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Hepatitis C Positive Doesn’t Always Mean You Have Hepatitis C

“People always think something’s all true.”  ~J.D. Salinger, Catcher in the Rye

Hepatitis C Positive Doesn’t Always Mean You Have Hepatitis C

Hep C-antibody can’t hurt you any more than a photo of a mugger can

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.

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{ 22 comments… add one }
  • zetta34 June 14, 2014, 1:50 PM
  • TestedNegative September 7, 2016, 8:11 PM

    zetta34, that link deals with people that have HIV as well as Hep C. It just says it can take time to develop in people with HIV.

    I am so happy today, for the past 15 years I have thought I had Hep C because I tested positive for antibodies a long time ago. I finally go to get treatment since I’ve been clean a good while now and when I got my viral test done, there is no Hep C in my body! So so happy, it is amazing what that little peace of mind does for the body.

    • Sherry Murray April 10, 2017, 10:09 PM

      Thank you Jesus . This man don’t have help c. I’m sure your very happy.

  • Ali Siddiqi May 19, 2017, 2:58 PM

    Dear mam,
    I have Negative HCV PCR Quantitative test, my body or in my blood I don’t have HCV Virus can you confirm me will it be transferable from me if I donate blood to some one?

    • Lucinda Porter May 24, 2017, 10:32 AM

      No one can get hep C from you because you don’t have it.

      • Ann beattie May 24, 2018, 7:56 PM

        I was told I had spontaneously cleared hep c treatment was stopped. I was tested had liver function tests all apparently fine. Now almost 10 years on my partner has just tested positive for antibodies. He hasn’t had full test yet. However I am devastated and I don’t understand.

        • Lucinda Porter May 29, 2018, 7:11 PM

          It’s quite possible that he was exposed from another source. Please let me know about his viral load.

  • Sisea Barton October 10, 2017, 7:09 PM

    Jesus is still working Miracles!
    Thank You Jesus!!!

    Thanks for the confirmation.
    After over 35 years of having Hep C
    and unsuccessful combination Rebutron/Interferon 15 years ago,
    My viral load is Suddenly. NEGATIVE! Oh yeah my (30-yrs) a top in his field doctor knows it’s a Miracle! !

  • Ifeanyi Valentine April 5, 2018, 12:50 PM

    Is there any treatment to make hypatitis c antigen leave the blood stem…. Because I went for test…. The doctor said I am having hypatitis c in my blood stem, he directed me for lever test… After the test he said that my lever is OK… That I am free… But I will be going for lever test every 5 months…. Now my other question is “is there any treatment to make it leave the blood stem?

    • Lucinda Porter April 11, 2018, 1:13 PM

      I am not sure what you mean by blood stem. Hep C is curable, and the cure makes the antigen undetectable. Hep C antibodies stay in the body permanently (although sometimes they fall below detectable levels after many decades).

  • Austin May 11, 2018, 7:21 AM

    Thanks for enlightenment. ignorance is bad, continue with this awareness… God will surely give you long life…

  • Donald June 11, 2018, 6:36 PM

    I was infected twice both times using a questionable needle(86 and 92 just recreational kicks no habit)….after a few days or so,, I became very sick,,weak…..dark…cola urine,,,even a trace of blood once….I was alerted at the blood bank,,said I had elevated liver enzymes…..later I went to the Health department,,said wasn’t a test to detect Hep c wasn’t even recognized only A & B,,,,later gave blood at the red cross,,, received a letter stating I had the antibodies and do not donate again even if was told cured….(2000)… I had put all this in the back of my mind until last week after seeing all the Hep C press….and seeing it was curable ect….also found out wife had a Hep C screening when she recently got a new local doctor….So why not get things moving along I thought….I called and scheduled a appointment,,,3 weeks out was first available,,,,me being impatient….I went to the local urgi care same day and had them do the order and went next door to do the lab test took 30 min from start to finish for everything…..The next afternoon the clinic called me with results…..I missed the call and didn’t realize it was the clinic until the next day,,,,and when I called for results the told me I was Positive for the antibodies,,,,which I probably had a good Idea already,,,,After studying up I realized I needed the HCV RNA QT test……I called urgi care again they said the initial test is as far as they go now I would need to see a specialist…ect…..Still being impatient and now my mind is weighing very heavy,,,looking at the whites of my eyes ,,,stool color,,,,thinking about my mortality,,,,when only a few days earlier I was feeling so strong…….I contacted link2labs…..to order my own HCV RNA QT and went down to Quest diagnostics for the lab(100.00)…..After I got home I logged on to the Urgi care web site to look at my initial antibody test and discovered they did do both tests and my HCV RNA QT showed no virus detected………Im 25%er……OOOOOOOOOOOOyea,,,,HCV PCR Quant Not Detected
    HCV PCR Quant (IU/mL) Reference range: Not Detected
    HCV Viral Load Interpretation
    Result (IU/mL)
    Not Detected HCV RNA not detected.
    No current HCV infection.
    Repeat HCV RNA testing
    if the person tested is
    suspected to have had
    HCV exposure within
    the past 6 months or has
    clinical evidence of HCV
    disease.HCV PCR QNT Log Not Detected
    HCV PCR Quant Not Detected
    Name
    Standard Range
    HCV PCR QNT Log
    HCV PCR Quant
    Hepatitis C Antibody REACT Non Reactive A
    Current guidelines* recommend that HCV screen results be
    confirmed with supplemental testing such as nucleic acid
    testing unless the sample to cutoff ratio obtained from
    the HCV screen result is high (>=5 for the Abbott
    Architect HCV Assay).
    The sample to cutoff ratio result for this specimen is
    high (>=5) and is considered a positive result. This
    result probably indicates past or present infection.
    Samples with high S/CO ratios usually (about 95% of the
    time) confirm positive, but <5 of every 100 might represent
    false positives. HCV Viral load testing will be performed.
    Results to follow.
    *Testing for HCV Infection: An update of guidance for
    clinicians and laboratorians. MMWR 2013;62(18).
    (11/2016)
    Pennsylvania law requires the lab to report this
    result to the Pennsylvania Department of Health.
    For diagnostic purposes, results should be used in
    conjunction with patient history and other hepatitis
    markers for diagnosis of acute and chronic infection.
    Assay perform
    ance characteristics have not been established
    for newborns, infants, children or populations of
    immunocompromised or immunosuppressed patients. Current
    methods for the detection of antibodies to HCV may not
    detect all infected individuals. A nonreactive test does
    not exclude the possibility of exposure to HCV.

