What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
Hepatitis C Testing And Diagnosis
Doctors will start by checking your blood for:
Anti-HCV antibodies: This blood test is the first — and sometimes only — one you may get. Also called the ELISA screen, it checks for antibodies that your body releases to fight the virus. These are proteins your body makes when it finds the hep C virus in your blood. They usually show up about 12 weeks after infection. Your test will be either negative or positive for antibodies. It usually takes a few days to a week to get results, though a rapid test is available in some places.
What the results mean
Negative . This is when your blood shows no signs of HCV antibodies. Most of the time, thatâs because you never came in contact with the virus and you do not have hep C.
Sometimes, your negative result can be false, meaning you have HCV. That may happen if you:
- Took the test too soon after your exposure. This test checks for only HCV antibodies, which can take several months to appear.
- Have HIV, a donated organ, or other conditions that weaken your immune system, which can suppress your antibodies
- Get hemodialysis for kidney problems
If youâve been exposed in the last 6 months, youâll need to be retested.
Positive . This means youâve been infected with HCV. But false positives are surprisingly common. More than 1 in 5 people who test positive donât actually have hepatitis C. Possible reasons include:
What the results mean
All Adults Pregnant Women And People With Risk Factors Should Get Tested For Hepatitis C
Most people who get infected with hepatitis C virus develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
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Tests After The Diagnosis
Once the doctor knows you have hep C, theyâll do tests to find out more about your condition. This will help determine your treatment. They could include:
- Genotype tests to find out which of the six kinds of hepatitis C you have.
- Liver function tests. They measure proteins and enzymes levels, which usually rise 7 to 8 weeks after youâre infected. As your liver gets damaged, enzymes leak into your bloodstream. But you can have normal enzyme levels and still have hepatitis C.
- Tests to check for liver damage. You might get:
- Elastography. Doctors use a special ultrasound machine to feel how stiff your liver is.
- Liver biopsy. The doctor inserts a needle into your liver to take a tiny piece to examine in the lab.
- Imaging tests. These use various methods to take pictures or show images of your insides. They include:
Hepatitis A Reactive Means
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How To Get Tested
Hepatitis C testing is performed by a doctor. Testing requires a blood sample, which can be collected in a hospital, lab, or other medical setting. Blood is often drawn from a vein in the arm or, in children, taken by pricking the skin. After blood is collected, the sample is sent to a laboratory for analysis.
Hepatitis B Core Igm Antibody
Order Name:HEP BCOR M Recent onset of hepatitis B infection. No evidence of recent hepatitis B infection. Indicates that test should be repeated in 1-2 weeks. Test Notes It should be noted that the assay performance characteristics of the IgM anti-HEP B core assay have not been established for either immunocompromised, immunosuppressed patients or on cord blood, neonatal specimens, infants or children less than 12 years age.
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Question 7 What Proportion Of Hcv Antibody
Among specimens with reactive HCV antibody results, approximately 52% have detectable HCV RNA at a level of > 15 IU/mL on reflex testing. However, the frequency varies markedly based on the strength of the signal of the antibody test, or signal-to-cutoff ratio. Specimens with an S/C ratio of at least 1.0 are considered reactive for HCV antibody7 and thus undergo reflex testing for HCV RNA. Analysis of approximately 200,000 specimens submitted to Quest Diagnostics for HCV antibody testing with reflex to HCV RNA testing demonstrate that the frequency of positive reflex results increases with increasing S/C ratio:
What Does A Reactive Result To A Hepatitis B Test Mean
The meaning of a reactive result for a hepatitis B test depends on the type of test performed, according to the Hepatitis B Foundation. The three most common blood tests detect the presence of hepatitis B surface antigens, hepatitis B surface antibodies or hepatitis B core antibodies.
In the hepatitis B surface antigen test, a reactive or positive result means that a person is currently infected with the hepatitis B virus, explains the Hepatitis B Foundation. Reactive results from the hepatitis B surface antibody test means that people are now immune to the virus because they have been infected in the past and their immune systems produced antibodies to fight the infection. For the hepatitis B core antibody test, a reactive or positive result can mean either that a person is currently infected with hepatitis B virus or have been some time in the test. A reactive result for this test can also be a false positive, meaning that the person has never been infected with the virus.
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Question 6 Is It Possible To Have Hcv Infection And Have A Non
Yes. Among persons with a non-reactive HCV antibody test, who are suspected of having liver disease or are at high risk of acute infection, testing for HCV RNA or follow-up testing for HCV antibody is recommended if high-risk exposure to HCV occurred within the past 6 months. Additionally, testing for HCV RNA can also be considered in persons who are immunocompromised .
Test Frequency And Turnaround Time
Hepatitis C Serology testing is performed daily Monday to Friday.
Turnaround time is up to 3 days from receipt by PHO laboratory for Non-reactive antibody results. Reactive and Indeterminate HCV antibody results are available and reported within 6 days.
Repeat testing may be indicated in those with ongoing risk factors for the acquisition of HCV.
Once a patient tests positive for HCV antibodies, other than in cases of maternal antibody transfer, there is no value in repeating the test as they will remain antibody positive for life regardless of whether they have cleared the virus or are chronic carriers.
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Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
When Should I Get Hepatitis C Testing
When used for early detection in patients without symptoms of hepatitis C, screening is recommended at least once for all adults aged 18 years or older, except in locations with very low prevalence of HCV. Screening is also recommended during pregnancy and for patients of any age with risk factors for HCV infection. In patients with risk factors, periodic screening is recommended for as long as risk factors persist.
