but the norm is for us to continue to test positive for antibodies for the rest of our lives -- all it means is that, because we were exposed to HCV in the past, our immune systems are on the alert for it.

As for being retested in 12 months, my hepatologist wants his cured patients to get a viral load annually for a total of three years. That seems like unnecessary "defensive medicine," given that the relapse rate on these DAAs is so very low, but being tested one year after the cure can provide additional peace of mind.

Gnatty

[Lynn K]

Hi Gnatty

I just wanted to confirm with Aussie that this test was I fact done 12 weeks after treatment was completed and not at the end of a 12 week treatment. What caught my attention was in Aussies signature "Currently on Zapatier (started 16-1-17)" . If Aussies treatment was started on January 16th that was only 93 days ago or 13 weeeks. That makes me think the reported test result was an EOT test and not an SVR 12 test.

[Aussie]

Hi everyone,

Thank you all for your quick responses!

To clarify, the blood that was tested was taken 3 days after I had my last dose of Zepatier.

I have yet to see all the results, but the pathology company kindly gave me the PCR results over the phone.

I was very concerned by the anti-bodies being present, but relieved this is quite normal and expected.

I guess it is promising news, but will have to have more tests done. It was just a notation from the pathologist suggesting another test in 12 months.

My treating doctor is away, however I will see someone else in the next few days at his surgery.

Therefore, to summarise what you have stated, I cannot consider that I am 'cured' but it is looking good so far. Pending blood test results in 12 weeks, these will give me a more definitive answer. Have I got this right?

[gnatcatcher]

. . . Therefore, to summarise what you have stated, I cannot consider that I am 'cured' but it is looking good so far. Pending blood test results in 12 weeks, these will give me a more definitive answer. Have I got this right?

Yes.