“People always think something’s all true.” ~J.D. Salinger, Catcher in the Rye
Hepatitis Awareness Day was May 19, and if you tested positive for hepatitis C, you may have spent the past few days thinking you have hepatitis C. However, unless you had follow-up viral load testing, you may or may not have hepatitis C.
The Centers for Disease Control and Prevention (CDC) recommends hepatitis C testing for everyone born from 1945 through 1965, as well as for others at risk. Although getting a hepatitis C test is straightforward, interpreting the results is confusing. Basically, the initial test, or hepatitis C antibody test, rules out hepatitis C or indicates the need for more testing.
If you requested a hepatitis C test, the initial test that your medical provider will order is a hepatitis C-antibody test. If this test comes back negative, then you don’t have hepatitis C (assuming you were exposed to hepatitis C more than six months ago. It takes 2 to 26 weeks for hepatitis C antibodies to form).
If the hepatitis C-antibody test is positive, then you might have hepatitis C. The CDC estimates that 15%–25% of people who are infected with hepatitis C are able to clear the virus on their own. This means that they don’t have hepatitis C, but they do have antibodies for it. No virus equals no hepatitis C.
This concept can be a little tricky, and here is how I explain it: If a mugger was about to attack you and someone happened to photograph the event, you would have a picture of the attack. Someone looking at the photo would not know if you got attacked or if the attack was fought off.
Imagine that the hepatitis C virus is the mugger and the hepatitis C antibody is the photograph of the mugger. If you were attacked by hepatitis C, your body would produce antibodies—much like photographs of the attack. As long as you carried the hepatitis C virus, your viral load and your antibody tests will be positive. However, if your body cleared hepatitis C on its own, the viral load would be negative, but the hepatitis C-antibody test would be positive. The virus is gone, but you have its photograph—proof that you once had hepatitis C. The hepatitis C antibody can’t hurt you any more than the mugger in the photo can hurt you.
You may wonder why they don’t just run a hepatitis C viral load in the first place, rather than testing for antibodies. The answer is cost—the antibody is an inexpensive test, whereas the viral load is considerably more expensive.
The bottom line is to never assume that a positive hepatitis C-antibody test means you have the virus—get further testing.