Risk factors for HCV include:
- Current or past injectable drug use
- Having a blood transfusion or organ transplant before July 1992
- Receiving kidney dialysis
- Pain in the abdomen or joints
- Nausea, vomiting, or loss of appetite
- Jaundice or yellowish skin and eyes
Hepatitis C testing may also be performed when liver tests are abnormal or when diagnosing the cause of existing liver damage.
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Getting Tested Is The Only Way To Know If You Have Hepatitis
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C virus either recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Centrifuge if using SST. Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection.
Specimens more than 7 days post collection will not be tested.
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How Much Does The Test Cost
The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.
For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.
At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.
Are Test Results Accurate
Although no test is perfect, hepatitis C testing is an important and accepted method of testing for HCV. In order to reduce the risk of inaccurate results, doctors take steps to verify a patients diagnosis. For example, a positive test result for hepatitis C antibody requires confirmation with HCV RNA testing.
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The Hepatitis C Testing Process
In the case of a suspected new infection, two test results are usually required to confirm if someone currently has hepatitis C.
The first test is a screening test, which is an antibody test. This test detects antibodies in the blood to determine if a person has ever had a hepatitis C infection.
- A non-reactive screening test result indicates that the person does not have hepatitis C antibodies and has never had a hepatitis C infection. No further testing is usually performed.
- If the antibody test is reactive , this means that the person has antibodies to hepatitis C and therefore has had a hepatitis C infection at some point in their life.
The antibody test alone cannot tell whether the person has a current hepatitis C infection. A person will test positive for hepatitis C antibodies if they have hepatitis C at present, but also if they had a hepatitis C infection in the past. In other words, people will still have hepatitis C antibodies even if they spontaneously cleared the virus in the past or if they were treated and cured.
The second test is a confirmatory test, which detects the hepatitis C virus itself. This test detects genetic material of the virus to determine if a person currently has a hepatitis C infection.
If a person has had a positive antibody test result in the past, they will test positive for hepatitis C antibodies every time they have another screening or antibody test.
Question 10 I Am Treating My Hcv
If HCV RNA is detectable at week 4 of treatment, per AASLD guidelines, it is suggested to repeat quantitative HCV RNA viral load testing after 2 additional weeks of treatment. If quantitative HCV RNA testing at week 6 of treatment shows an increase of greater than 10-fold , discontinuation of HCV treatment is recommended. The cause of a positive HCV RNA test result at week 4, with decreasing levels at week 6 or week 8, is unknown. There is no recommendation to stop therapy or extend therapy for these patients.9
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What Does A Reactive Hcv Antibody Test Result Mean
A reactive or positive antibody test means you have been infected with the hepatitis C virus at some point in time.
Once people have been infected, they will always have antibodies in their blood. This is true if they have cleared the virus, have been cured, or still have the virus in their blood.
A reactive antibody test does not necessarily mean that you currently have hepatitis C and a follow-up test is needed.
Other Things To Know:
- After a successful course of treatment for hepatitis C, the hepatitis C antibody remains detectable, but the hepatitis C RNA will be undetectable.
- If you plan to donate blood, you will be tested for the hepatitis C antibody and will be turned away even if you do not have an active infection.
- Any patient with a positive test result for the hepatitis C antibody should have additional tests to determine whether or not the virus is still active.
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Rna Or Viral Load Test
If you test positively for hepatitis C antibodies, you will need to get an RNA or viral load test. The RNA test is a blood test that checks to see if hepatitis C is active in your body.
- If your RNA test result is negative, you do not have hepatitis C.
Supported by an independent educational grant from Merck & Co., Inc.
Question 8 What Do The Following Hcv Rna Results Mean: < 15 Iu/ml Detected Or < 15 Iu/ml Not Detected
The result < 15 IU/mL, Detected means that HCV RNA is detected, although at a level that is too low to be quantified. This result could indicate current active HCV infection if consistent with other clinical and laboratory data. NOTE: If this test is being performed for HCV diagnosis, then this < 15 IU/mL Detected result should be confirmed using a second sample from the patient.
In contrast, the result < 15 IU/mL, Not Detected means that HCV RNA is not detected and there is no evidence of current active infection.
Quest Diagnostics measures HCV RNA viral load with the Roche cobas® HCV methodology. This is a quantitative real-time PCR assay with a lower limit of quantification of 15 IU/mL the limit of detection is slightly lower, at 10 IU/mL to 13 IU/mL. If the viral load is just at or above this LOD, but less than 15 IU/mL, the assay can determine that HCV RNA is present but cannot provide a reliable quantitative result. In such cases, the qualitative result of < 15 IU/mL, Detected is provided.
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How Is Hepatitis Spread
The hepatitis C virus is usually spread when someone comes into contact with blood from an infected person. This can happen through:
Sharing drug-injection equipment Today, most people become infected with hepatitis C by sharing needles, syringes, or any equipment used to prepare and inject drugs.
Birth Approximately 6% of infants born to infected mothers will get hepatitis C.
Healthcare exposures Although uncommon, people can become infected when healthcare professionals do not follow the proper steps needed to prevent the spread of bloodborne infections.
Sex with an infected person While uncommon, hepatitis C can spread during sex, though it has been reported more often among men who have sex with men.
Unregulated tattoos or body piercings Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with non-sterile instruments.
Sharing personal items People can get infected from sharing glucose monitors, razors, nail clippers, toothbrushes, and other items that may have come into contact with infected blood, even in amounts too small to see.
Blood transfusions and organ transplants Before widespread screening of the blood supply in 1992, hepatitis C was also spread through blood transfusions and organ transplants.