That high of a cutoff ratio usually indicates the presence of virus. There have been several studies that show a very high correlation to s/co ratios above 10 and viral presence. However, it's not an absolute.
As Bill suggested, a PCR test is in order to confirm.
RBW
Hi Nicci—
The s c/o ratio (as it pertains to HCV) helps define true positive results in HCV antibody testing. A high result like the one you have is suggestive of exposure to the virus at some point in the past.
Additional testing that looks for the presence of active, RNA virus will be required for follow up. Here’s a page that tells more about signal to cut-off ratios:
http://www.cdc.gov/hepatitis/hcv/LabTesting.htm
Remember that the development of HCV antibodies doesn’t mean you’re diagnosed with HCV; only that you’ve been exposed at some point. Roughly 20% of those in your position will clear the virus with the help of their own immune response in the initial six months of infection.
Good luck with future test results,
--Bill