Tested Positive for Hep C antibodies - have several questions

[Gwendolyn2009]

Hi all.  Last year I was diagnosed with an autoimmune disease (Hashimoto's), Hypothroidism low vit d, b12, and ferritin after years of not feeling well.  When the did the blood work to determine this they found my liver enzyme test was elevated.  Nothing was done about the liver enzymes at that time.  Well since that time, the have tested high 3 times.  In September, our office gave us complementary blood work.  This time liver enzymes were even higher AST 45 ; ALT 93 and GGT 65; so I called my dr. He told me to make an appt.  I thought maybe I had autoimmue hep because I have read that if you have one autoimmune disease you will most likely have others.

He did a hep c panel and it came back positve for antibodies at 4.1. He also ran antismooth mscle and it
was high at 21.  I have an appt to see a specialist.  He called me into his office to discuss my results last Monday.  Needless to say I was very, very upset. He said this would explain why I still feel so bad all the time. I am very confused because I give blood all the time.  I just gave in July and I called the red cross so I called them to see,  and they said it was neg. for hep c and faxed me my results.

I have not used drugs in 20 years, I have a tattoo but have had it for 20 years, am married for 18 years and have 2 children.   The only thing that did happen was 2 weeks before the bood test for hep c, I stopped to help an elderly man who had fallen and was bleeding everyplace.   I was on the phone with 911 and they wanted me to try to stop the bleeding so I had to get some towels and wrap up his arm.  I ended up having blood on my hands, not to much but some.  The emts cleaned me up when they arrived.  The only thing I know about him is he told me he was on dialysis.  He has since passed.  

I have several questions:  Could I test positive that quickly?  I've read that dialysis patients often have hep c, why is that?  If it is true that I picked this up from the elderly man, that does not explain the elevated liver enzymes over the last year.

Do you think it could be a false positive?  I've also read that people with autoimmnue disease often have false positives.  

I've also read that hep c patients end up with autoimmune and thyroid disease because of the hep c. This is very confusing.

If I have always tested neg in the past when I have given blood, does that mean I was truly neg?  Can hep c be dormant in your body and then you test positve all the sudden?

Thank you for your opinions!

[Gwendolyn2009]

I just went to the hospital and picked up my test results.  I can't seem to get my dr. to call me back so I thought I'd post them here and see if anyone has any opinion about the results.

Final Diagnosis of Liver Biopsy: Mild Lobular Hepatitis with Mild to Moderate Central Venular Fibrosis without bridging Fibrosis or Cirrhosis.   Comment: there is no evidence of interface hepatits.  Bile ductules are well preserved which is counter to the usual findings of primary biliary cirrhosis.  The most striking find is mild sinusoidal fibrosis and mild to moderate fibrosis of central veins.  Clinical correlation is necessary.

Labs:

Antismooth muscle AB:  22     range 0-19 negative 20-30 weak positive
Hepatits C Quantitation: <43 (B)
Antinuclear Antibodies Direct: Negative

Thanks,

[Gwendolyn2009]

haha I know that any type of hep is bad and no way does having hep compare to eating a rotten banana or apple.  It was just my stupid analogy lol

[Bill1954]

“ I don't want autoimmune hep either.  What do you want the rotten banana or the rotten apple?.  They are both bad.  I want neither!”

LOL, that’s about the size of it, huh? Hopefully, you’ll find out that you only have a touch of fatty liver, and nothing else; the doc will suggest you lose 10 pounds, and your wish will come true. You’re enzymes really aren’t all that high; only about 2 x normal, so that might be in the cards still.

Best wishes and hoping for good news—

Bill

[Gwendolyn2009]

Just a quick update....I went to the specialist Tuesday. She ordered a bunch more blood work and a liver biopsy which is scheduled for tomorrow.  She said I had some sort of liver disease because my enzymes have been high for a year (I don't know how she could say thay just yet).  She also told me that auto immune disease patients test false positive for HEP C, which I already knew from research, but it helped hearing it from her.    I hope that is the case.  I just don't see how I could have contracted Hep C from the time I gave blood in July.  I don't want autoimmune hep either.  What do you want the rotten banana or the rotten apple?.  They are both bad.  I want neither!

