Hep C - Could "Not Detected" RNA be wrong?

[flupbear]

In late September I had an anti-HCV test due to feeling crummy that I was shocked to have come out reactive (low-risk - no tattoos, no drugs, only risk would be body piercings always done at sterile places, manicures, or recent hospitalization for gallbladder removal). Sc/o was 1.24.

I had an  HVC RNA test about a week later that gave a "Not Detected" result.

I was tested again a month later (beginning of November) - anti-HCV sc/o was 1.61, but HCV RNA was again "Not Detected."

Is it possible that these two RNA tests are wrong and I do have HCV? My doctor keeps saying I do not have it, but I read that RNA levels can be transient and intermittent. How will I ever know for sure that I do not have it if that's the case?

I have to take medications daily for other health issues and I'm not a big drinker but I do enjoy having wine sometimes...I'm just afraid I'm unknowingly damaging my liver by living my "normal" life.

Does HCV RNA ever plateau into a detectable rate? Is there a certain time window I have to wait to be truly sure?  

[flyinlynn]

As you said you do drink alcohol how are your liver enzyme test results (ALT and AST) those could indicate if you are experiencing liver damage. Elevated liver enzymes was my first indication I had hep c as they were chronically slightly elevated. Willing to bet yours are normal.

[flupbear]

Hi flyinlynn,

Thank you again for your responses. To my knowledge I did not have any HCV exposure, but as I said I have body piercings (all accredited/sterilized) and have been hospitalized several times in the past year.

As far as blood tests, I had one CBC in June where my ALT came back one point out of normal range (30/29). At the time I had other things out of whack, but my doctor was not concerned, saying it just signified a "non-specific inflammatory response." All CBCs before and since then have been normal for AST/ALT.

In addition to the cherry angiomas that keep popping up at an alarming rate as well as the petichaie, I have also had a rash on my thighs since November that looks a lot like eruptive xanthosis. I've been developing little spots of hyperpigmentation (the size of freckles) on my face and arms.

I have had several other blood tests come back slightly abnormal (a1 globulin slightly increased, albumin slightly elevated) from time to time. I try to keep in mind that prior to the HCV result I would have never worried about my liver given that I have no history of abuse or familial disease, but given all my symptoms plus the positive test, I can't help but feel it all points to liver issues.

I had another RNA test Thursday so I am waiting in that result. Even if it is negative, I don't know what to think at this point. I get more skin symptoms daily and my gastro issues are persistent.

Thank you again for taking the time to respond. It's nice to have someone to express concerns to because it's too scary to share with my family.

[flyinlynn]

Perhaps you should see a dermatologist. You really have no reason to suspect liver disease.

Hep c in general is a silent illness with most  people being unaware they are infected.  The most commonly reported symptom of long-term hepatitis C infection is tiredness.  Other symptoms may develop after decades of infection and that is only for the few that go on to develop significant liver damage. In general only about 20% of those infected for over 20 years will develop liver cirrhosis.

The majority of the symptoms you have listed are not from hep c or liver disease except the petechia which could be a symptom of liver disease which would be identified by the testing you have done. Petechia can be caused by many benign causes as well.

[flyinlynn]

Causes
By Mayo Clinic Staff
Tiny blood vessels (capillaries) link the smallest parts of your arteries to the smallest parts of your veins. Petechiae appear when capillaries bleed, leaking blood into the skin. A number of things can cause this bleeding, including:

Prolonged straining
Certain medical conditions
Specific types of injuries
Medications
Injuries and sunburn

Prolonged straining

Tiny petechiae of the face, neck and chest can be caused by prolonged straining during activities such as:

Crying
Coughing
Vomiting
Childbirth
Weightlifting
Certain medications

Petechiae may result from taking some types of medications, including:

Anticoagulants (warfarin, heparin)
Atropine (Atropen)
Carbamazepine (Carbatrol, Epitol, Tegretol, others)
Chloral hydrate (Somnote)
Desipramine (Norpramin)
Indomethacin (Indocin)
Naproxen (Aleve, Anaprox, Naprosyn)
Nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Penicillin
Quinine (Qualaquin)
Infectious diseases

Petechiae may be caused by any of a number of fungal, viral and bacterial infections, including:

Cytomegalovirus (CMV) infection
Endocarditis
Hantavirus pulmonary syndrome
Meningococcemia
Mononucleosis
Rocky Mountain spotted fever
Scarlet fever
Sepsis — an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced
Strep throat
Viral hemorrhagic fevers
Other medical conditions

Petechiae may also be caused by noninfectious medical conditions. Examples include:

Vasculitis
Thrombocytopenia (low platelet count)
Leukemia
Scurvy (vitamin C deficiency)
Vitamin K deficiency
Injuries or sunburns

Child abuse involving strangulation or smothering can cause petechiae in the face and eyes. Biting and spanking can also cause petechiae. Crush injuries, such as those experienced during car crashes, can result in petechiae of the face, neck and chest. Severe sunburn also can sometimes include petechiae.

As you can see there are many reasons for petechia

[flyinlynn]

Believe your doctor. You don't have hep c.

[flupbear]

Thanks for your response. My issue with believing it stems from my symptoms. At first I tried to dismiss the vague ones like itchiness and fatigue and even a permanently swollen lymph node as stuff I only noticed because I was extra concerned, but they seem to be getting worse. Now I am getting cherry angiomas (which I know are harmless) and petichaie for no apparent reason - I've never experienced petichaie even when lifting heavy weights. I know these things can be caused by other issues but I've had a better of tests and the hep C is the only thing that has shown up.

[flyinlynn]

Hep c for the majority of people has no symptoms the most common reported symptom of hep c is tiredness. About 20% of patients over 20 years of infection may develop liver cirrhosis. Itchiness from advanced liver disease is caused from elevated Bilirubin levels but again that takes decades if ever to happen did to hep c infection.

Have you had an incident where your were exposed to hep c contamited blood and that blood possible entered your blood stream? If you did not experience a blood to blood contact and since you test not detected for the hep c virus I recommend you trust your doctors opinion and look elsewhere for the cause of your symptoms.

[flyinlynn]

I got this from the Mayo Clinic web page

Possible causes of itchy skin include:

Dry skin. If you don't see a crop of bright, red bumps or some other dramatic change in the itchy area, dry skin (xerosis) is a likely cause. Dry skin usually results from older age or environmental factors such as long-term use of air conditioning or central heating, and washing or bathing too much.
Skin conditions and rashes. Many skin conditions itch, including eczema (dermatitis), psoriasis, scabies, lice, chickenpox and hives. The itching usually affects specific areas and is accompanied by other signs, such as red, irritated skin or bumps and blisters.
Internal diseases. Itchy skin can be a symptom of an underlying illness. These include liver disease, kidney failure, iron deficiency anemia, thyroid problems and cancers, including leukemia and lymphoma. The itching usually affects the whole body. The skin may look otherwise normal except for the repeatedly scratched areas.
Nerve disorders. Conditions that affect the nervous system — such as multiple sclerosis, diabetes mellitus, pinched nerves and shingles (herpes zoster) — can cause itching.
Irritation and allergic reactions. Wool, chemicals, soaps and other substances can irritate the skin and cause itching. Sometimes the substance, such as poison ivy or cosmetics, causes an allergic reaction. Food allergies also may cause skin to itch.
Drugs. Reactions to drugs, such as antibiotics, antifungal drugs or narcotic pain medications, can cause widespread rashes and itching.
Pregnancy. During pregnancy, some women experience itchy skin, especially on the abdomen and thighs. Also, itchy skin conditions, such as dermatitis, can worsen during pregnancy.