Can somebody explain this?

[clark123]

Here's the situation.

I'm a 30 yr old male. No tats. Never done drugs. No surgeries. Not gay. Have only had needles in me for the purpose of giving blood (which I've done multiple times per year for a few years now).

I tested reactive to Hep C antibodies twice in the last month (1.22 and 1.33).

The RNA test afterward was negative.

Here's the kicker. Between those two tests, I gave blood (did not know I had the antibodies) and Red Cross didn't notify me of it being a bad sample or anything.

So after the 2nd reactive antibody test, I called Red Cross and they checked back at my results and said no, the blood was not reactive and they have the most sensitive testing. He could not explain why my healthcare provider got reactive results.

My healthcare provider also doesn't have an answer yet.

What I do understand is that I don't have Hep C because the RNA was negative, but the inconsistent antibodies test is confusing me. Does anybody here have any explanation or theory?

[gnatcatcher]

Hi, Clark --

Here's one possible explanation for your false positives on the antibody test:
https://www.hepmag.com/article/false-test-result-25760-476718382
Excerpt: "A false positive occurs when the ELISA test comes up positive for hep C antibodies, but the person taking the test was never exposed to hep C virus, which leads the RNA test to read as negative. The problem is that antibodies that the immune system has produced to combat infections other than hep C can be what’s known as “cross-reactive”: The ELISA winds up picking up on these antibodies’ presence and incorrectly coming up positive."

I knew different labs have different sensitivities to their RNA tests (i.e., how low an amount of virus they can still quantify). From what the Red Cross told you, it sounds like different labs may also have different sensitivities to their ELISA tests, which would lead to the hypothesis that the test at your healthcare provider is more easily fooled by cross-reactivity.

Glad that your final news is excellent, even though you had a bit of a roller-coaster ride getting there.

Gnatty

P.S. If your healthcare provider finds an answer (either confirming this hypothesis or concluding something else), please let us know. Thanks.

[Mugwump]

Here's the situation.

I'm a 30 yr old male. No tats. Never done drugs. No surgeries. Not gay. Have only had needles in me for the purpose of giving blood (which I've done multiple times per year for a few years now).

I tested reactive to Hep C antibodies twice in the last month (1.22 and 1.33).

The RNA test afterward was negative.

Here's the kicker. Between those two tests, I gave blood (did not know I had the antibodies) and Red Cross didn't notify me of it being a bad sample or anything.

So after the 2nd reactive antibody test, I called Red Cross and they checked back at my results and said no, the blood was not reactive and they have the most sensitive testing. He could not explain why my healthcare provider got reactive results.

My healthcare provider also doesn't have an answer yet.

What I do understand is that I don't have Hep C because the RNA was negative, but the inconsistent antibodies test is confusing me. Does anybody here have any explanation or theory?

Some antibody tests can yield up to 20% false positives depending on how old the reagents are. So it might very well be that you had 2 false positive tests. There is also a possibility of unsound lab practices causing a contaminated test.

At one time it was standard practice to repeat the antibody test before moving on to a test for the presence of the virus.

Either way I would do an antibody test again in about 6 months just to make certain that you have not been exposed somehow and developed antibodies. You can also ask your doctor to have it done at a different lab with a different type test kit if your insurance company will allow it. Or if you can afford a test on your own and your insurance only covers it through at the cheapest lab in town, have it done at a different lab. 

[clark123]

How it all ended up almost a year later.

Did the anti-body and RNA test every few months. Anti-bodies spiked up to like 1.50 but last month was back down to 1.10, which was lower than when it all started. RNA has been negative every time. My non-doctor theory is I was exposed to Hep C, anti-bodies spiked, and now normalizing again.

Still no idea where the exposure could have came from though. But I guess it's better to have anti-bodies than not as long as RNA is negative?

[Lynn K]

Really antibodies don’t mean much in the case of hep c. Hep c antibodies are not able to fight off the hep c virus if they were we would probably have a vaccine for hep c now which we don’t yet. Other virus like measles also cause the body to create antibodies to this virus. So if you were ever infected with measles you will have measles antibodies. Or if you were immunized against the measles this caused your body to create measles antibodies which unlike hep c antibodies are able to ward off measles infection.

Having hep c antibodies will neither harm or help you. But having a not detected test for the virus the HCV RNA test is all that matters.

We sometimes have to accept that we may never know the reason for things. It may remain a mystery why you test positive for hep c antibodies on some tests but at least you know you don’t have hep c.

[Mugwump]

How it all ended up almost a year later.

Did the anti-body and RNA test every few months. Anti-bodies spiked up to like 1.50 but last month was back down to 1.10, which was lower than when it all started. RNA has been negative every time. My non-doctor theory is I was exposed to Hep C, anti-bodies spiked, and now normalizing again.

Still no idea where the exposure could have came from though. But I guess it's better to have anti-bodies than not as long as RNA is negative?

Not so sure Lynn if having increased antibody levels to HCV is quite as harmless as we currently understand. Hopefully I am wrong though!

From my understanding clark123 is reporting what is happening regarding qualitative differences in test here.This could be very interesting indeed if the newer antibody tests are becoming much more accurate than in the past, in as much as the antibody test being reported here are current and qualitative not quantitative.

Therefore the tests should have a similar result if your immune system is stable. It could very well be that minor changes in ones immune system occur for any number of reasons and the numbers of anti-bodies one creates will vary greatly at anytime post exposure to HCV regardless of whether or not there is actually an active HCV infection involved in the equation. Clark123 is HCV RNA negative thus not infected. But indeed having high levels of antibodies to HCV themselves may very well create other symptoms in some individuals.

Obviously more research into the effects of HCV antibodies on the human body needs to be undertaken. If findings indicate that having levels of antibodies to HCV are more harmful that once thought all the more reason to eradicate the spread of this disease if at all possible.

Just a thought from a simple observation of what we see here.

Cheers
Eric

[gnatcatcher]

Whether or not antibodies to HCV turn out to be more harmful than once thought, the main point for clark123 is that he doesn't have HCV and therefore doesn't need treatment. As Lynn wrote, clark123 may never know why those antibody tests came back positive -- cross-reactive antibodies are among the possibilities that can't be ruled out or in. What ultimately matters is that clark123 is FREE OF HCV!

[Mugwump]

NO argument there from me Gnatty!!

[Lynn K]

As Gnatty mentioned originally in 2017 it could be a cross response to something other than hep c antibodies. Especially as the more sensitive tests used by the blood bank did not detect hep c antibodies.

I think it is entirely possible there are in fact no hep c antibodies present and the less sensitive tests are reacting to something other than hep c antibodies.

But bottom line no hep c virus after this long is very good news.