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Another Hep C question
Feb 13, 2010

On August 25, 2008 I asked a question regarding my Hepatitis C positive test. Some of my is that I had a needle stick on 12/2004. On my 2 and 6 month needle stick follow up I tested neg for hiv and hepC. At 12 month follow up I tested positive for HepC. I was pregnant when the needle stick occured. At my 2 month follow up (2/05)my albumin was low and my ALT and AST where around the low hundreds. I had been having severe achy legs and even had an ultrasound to R/O DVT since I had a miscarriage 1/09. I had a ruptured ectopic pregnancy and had emergency surgery 10/09. Then 12/09 at my 12 month needle stick follow up I tested positive for Hep C antibodies. I was tested for Hep C PCR and RIBA and both came back negative. I've had both test done yearly for 2 years and they are always negative but my Hep C antibody test is always postive. My question is this. 2 yrs ago I was having some problems with weakness on my left side of my face on and off. A CT r/o a stroke and neuro diagnose me as having trigeminal neuropathy. My PMD ordered an ANA just to check and my ANA is 1:1280 and my DS DNA is 15. All other rheumatological labs and routine labs are normal. My rheumatologist told me that he cannot diagnose my as having lupus because I don't meet all the criteria and he thinks the elevated ANA and DS DNA are high due to my Hep C. You previously told me that if the RIBA is negative which is the "gold standard " then I don't have Hep C. What would be causing the Hep C antibodies to remaine on? Could it be the other way around and the Autoimmune issue is causing the Hep C antibodies? I am very confused and nobody seems to think it is that important to find out. My current situation is that I had another needle stick injury 12-17-09 with a low risk needle. Someone left the cap of a needle that was in an insulin demo kit that we used for insulin demonstration at the clinic I work in. We are not supposed to use the needles on patients but just to demo how to draw the insulin. I insisted on getting tested for HIV since they did not want to test me for Hep C because they said I already have hep C. I stopped breastfeeding my 6 month baby just incase because I am worried I will develop HIV and it will take 12 months for my antibodies to develop. I asked Dr.Frascino regarding could I possibly have delay antibody production for HIV and how at risk am I from my exposure. I wanted to do an antibody test for HIV at 3 monhs and then continue to breastfeed but I'm not sure. What do you think can cause a person to develop Hep C antibodies and continue to test positive even if RIBA and PCR are negative. I know I have some autoimmune issue I just don't know what. I love patient care but this is my second issue with a needle stick due to someone else being careless. I am considering another career. Thank you for your help. I am very concern because I still wanted to breastfeed for six more months.

Response from Dr. McGovern

Your RIBA test is the "gold standard" yes! Since that was negative and your HCV RNA is negative, I do NOT suspect you have HCV infection. However, your autoimmune disease may be causing false positive antibody testing.



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