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False Positive?: HCV RNA,QN,PCR

My wife recently had some routine bloodwork done ordered by her PCP, one test which was HCV RNA,QN,PCR (Quest Diagnostics).   We're not sure why this was included or ordered as my wife does not fall into any of the high risk categories typically found on informational sights.  Her test results came back yesterday with a value of 23 IU/ml (1.38) log.   The lower limit of detection is 15 (1.18).

We are obviously concerned as this came out of the blue - would not have suspected HCV otherwise.  Her ordering Dr is out of the office today and we are having trouble gaining some perspective.   Does anyone know if:

1) This could be a false positive?  (She did not have any of the anti tests or RIBA as of yet)
2) Could she have had this since birth?  (possible but rare transmission from her mother who did have a tranfusion 5 years prior to her birth)
3) Does this result alone mean she definitely has it or will we be doing further tests?

Thanks in advance - it just seems odd that she would have a VL that low on a test she probably didn't think she needed to take.


http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=35645X&labCode=QBA
24 Responses
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Avatar universal
yes, and my OB/GYN even have no sense of the number...............i discussed the extreme low units, all he said was : i refered you to the specialist.,...................
Helpful - 0
Avatar universal
Hep c isn't considered an STD so I'm not sure why so many drs are ordering such an expensive test
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Avatar universal
My non expert opinion is that this is most likely a false positive based on all the research I did and my experience.  It's horrible you have to deal with it and hep-c isn't c
Helpful - 0
Avatar universal
i also have this problem now , the test result is 18 IU/ml still waiting for the restest..... hope it is a lab err
Helpful - 0
317787 tn?1473358451
I am so happy that it was a mix up, I had something like this where I received a false negative, went another 10 years before I was finally diagnosed.

I am so very happy for you and your wife.

On the bright side you are much more educated than the normal person and have learned there are many ways to get it.

Have a great life! :)
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Avatar universal
That is GREAT NEWS....an early Holiday present for sure....  
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1815939 tn?1377991799

It is great news that she was UND on this last test. Sounds like the first test was a lab error or a lab mix-up.

Best wishes for the future (and for your family).
Helpful - 0
Avatar universal
Pooh had the same responses I would have given you.  There are 100's of ways this virus can enter one's system...  I am a baby boomer and I can't believe how many ways I possibly, inadvertently could have infected myself.  It's pretty much a blood to blood virus unlike Hep A and B.   I could bore you and list a hundred of ways I could have gotten this but I won't.  

As for the false/positive aspect of it all....when I had my first set of tests, they had to do them again to rule out false/positive....since I was an EMT in a prominent ER and had had the A/B shots they made absolutely sure.  I was stunned to say the least but could think of dozens of ways I got infected working there.  Baby boomers, health care workers ..... like I said, hundreds of ways but remember, HCV is known as a blood to blood virus.
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Avatar universal
We got the RNA test back.  It was marked undetected with a value of 0 IU/ML!!!  If it were detected but less than 12 it would have said so and/or any value above 12 would be reported.  But we have a zero undetected   The test notes say we can't assume the sample is hcv negative but this plus the negative anti test means we are home free right? As you can imagine we are a little bit distrusting these days. Thanks for the support !
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142526 tn?1397090672
Yes I think it's possible to have a low VL if it's a very recent exposure and antibodies have not fully developed. Yes it's better news if this is a recent exposure rather than at birth, and if that were her case she would have pos. antibodies.
Hopefully this was a lab error, the next PCR should validate what is going on. Sorry to hear you guys are going through this, the waiting is the hard part.
Best of luck!
Helpful - 0
Avatar universal
MagTx,

Thanks - considering her low VL (23), would the exception to your rule be only a recent infection?  From what I read, recent exposures can lead to a situation where Antibodies haven't formed yet the Quant would show a reading.  At that point, its either that or a messed up RNA test and we are treating both as better news than worrying about her being exposed at birth.

