Thanks for writing in.
HCV antibodies usually develop within 3-6 weeks after acquisition of the virus. Hence the ELISA test done after this period is pretty reliable provided there are no co-existing autoimmune disorders or immunosuppression. However, RIBA is a more specific test and a positive RIBA with a negative ELISA may suggest a low level of antibodies.
1) Over a period of time, the infection may resolve if it is in the convalescent stage or the antibody titre may increase if you are now in the early phase of infection. The chances of turning positive cannot be exactly determined. So I would suggest you either get a HCV RNA tested or wait for one month and repeat the RIBA test.
2) HCV infection with liver damage is an indication for treatment and one has to look at the liver function test results, the HCV RNA titres and the genotype before deciding on the treatment. Treatment has best efficacy in acute symptomatic (ie with jaundice) phase which is not the situation here
3) Normally HCV infection causes slow and progressive liver damage over years. In the absence of other hepatotoxic agents significant liver damage and cirrhosis develops over 8-12years. However, well treated patients, in whom there is sustained suppression or eradication of the virus, can expect a normal life expectancy.
Hope that this information helps and hope that you will get better soon.
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Dr. Poorna Chandra