The Fourth Or Reactivation Phase
The previous phase of HBeAg-negative/anti-HBe-positive inactive HBsAg carrier state is not synonymous with permanent termination of HBV replication and of HBV-induced chronic liver damage. Although the majority of patients may remain for life in an inactive HBsAg carrier state, and a number of them may also lose HBsAg and enjoy a complete recovery, others retain or redevelop over time significant HBV replication and progressive liver damage .
This state of HBV-induced liver damage has been first referred to as HBeAg-negative/anti-HBe-positive CHB, and similarly to HBeAg-positive CHB, it also represents an immune active phase in the natural course of chronic HBV infection. It is generally viewed as a fourth phase in the natural history of chronic HBV infection usually developing because of reactivation of HBV replication, though in some patients, it may immediately follow the second phase of HBeAg-positive CHB despite clearance and even seroconversion of HBeAg .
Stephen N.J. Korsman MMed FCPath, Wolfgang Preiser MRCPath, in, 2012
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Rna Or Viral Load Test
If you test positively for hepatitis C antibodies, you will need to get a RNA or viral load test. The RNA test is a blood test that checks to see if hepatitis C is active in your body.
- Negative
- If your RNA test result is negative, you do not have hepatitis C.
- Positive
- If your RNA test result is positive, you may have chronic hepatitis C. Talk to your doctor right away about a treatment plan.
What Does High/low Viral Load Mean
Viral load is the amount of virus present in the bloodstream. It is expressed as the amount of viral genetic material per milliliter of blood. The amount of virus does not predict how severe the liver disease is or will become. The level of the viral load does not tell us anything about the risk of liver damage or how sick someone is. In hepatitis C, it matters if virus is present or absent. Some treatment regimens can be shortened if the patient has a low viral load to start with, but most often, treatment regimens are the same for people with high hepatitis C viral loads or low viral loads.
The RNA test is essential for making the diagnosis of hepatitis C infectionhaving a positive RNA test is the definition of having infection. After the diagnosis is made, the RNA level does not need to be checked over and over unless it is checked during the time that the patient is undergoing treatment. During treatment, regular RNA tests are done to follow the dropping virus level until it reaches an undetectable state. But before treatment and after treatment, repeated RNA testing is not necessary.
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There Are Three Main Tests:
- Fourth Generation: The 4th generation test, is a type of blood test which takes about 3-5 days to get the results. This test is sensitive enough to detect HIV in your blood 2 weeks after a possible exposure. Offered almost everywhere.
- Rapid test :Both tests take about 20 minutes to get the results. This test will provide you with results 6 to 8 weeks after an exposure.
- Blood test is a finger stick a small amount of blood is taken from the tip of the finger and mixed in a solution. There are both 4th and 3rd generation rapid tests.
- Oral test a small amount of saliva from a persons mouth is obtained using a cotton swab that looks like a toothbrush. You can buy this test at a pharmacy. We strongly encourage people to get tested in a clinic or at your primary care providers office for additional support and education.
If any preliminary test is positive, the NAT blood test is done to confirm that the person is HIV positive.
Its important to know there are three types of results that can come from a rapid test: invalid, non-reactive and reactive.
The third and last part of testing is getting your results and talking about what those results mean for the future. No matter which test a person chooses to do, its very important to always get your results!
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Explanation Of Test Results:
If this test result is positive, it means your body was exposed to the hepatitis C virus and made antibodies . However, it does not tell you whether you are still infected with hepatitis C. If the antibody test result is positive, you should be tested for hepatitis C RNA , which determines whether you are chronically infected. The lab will perform this RNA test automatically if your hepatitis C antibody test is positive.
If the antibody test result is negative, it means you have not been infected with the hepatitis C virus, and further testing for hepatitis C usually is not needed.
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When Can You Get A 4th Generation Hiv Test
Currently there no HIV tests that can detect the presence of HIV immediately.
Once someone is exposed to the virus, the body starts producing antibodies, this is called seroconversion. HIV tests cant reliably detect the virus during the window period the time from when a person gets the infection to when tests can detect the virus.
This time can vary from person to person. Testing too early will give false negative results, meaning you have the virus, but you test negative.
In some people, the virus can be detected within 2 weeks of exposure, depending on the type of test. The fourth generation test can detect p24 within 1 month of exposure. If you test before the average window period of 18 days, you may get a false negative test.
If you think youve been exposed to HIV, its important to contact your healthcare provider or visit a health clinic to get tested and begin prevention treatment if needed. If you receive a negative test, be sure to do a follow-up test.
Your healthcare provider may start you on the pre-exposure prophylaxis medication protocol as a prevention measure. PrEP medications can reduce the risk for infection, if started within 72 hours of high risk exposure.
The fourth generation test is reliable and highly accurate.
The reliability of tests depends on:
- when you get tested
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What Does The Test Measure
Hepatitis C testing identifies antibodies to the hepatitis C virus, detects viral RNA, and/or determines the strain of hepatitis C. Hepatitis C testing may involve several different tests:
- Hepatitis C antibody test: Antibodies are a part of the bodys response to an infection. Testing for hepatitis C antibodies determines whether or not a patient has been exposed to the hepatitis C virus at some point in their life. If this test is positive, the next step is to test for hepatitis C RNA which can tell you if you have a current infection.
- Hepatitis C RNA test: RNA is a type of genetic material from the hepatitis C virus that can be detected in the blood. If test results are positive after a hepatitis C antibody test, doctors use a hepatitis C RNA test to look for and/or measure the amount of the virus in the blood. Qualitative HCV RNA tests can detect the presence of HCV RNA, while quantitative HCV RNA tests measure the amount of HCV RNA. Understanding the amount of HCV in the blood helps to monitor response to treatment.
