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If I had Hep C how come the antibody doesn't show up?
Jun 17, 2007

Dear Dr. McGovern,

I am a nurse who was diagnosis with Hep. C in Feb. 2007 by a random test run by my Nephrologist who was r/o polycystic kidney diease. One month later it was confirmed with a viral count of HCV RNA QT 2190 IU/ml by PCR, however they were unable to genotype at this time. In May I saw my gastrointerologist who confirmed Hep C. He ordered further testing to see what the viral count and bleeding time was before a liver biopsy. That test came back with Hep C HCV RNA QT less than 50 IU/ml. Then a week later at a different lab, it was confirmed no Hep C virus antibody- non-reactive. How can this be? If I had Hep C how come the antibody doesn't show up????? thanks,

Response from Dr. McGovern

Your results are somewhat of a mystery to me. I wonder about a few things: 1. Your level of virus on the first go around was extremely low suggesting recent infection and then followed by clearance. 2. Regardless, the most puzzling aspect is your loss of antibody, also known as seroreversion. 3. Since you are a health care worker, it is certainly possible that you have an exposure. 4. I would suggest further monitoring of your viral load over the next 18 months on a six-month basis. If all are negative, I would not pursue further testing.



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