  • Manpreet Singh August 26, 2018, 8:42 PM

    Hii,,

    Then how can i make my anti hcv positive to negative, i mean the positive results of antibodies of hcv could be turn to negative?

    In my case, sometimes it showed my blood test as anti hcv+ while sometimes it showed anti hcv-.

    Please tell me what should i do?

    • Lucinda Porter August 29, 2018, 11:16 AM

      You can’t. However, sometimes HCV antibodies are so few that they appear to be negative.

  • Danyal Qaisar Malik September 20, 2018, 8:22 AM

    Dear Maam,
    I would like to tell you something . On the recommendation of doctor i had taken a Anti-HCV test but from one Lab the result was positive. I was shocked to see the result. Then i go to another lab on the same day and it shows that it is negative. Third time i go to the different lab and the result was negative on the third time.
    Please help me and solve my curiousness ????

    • Lucinda Porter September 20, 2018, 3:27 PM

      Either the first test was wrong, or the first test was more sensitive it measured a slight antibody reaction. You are almost certainly negative, but if you need to know for sure, then you need a viral load test.

  • Sharlene September 27, 2018, 2:20 PM

    Can you please advise me of which antibodies stay in the body forever. I have antibodies but no one can seem to answer me as to why i seem to have these antibodies.

    • Lucinda Porter September 30, 2018, 8:21 PM

      If you are referring to hep C antibodies, the most likely explanation is that you were exposed to hep C but your body successfully fought the virus and prevented it frombecoming chronic. This is actually fairly common, especially among women who were exposed before age 40.

  • Debra Green November 23, 2018, 11:27 AM

    My boyfriend left me after 15 yrs. & was w someone else! We r both Cancer Survivors!! Yay Anyway His prostate was removed & she told him she was nurse so she knew what to do to have Sex! So comes he goes to Donate & they say he has string of hep c in his blood/ plasma… Does he
    Have Hep c? He went to see Dr. Yesterday & Dr. Assured him he was 99% fine. He will go to quest after Holiday MONDAY. What result do u think it will be?? BTW WE WAITED OVER 3 YRS TO DO THIS TOGETHER & HE LEFT ME & DID OUR SPECIAL TIME W A STRANGER! DOES HE
    HAVE IT???

    • Lucinda Porter November 26, 2018, 3:11 PM

      Without looking at lab work, I can’t answer your question. However, I can tell you that hep C is not passed sexually from a man to woman.

  • Tons December 26, 2018, 10:54 PM

    I have detected hep c when tested on april of 2017 but i got treated for (84 days) less than 3 months taking hep c medication on the advice of doctor,but after finishing taking my period of medication i have never tested hep c again until december of 2018 and i tested positive again, this time i m so freaking out and my mind is all upset,so what should i do to get rid of this disease forever from my body, somebody please tell me.

    • Lucinda Porter January 9, 2019, 3:33 PM

      You don’t say whether you test positive for hep C via the antibody test or HCV RNA (viral load). We always have hep C antibodies in our body, even if there is no hep C. A good way to get quick feedback on other issues related to hep C are the Hep Forums http://forums.hepmag.com and Help4Hep at 877 Help 4 Hep (877 435 7443).

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