- Genotype test: There are at least six types of hepatitis C, which are also called strains or genotypes. Treatment for hepatitis C depends on the strain, so genotype testing to guide treatment is performed in patients who are diagnosed with an HCV infection.
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The Cdc Recommends You Get Tested If You:
- Are 18 years of age and older
- Are pregnant
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Received donated blood or organs before July 1992
- Received clotting factor concentrates before 1987
- Have been exposed to blood from a person who has hepatitis C
- Were born to a mother with hepatitis C
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What Does It Mean When Different Types Of Blood Tests For Hepatitis C Give Different Results
The first test your provider probably will perform is called an antibody test. A positive result means that you were exposed to the hepatitis C virus at some point in your life.
If the result is positive, your provider will perform a second test called hepatitis C virus RNA to see if the virus is still in your body. If the RNA test result is positive, then you have chronic hepatitis C infection.
So what does it mean if you have a positive result for the first test but a negative result for the second?
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Taking A Hepatitis C Test
Hepatitis C testing is conducted on a sample of blood. Blood samples can be collected by a doctor, nurse, technician, or other health care provider from an adult patients vein using a small needle or a skin prick on a childs heel.
For an at-home hepatitis C test, patients collect a blood sample according to the manufacturers directions. Instructions provided in the test kit detail the steps to obtain a small sample of blood and mail it for testing.
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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How Do I Get My Results
Depending on the type of test you take, you will have to wait either a few minutes for your results , or anywhere between a couple of days or weeks . Your healthcare professional should explain how you will get your test results. If you are self-testing, there will be information on how to read your results with your test kit.
If your result is negative, the health centre will contact you to let you know that you tested negative. All positive and will have to be checked again, so you will be asked to come back for further testing.If you get a positive result after using a self-test kit you will need to go to a healthcare clinic.
What Are Antibodies
Antibodies are Y-shaped proteins made by a persons immune system. They are part of the immune systems response to viruses, bacteria, and other harmful substances .
Antibodies attach themselves to antigens or infected cells and tag them so that other immune cells can find and disable them. Antibodies stay in a persons body long after the antigen that triggered them disappears . If the same antigen enters a persons body again, even years later, the immune system will remember itand send antibodies to destroy it.
When HCV enters a persons bloodstream, it triggers an immune response. The immune system makes HCV-fighting antibodies. Sometimes, the immune system gets rid of hepatitis C virus by itself . About a quarter of people with hepatitis C will spontaneously clear the virus. This is more likely in young people , people who do not have HIV, and people with the IL28B CC genotype .
Even when a person has cleared HCV or been cured by treatment, HCV antibodies remain in a persons blood for years.
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What Is A Biopsy
A biopsy is a medical procedure. A tiny piece of liver is removed and examined to find out the extent of damage. It involves a large needle and local anesthetic, as well as some risk of bleeding. A pathologist looks at the piece of liver under microscopes to determine how much damage has occurred in the liver. This is a very useful test and used to be done very commonly. However, the procedure is done much less frequently than in the past. For most patients with hepatitis B and C, liver biopsy is not required. Today, other tests can be used to try to estimate the fibrosis in the liver.
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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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How The Test Works
The HCV antibody test requires a small blood sample. This sample is usually taken by a lab technician who draws a vial of blood from a vein in your arm. The actual blood draw usually takes less than a minute.
Your blood sample is then analyzed to see if antibodies for hepatitis C are present in your blood. Antibodies are Y-shaped proteins that your body creates to fight off pathogens.
Antibodies are specific to the virus or infection they are created to target, so if youve ever had hepatitis C, your body will have produced antibodies to fight it. If youve never had a hep C infection, those antibodies wont be present in your blood.
Results from the test can take anywhere from a few days to a week or two. Rapid tests for hepatitis C are also available if you need the results in an hour or less.
If your HCV antibody test comes back as reactive, it means that one of two things is true:
- you have an active case of hepatitis COR
- you have had hepatitis C at some point in the past
If you have hepatitis C, your body will have the ability to produce hepatitis C antibodies for the rest of your life. This is why a reactive result doesnt always mean that you have an active infection.
If your HCV antibody test comes back as nonreactive, it means two things are true:
- you dont currently have hepatitis C AND
- youve never had an active hepatitis C infection
Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
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What Is Hepatitis C
Hepatitis C is a virus that causes inflammation of the liver. It is a member of the family of viruses that includes hepatitis A and hepatitis B. These viruses behave differently and have different modes of transmission. Hepatitis C can cause serious liver damage, liver failure, liver cancer, and even death.
Discusses Physiology Pathophysiology And General Clinical Aspects As They Relate To A Laboratory Test
AIDS is caused by 2 known types of HIV. HIV type 1 is found in patients with AIDS or AIDS-related complex and in asymptomatic infected individuals at high risk for AIDS. The virus is transmitted by sexual contact, by exposure to infected blood or blood products, or from an infected mother to her fetus or infant. HIV type 2 infection is endemic only in West Africa, and it has been identified in individuals who had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in viral morphology, overall genomic structure, and its ability to cause AIDS.
Antibodies against HIV-1 and HIV-2 are usually not detectable until 6 to 12 weeks following exposure and are almost always detectable by 12 months. They may fall to undetectable levels in the terminal stage of AIDS when the patients immune system is severely depressed.
Routine serologic screening of patients at risk for HIV-1 or HIV-2 infection usually begins with a HIV-1/-2 antigen and/or antibody screening test, which may be performed by various FDA-approved assay methods, including rapid HIV antibody tests, enzyme immunoassays, and chemiluminescent immunoassays. In testing algorithms that begin with these methods, supplemental or confirmatory testing should be requested only for specimens that are repeatedly reactive by these methods according to assay manufacturers instructions for use.
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