Please Help..Going Crazy Here On A Friday Night

[coastgardsman]

Hello everyone, Thanks for taking the time to read this. Im a health freak as it is and this is freaking me out.  Im a 29M happily married with 2 kids.  Never done anything to jepordize my health or marriage.  Im active duty military and get poked and sticked all the time for check ups that pertain to my job.  Last week i went to donate blood and I ASSUMED everything was ok until i got that letter in the mail yest.  I know it may not be a big deal but i would like your help to make me understand what the hecks going on. I cant sleep, i feel down just thinkin about it.  The letter is from United Blood Services. It says "your blood has tested false-positive for Hepatitis C. Then it says the following test were done:
HCV antibody (EIA) - REACTIVE
HCV antibody (RIBA)- Negative
HCV NAT------------------Negative
      (no medical follow up is needed)
Im just freaking out becuase i have always donated blood and have never had this happen. Im up to date on vaccines.  I have done the whole research online on testing, and correct me if im wrong but the NAT finds the virus itself right? so if EIA was reactive for antibodys, the virus itself should of been there prior the antibodies right? Thus, The NAT would of detected(positive) if there were any?  Im fixing to go in on monday to my DR and get the same test done no matter what it costs to get it out of my head.  Any help from you guys would b a great...im glad i ran across this forum...

[portann]

Hi there,

Your first test, the Elisa, is an entry-level cheapie test and produces a certain percentage of false positives.

The subsequent and better tests show you are negative. Negative, whew, so take that and run for joy and relief.

If you want to be absolutely vigilant,  follow up in six months with another HCV antibody RIBA test (skip the Elisa) and if it is still negative, you can forget about all this.

There is no need for an HCV RNA test, in my opinion.  

I hate false positives and so does my family doc. So many of her patients seem to get scary preliminary results in mammograms and then there's freaking out and worrying until better tests show that all the strange, mixed up emotions were for nothing, absolutely nothing at all. So I know how you feel right now, especially that you're stationed away from your family.

Congratulations on your healthy lifestyle, which will serve you well aways, no matter what comes your way.  

If you work with blood from time to time, as you say, then you need to bone up on precautions and take these seriously, because things such as HCV are transmitted blood-to-blood. Maybe this scare will serve to make you more conscious of - and careful about - these risks.

And congratulations to your wife on soon becoming an RN. Nice Mother's Day gift for her, that her young old man does not have HCV.

Thanks for all you do and best wishes,

Susan

[Trinity4]

But I think even if guardsman had been exposed and the virus resolved itself the RIBA test would have been positive for antibodies.

If you are in doubt gardsman which I don't think you have any reason to be, you can have an HCV RNA by PCR done.  If the virus is present, it should show up as soon as 2 weeks after exposure.  Positive for antibodies really isn't as important (which your RIBA test showed negative) as whether or not you have the active virus.  If by chance you were exposed and your body fought it off you will test positive for antibodies probably your entire life and would not be able to donate blood because they consider it a risk and leave nothing to chance.  Also as far as the general public goes it is too costly to perform additional testing on every positive antibody test.

Thank you for service to our country.  

Trinity

[coastgardsman]

Thank U guys so much for explaining that to me.  It has eased some tension off my shoulders.  Im stationed 6hrs away from my wife and kids and live alone so sitting here in my place alone starts to make my mind wonder and think the worse.  I love what i do job wise and i as i have grown older and had kids, i started to relize how important my health is to me for my family..My wife grads in dec to be a RN, and once shes back up here i will have her use what shes learned OJT to help on this site..thanks again n god bless all u....

[mike716]

Hi, Coastguardsman. Here's a link to a very complete, detailed, and reliable article (it comes from the Journal of the American Medical Association) on "Molecular Diagnostics of Hepatitis C Virus Infection":

http://jama.ama-assn.org/cgi/content/full/297/7/724

The answers to all your questions are in there, although it may be difficult to weed them out and get through all the acronyms and medicalese.

I agree with Trinity and RobertBeWell that you are probably okay. Note, however, what the JAMA article has to say: "A negative NAT result following a positive serological test result is usually indicative of a resolved infection. However, intermittent or low-level viremia may occur during chronic infection, and for this reason clinicians should perform a second NAT 6 to 12 months later. In addition, those patients with ongoing exposure to HCV can be reinfected."

If you do decide to have another Nucleic Acid Test done, I would get the most sensitive one I could find, if I were you. If they were using a test that only measures from 600 to 650,000 IU/mL, that may not be sensitive enough to detect low-level viremia.

I am NOT trying to scare you. It just pays to take precautions.


Mike

[RobertBeWell]

You're good bro. Thanks for your service to our country!

Enjoy your weekend!

[Trinity4]

I don't know about HIV but I would assume because the NAT test is specific for HIV and HCV and it was negative you are fine.  They certainly would have notified you if the test was reactive to HIV because it is one of the infectious diseases they absolutely must screen for.  Perhaps you could post on the HIV forum for specifics or someone else here may chime in.

Truly, I think you are fine and in no danger.  Your kind of experience would freak most people out but keep in mind HCV is not transmitted from casual exposure nor is it considered an STD.  Infected blood MUST enter the bloodstream of another person and the most common route of transmission currently is IV drug use because all blood donations have been screened for HCV since 1992.  Not sure when they started screening for HIV.

Relax, have a beer and enjoy your Saturday night.  

Trinity

[coastgardsman]

Thank u so much for explaining that.  God Forbid, do they do the secondary test on the HIV as well if it was reactive to that too to eliminate that? Anotherwards if they screen for HIV n HCV with the same test n it reacts, do they do seperate test for HIV n HCV to figure out whats going on? or for which one reacted? And would i have been notfied on the same sheet if HIV was detected?  I just get so freaked out with all these medical terms and i work with blood from time to time and just worry about what is out there occupational wise. Thank u so much again

[Trinity4]

I'm not sure if the NAT test isn't the same thing as the RNA PCR test but from what I understand it detects the virus if present in the blood and your was most definately negative.  BE HAPPY!!!

Trinty

[Trinity4]

False positives happen and that is why they did the additional testing. As indicated, no medical follow up is needed.  If you were exposed to the hepc virus the RIBA test would have shown positive even if your immunne system fought off the virus. The NAT test is allows very small amounts of genetic material, such as DNA and RNA, to be detected by a process of massive copying of a gene fragment. The systems permits highly sensitive detection of RNA from HIV type 1 and HCV in test pools.
If the test pool is positive for either HIV or HCV, the individual donation suspected of containing a virus can be identified and excluded from manufacturing use. Also, the donor can be notified and deferred.

If you are still not at ease with your test results you can have an HCV RNA by PCR done.  This test will show if there is any active virus in your blood although I don't think it's necessary.  

Trinity