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Weakly reactive hep C Ab test

So I was doing some routine blood work for a future healthcare job, and my initial hep c Ab screen came back as weakly positive (I wasn't provided any quantifiable values). The doctor wanted me to redo the test and also do an RNA test and liver function test.

I am 22 years old and perfectly healthy. The only exposure risk I may have is that my dad has hep c. He found out he had it 7 years ago and now is undergoing treatment. He most likely has had it for 20+ years.  My doctor told me that it is more likely for me to have gotten it from a separate incident than from my dad since household transmission is extremely rare, although still possible. To add to this, my mom and dad have been together for 20+ years and she is negative.

I've read on this forum that weakly positive initial Ab tests are usually/can be false positives, especially for low risk individuals. Can anyone confirm this? The three options they gave me on my blood work is either 1) false positive 2) waning antibody 3) early infection and sercoconversion. None of these seem to suggest a chronic infection, however a current infection is possible. I do have a science background, although I am not an expert on the immune system, but it seems unlikely to receive a weakly reactive test result, if I currently have a chronic infection, as this would mean that there should be plenty of antibodies in my blood in order to give a clear positive test rresul. I know I'll only be able to know for sure once I get my results from my blood work, but typing this out at least helps with some anxiety haha.

Fortunately, whatever the results turn out to be, I am pretty knowledgable about the infection and the successful treatments currently available due to my dad currently undergoing his Harvoni treatment.  Additionally, the healthcare system where I live is now covering all hep c medications for individuals with the infection no matter the extent of infection. Therefore, I am definitely eager to know my results to either not have to worry about it or begin treatment.

Thanks!
4 Responses
Avatar universal
Your physician is spot on with what he has told you and done as a follow up.
1) That weak(or low s/co numbers) are very often false pos. This happens as the test is also very sensitive to other anti-bodies in the body (ie measles etc) and they cross react.
2)He is correct that infection is hard to contract in households. (Unless constantly sharing personal items like razors.toothbrushes etc.)

And 3) He has done the right thing by ordering the HCV/RNA test which will definitevly tell you if you do have  chronic HCV.

Also ,you are correct that current treatments are very successful and if they are covered for you ,all the better.

Good luck
2 Comments
Great answer willbb
Thanks for the answer!  

Do you have a possible explanation for how it would be possible to still have chronic hep C but yet have a weakly reactive Ab test? Would this be caused by other lab error or a deficiency in the body to produce enough Antibodies ?
Avatar universal
I went in for my follow up blood work results and the antibody test was weakly reactive again but the HCV RNA test did not detect the virus. That means I do not have hep c.

However, my doctor also ordered some liver function tests and he never went over them with me as I think we both forgot about them , since the hep c results were most important. Looking at the results however, I see that my ALT levels are quite high, at around 280 , however my ALP, billirubin , and GGT levels are normal. He did not test me for AST, not sure why.

I have made a follow up appointment, but I am wondering if any of you have a possible interpretation as to what these results could mean.

Thanks!
3 Comments
It is not surprising your Hcv/an test was again pos
Once they test positive they most often always do.
Couple of things...
You may have at one time been exposed to HCV and your body fought it off . This happens approx25% of the time hence the neg. PCR
Or you were never exposed and keep getting faster/pos an tests.
That is not uncommon
What is a bit troubling is that you have an ALT level quite high and there Beas no discussion about this with your physician
ALT is quite liver  injury specific and many isuues can cause this elevation(drugs alcohol , nafld, Nash. ) just to name a few l
Your doctor needs to discuss this and get to the bottom of it

It is not surprising your Hcv/an test was again pos
Once they test positive they most often always do.
Couple of things...
You may have at one time been exposed to HCV and your body fought it off . This happens approx25% of the time hence the neg. PCR
Or you were never exposed and keep getting faster/pos an tests.
That is not uncommon
What is a bit troubling is that you have an ALT level quite high and there Beas no discussion about this with your physician
ALT is quite liver  injury specific and many isuues can cause this elevation(drugs alcohol , nafld, Nash. ) just to name a few l
Your doctor needs to discuss this and get to the bottom of it

Sorry about double post and spell check
Meant. False/ pos. Not faster/ pos
Meant. ab.  Not. an
And meant. was.  Not Beas
683231 tn?1467323017
I am betting if the tested ALT the tested AST as they ar part of the same test a liver enzyme test.

I did find this about elevated ALT

“Slightly high ALT levels may be caused by:

Alcohol abuse
Cirrhosis (long-term damage and scarring of the liver)
Mononucleosis
Drugs such as statins, aspirin, and some sleep aids

Moderately high ALT levels may be because of:

Chronic (ongoing) liver disease
Alcohol abuse
Cirrhosis
Blockage of the bile ducts
Heart attack or heart failure (when your heart can’t pump enough blood to your body)
Kidney damage
Muscle injury
Damage to red blood cells
Heat stroke
Too much vitamin A

Very high ALT levels can be caused by:

Acute viral hepatitis
An overdose of drugs such as acetaminophen (Tylenol)
Liver cancer“

I think a result around 280 would be slightly to moderately elevated. Very high results would be over 500 to 1000.

But yes definitely work with your doctor about the elevated ALT.

As willbb said you will always test positive for hep c antibodies probably for life so no reason to have hep c antibody tests done you know what your result be.

Good luck
2 Comments
Thanks for the reply,

It seems likely that the elevated levels are due to mono. I have been sick on and off for the last few weeks and feeling very tired , but I didn't think too much of it. I have redone the liver enzymes tests and also a monospot test.

My doctor said that mono is most likely , especially with my symptoms, as the other possibilities are viral hepatitis which i have just been tested for.
Yep, that will do it
Good luck
Avatar universal
Just wanted to update that my elevated ALT levels were due to me having mono at the time. I did a monospot test and a second liver function test and I tested positive for mono, while my ALT levels have already started decreasing. They are now at 130, only 2 weeks after my initial liver function tests. Just wanted to thank all of you for your answers and support.
I will be starting medical school soon and after this experience I definitely have my eyes set on a career as a hepatologist.
2 Comments
Thank you for dropping back in to  say thanks. Very much appreciate that and glad everything is returning to normal.
And hey thinking of being a HEPA!!
The world can use another good one, they are invaluable given all the different liver disease.
Best of luck in your future endeavours .
Happy to hear you have your answers and thanks for checking back in to let us know.

Wishing you much success with your studies and your future!
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