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Non reactive HCV, HIV negative, HCV RNA PCR. Risk?

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Practicing since : 2000
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Do I Have Hep C?

On September 2, 2011 I received a tattoo. I watched artist open a new needle and fill a single use ink cup. The shop was clean and the artist had his state certification posted as well as blood born pathogen certificate. Even so afterwards I got worried about HIV and Hep C. I tested at 10 weeks, 3 months and 6 months for HIV and all were negative.

My HCV test was non reactive at 10 weeks but then REACTIVE at 6 months (just a week ago)? For some recall reason RIBA test was not available to confirm so an HCV RNA PCR test was done with results negative and non detected.

1 Why did the HCV antibody test change from negative to positive?
2. Do I have Hep C? Or could the second antibody test be a false positive?
3. Is my 6 month negative HIV test conclusive or if I contracted HCV would that effect the test window?
4. Dr. wants to retest HCV RNA PCR in six months and says don't worry but I'm worried

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.
Posted Tue, 22 May 2012 in GERD
Answered by Dr. Poorna Chandra K.S 5 hours later
Hi and thanks for the query
In the tests that are done for HCV - anti HCV tells about exposure to HCV either present or past and HCV RNA confirms the ongoing infection. Anti HCV usually takes around 6-12 weeks to appear after an infection and RNA can be detected by 1week.
Reasons for a positive anti HCV with an undetectable HCV RNA are
1) HCV RNA is very low it may not be detected and anti HCV may be positive
2) Recovering infection where the HCV has been eradicated and the antibody is a telltale evidence of prior infection
3) False positive reports - less common now a days 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.
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.
I would suggest get yourself retested by RIBA and repeat the RNA testing after 3 months or so and clear the confusion. Meanwhile take precautions to prevent any risk of acquisition.
Hope this clears your doubts
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