So you do feel my HIV test is conclusive ... That I do not have HIV?
Thanks for writing in. I do understand your predicament. I would first like to clarify the role of the tests in detecting a HCV infection.
In the tests that are done for HCV, anti HCV tells us about the exposure to HCV (either present or past) and HCV RNA confirms the on-going infection. Anti HCV usually takes around 6-12 weeks to appear after an infection and HCV RNA can be detected by 1 week after conception.
1) Reasons for a positive anti HCV with an undetectable HCV RNA are
a) HCV RNA is very low and it may not be detected and anti HCV may be positive
b) A patient recovering from an infection where HCV has been eradicated and the antibody is a telltale evidence of prior infection
c) A false positive report. This is less common nowadays with the third generation ELISA tests but can be seen in people with autoimmune disorders. HIV co -infection causes more of false negative anti HCV antibody with a detectable HCV RNA.
2) Whether you have HCV or not can be confirmed when you get yourself retested by RIBA and repeat the RNA testing after 3 months or so and clear the confusion. As I explained, the second antibody test could be a false positive.
3) If you are sure that you had no more exposure after the one stated then I don't think there is any merit in repeating a test for HIV. Also, HIV co-infection can cause an increased likelihood of a false negative anti-HCV antibody.
4) I would suggest you repeat a RIBA and get tested for HCV RNA after 3 months. Meanwhile, follow every measure possible to prevent any risk of acquisition.
I hope I have addressed your concerns. I will be available for follow ups.
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Dr. Poorna Chandra
Also I have no other risk factors for either HIV or Hep C ... In a 20 year monogamous marriage (with only sex partner I have ever had) and no drug use of any kind.