I should have results next week.  I will update.  Thanks.

BTW This is a very informative site.

[Bill1954]

As an after thought, if you’d like to learn a little more about HCV, take a peek at Janis and Friends:

http://janis7hepc.com/have_you_been_just_diagnosed.htm

I linked you to their ‘newly diagnosed’ page; be sure to glance through the section “other HCV information” located in the right-hand margin as well. Remember that you don’t have a diagnosis until the HCV RNA results are in, so don’t get all worked up prematurely.

Best to you—

Bill

[Bill1954]

The HCV RNA test takes about 7 to 10 working days to turn around. It is a special test; there are only a handful of locations in the U.S. that perform it. Quest diagnostics takes all there PCR work to Nichols Institute in San Juan Capistrano, CA for instance.

Despite the intuitive possibilities that you might have transmitted this to family members, it very rarely happens. In fact, so many of us had HCV for years, while the spouse and other family continue to test negative. I was probably infected in the early seventies, and my wife of 20 years and all my kids tested negative, despite all the possibilities.

Autoimmune Hepatitis (AIH) isn’t a picnic either; I think I’d rather deal with HCV personally. In the outside chance you are positive for HCV; it can be treated successfully in about 75% of the patients.

Try not to sweat it; I know, hard to do, but try anyway. You should have a pretty good idea what you’re up against in a couple of weeks, and like the rest of us, you’ll deal with it one way or another. The HCV really isn’t all that bad… it’s definitely a challenge, but there are worse things that can happen to us :o).

Take care, and let us know how things go—

Bill

[Gwendolyn2009]

Thank you for your comments.  I have an appt tuesday with a Gastroenterologist but she specializes in Diseases of the Liver.  My primary dr. referred me to her.  

I'm just so stressed over this.  I'm so worried about my kids and husband too.  I have a teen daugher, and we have shared a razor.  I've used my husbands razor too. Ugh.  Never thought that would be something to worry about.

I also am ready to feel better and all this stress isn't helping at all.  I was glad to hear the comment about the ferritn because no matter what I can't get mine up.

I really don't want autoimmune hep either.  It sounds almost worse than hep c if that is possible.  

How long does it take to get the test results that show you actually have the virus in your blood?  I hope it is quick!

Thanks again Bill.

[Bill1954]

Sorry to hear of all your problems; you have a lot going on. With serial liver enzyme tests all reporting on the high side, it sounds like you probably have something going on there; a single high result might have just been coincidence.

Obviously, the autoimmune issues are confusing the diagnosis as well; and yes, I’ve heard anecdotally that autoimmune issues can increase false positive results with the HCV antibody tests.

I don’t believe the recent incident involving helping the old man would have been the point of transmission for your positive test; I don’t think you would have developed antibodies that quickly. I suppose it’s possible, but not likely.  That doesn’t help explain the previous Red Cross negative results though.

It might be that you had a false positive HCV result; this does happen rather frequently; the tests are designed to screen large groups of people in a cost-effective manner, and rely heavily on follow up testing. There are other issues that can cause elevated liver enzymes; as you said, autoimmune hepatitis is a possibility.

“If I have always tested neg in the past when I have given blood, does that mean I was truly neg?  Can hep c be dormant in your body and then you test positve all the sudden?”

We’d sure like to think that the blood bank would have caught this before; and no, an HCV positive patient should test antibody positive, minus any infrequent test errors.

“I've also read that hep c patients end up with autoimmune and thyroid disease because of the hep c. This is very confusing.”

Yes; HCV can either cause or exacerbate autoimmune issues; and so can the immune modulating properties of the interferon we use to ‘cure’ HCV, to make things even more confusing.

To further complicate this, HCV patients often have iron storage problems; although they generally store too much ferritin, not to little.

You’ll want a referral to a GI or hepatologist to follow up with this; a primary care doctor simply won’t have the knowledge base to work with. The specialist will order an HCV RNA by PCR test; this checks for the presence of active virus, so that appropriate measures can be taken.

Best of luck to you; and if you have the chance, it’d be great if you could check back in and let us know how things proceed.

Take care—

Bill