And to confirm, the .08 Signal/Cutoff ratio should be considered negative, right?
Helpful - 0
142526 tn?1397090672
Any one that's never been exposed to hep c will test neg. to to hep c antibodies.  The antibodies stay with us for life even after we are cured and do not have a VL on a PCR test.
Another words if the antibody test was neg. than your wife has never been exposed / infected.
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Avatar universal
More good news we think.  Hcv anti test just came back with a s/co  .08 which we are interpreting as good news.  As on if she has it it just happened.  Still waiting for quant retest.   Is our understanding correct?   She couldn't have it for 29 years and test negative on anti ?
Helpful - 0
Avatar universal
The 23 is the value listed off the test on the subject which is a quantitative RNA test.  It is not an antibody test and my interpretation has been confirmed by a hepatologist.  We are in the process of retesting.  No anti test was administered and in fact this test was mistakenly ordered instead of the hep-b test.
Helpful - 0
Avatar universal
I afraid you all are mixed up. The 23 is not the viral load. It is the measure of the hepatitis antibody. They will confirm this positive antibody test with a HCV quantitative/Viral load. Yes it is posible to have a positive HCV Qualitative and a negative viral load on follow up.
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Avatar universal
As an update, she spoke with the ob gyn who ordered the test and he is referring her to a specialist.  Wasn't too helpful but understandable ad it's not his domain.  Mentioned that while testing errors could happen in theory that a number on that test means you have it.   On fact the lab did run the wrong test in one case. We didn't get the impression that he felt a 23 was different from 2.3 million.  Only thing left to do is wait.  Thanks for all of the responses.
Helpful - 0
979080 tn?1323433639
A viral load of 23 IU/ml is extremely low for someone infected and
not undergoing tx  I would definately retest in hopes it is
a lab sample cross contamination error.

Helpful - 0
Avatar universal
Thanks all.  They ordered these tests because we are planning to start a family.  For what it's worth she had normal lipids as well as very good levels for all 5 liver tests. There was no prior concern to even look for any hepatitis.
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Avatar universal
Opps...I meant to say "is it possible that her doctor may be...."
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Avatar universal
Is it possible that her may concerned due to elevated liver enzymes and therefore requested the Hep C tests?
Helpful - 0
4113881 tn?1415850276
That is a really low VL...I would definitely re-test.

Helpful - 0
1815939 tn?1377991799
Something I should add:

People can get Hepatitis C in many different ways. Many things people do not think of is that they could have been infected via improperly cleaned medical equipment or dental equipment. Also tattoo equipment, acupuncture equipment, razors, nail clippers, nail salon equipment, etc. Any exchange of blood can transmit Hepatitis C.

Has her mother been tested for Hepatitis C? If her mother is positive, then that is another source of possible infection.

However, hopefully this was a lab error and your wife is not infected.
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Avatar universal
Thanks for responding.  She is 29.
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1815939 tn?1377991799
"We're not sure why this was included or ordered as my wife does not fall into any of the high risk categories typically found on informational sights."
--------------------------------------------
You do not say how old your wife is. If she is a Baby Boomer born between 1945 and 1965, the CDC recommends testing all Baby Boomers for Hepatitis C.


Does anyone know if:

1) This could be a false positive?  (She did not have any of the anti tests or RIBA as of yet)
------------------------------------------------
It is possible it is a lab error or mix up. If it was me I would get another test drawn and see if it shows a viral load. (Generally they do the antibody tests first and then do a VL only if the antibody test is positive. Not sure why they did the VL test first on your wife.)


2) Could she have had this since birth?  (possible but rare transmission from her mother who did have a tranfusion 5 years prior to her birth).
-------------------------------------------------
If her mother had Hepatitis C then there would be about a 5% chance of vertical transmission to the baby.


3) Does this result alone mean she definitely has it or will we be doing further tests?
---------------------------------------------------
It is possible that the test result of 23 is a lab error, lab mix-up, or lab contamination. Since the VL is so low (23) I would get another test drawn. Draw new blood and test it.
Helpful - 0
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