Mar 5, 2012
Hi Doctor, I am HIV+ (cd4: 800, no meds) homosexual man. Six months ago I had a negative HCV test result. However, this week I had indeterminate results twice on RIBA (I am not sure which generation RIBA, but living in the Netherlands I assume, it is an up to date version). Now I am waiting for the results for mRNA test. I search in here and in pubmed but I cant reach to concrete numbers: What is the chance of an indeterminate test turning with negative or positive mRNA results? Should I prepare myself for the bad news, or just ignore the results as possible false positives? Within last year, I had unprotected sex only once. It was not a "rough" one, did not last more than 10 minutes. And I had no other behavior that involves risk for a transmission.
Response from Dr. McGovern
I think your chance of acquiring HCV through one exposure which was not associated with obvious mucosal tearing or any sexually transmitted disease (like syphilis) which can increase risk is low. However, I agree with the need for further evaluation with an HCV RNA. Indeterminate RIBA in just that - indeterminate. You need HCV RNA testing to finalize if you are infected or not.
Now another thing of great importance...Your HCV test result was negative six months ago. IF your HCV RNA is detectable, the great news is that your chance of cure is VERY high because your infection is new.
That is the advantage of routine screening if there is any risk whatsoever. Finding acute HCV is the goal because of the treatment advantage.
I would be certain that your Hepatitis B surface antibody is consistent with protective antibodies as well. If not get a booster vaccine if you need one. You also should be immunized against hepatitis A.
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