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Could my anti-hcv test be false positive?
May 17, 2014

Last week I learned that an anti-hcv antibody screening came back "reactive." The signal to cutoff ratio was 7.20. I was given the screening in the first place because bloodwork done in March showed my bilirubin slightly elevated at 1.6 mg/dL.

I am a 51 year old male. I am not in any high risk group for hcv (for that matter) - I have never shot drugs, I have no tattoos, I have received no blood transfusions at all (let alone since 1992), etc, and I have not had sex where I could have crossed paths with anyone's blood. I have had a secondary screening to see if I do have the virus, and if so, what the genotype is, as well as the viral load, and I am waiting for those results.

Some facts:

- In March, I discovered that I had very high blood pressure (it was 160ish/110ish at the doctor's office, and was as high as 192/121 on my home monitor. This was primarily due, I think, to a high sodium diet, though my age and hereditary factors may be involved as well. At any rate, my doctor prescribed my Bystolic, and this along with a much healthier diet (lots of potassium rich foods, particularly fruits, vegetables, nuts, etc) as well as regular cardio workouts at a gym have brought it down to a much safer level, though it's still a tad high for my tastes (I'd like to be below 120/80 more often than not).

- The anti-hcv screening also showed my bilirubin to be at 1.0, down from 1.6. My AST's and ALT's were also in good places. I realize that it's possible to be infected with HCV and still have good liver enzyme readings.

- I don't smoke, and I drink moderately (though I haven't had nary a beer since I learned of the "reactive" anti=hcv results.

Now this next part may seem like I'm grasping at straws, but I think it's worth considering:

- In 1993, I had to have my gallbladder removed as it had become gangrenous. It was so bad they had to open me up to remove it, rather than use lathroscopic technology. I have a long scar from approximately the center of my rib cage to right above my belly button. At the time, I had been selling plasma for extra money, and the plasma center would, of course, screen your plasma for any infectious diseases, particularly Hep C, as well as HIV. One day when I went in to donate, they took me into an office and told me something to the effect that I had failed a screening for HIV and wouldn't be able to donate plasma anymore, and that I should get tested right away. I did, and the test was negative. I was puzzled why this would happen as I am not in any risk group for HIV whatsoever (gay, drug user, traveled to sub saharan Africa after 1977, etc). A tech there told me that maybe my surgery had something to do with this false positive hiv screening (antibodies fighting the infected gallbladder showing up on the hiv screening) but he wasn't sure. I didn't pursue it any further because I was negative and that's all I cared about.

And this may REALLY be a reach, but what the hell

I did some research and found an abstract from a study done in 1992, one that was cited in an medical journal article about hcv testing more than ten years later, that showed that influenza vaccines had resulted in multiple false positive anti-hcv screenings because the antibodies from the vaccine could show up on the hcv screening. I had a flu shot this past December, and those are supposed to be good for about one year.

So, my basic question, as the title says, is it possible that my anti-hcv screening was false positive? I've asked this question on other medical sites, and some doctors have acted as if I had asked if Elvis was still alive. I realize what is at stake, and like I said, I've had blood drawn for a viral screening (to see if I do have the virus). So I've done all I can do up to now, but I am very confused, and quite frankly, really scared, because I know what having Hep C can mean. I just need some answers because this whole thing just doesn't add up.

And I do know that about a quarter of people infected with acute hcv can clear the virus from there body on their own, and if that's the case, antibodies will still show on an anti-hcv screening.

Thank you so much in advance for reading this and for your answer. I know this is long, but like I said, I'm really worried about this, and any insight you can give will make a big difference.

Take care. :)

Response from Dr. Taylor

In the United States, 75% of hep C infections exist among baby boomers -- that is, people born between 1945-1965. Most of these individuals have not yet been diagnosed with hep C, and many will never be able to figure out why they have hep C. We did not know much about this infection until recently, and we may have acquired it (caught it), in health care settings before infection control practices were widespread. So just by virture of your age, if you have been living in the U.S., you have a 1 in 30 chance of having hep C overall, and with a reactive antibody test, the chance is higher. You may be from another part of the world, and all around the world many people your age have hep C and will not be able to determine when and how they caught it.

The next best step is to be sure you are being tested for the virus itself. It sounds as though the correct tests have been ordered. If you do turn out to have the virus, know that it is curable, and with the new medications you will be able to be cured safely. I concur with stopping alcohol until you learn of your results, and if you do have hep C , of continuing without alcohol and discussing your liver health further with your doctor.

So for all readers, in the US being 51 years of age IS a risk factor for hep C -- if you are born between the years 1945 and 1965 the CDC analyses and recommendations support getting tested.

Regarding false hep C antibodies, a false positive screening test -- If you are from a part of the world where hepatitis C infection is rare, there is a higher chance of a false positive antibody result. There may be false positive results due to technical errors in checking the hepatitis C antibody. Sometime the hepatitis C antibody may cross-react with antibodies for other diseases, such as autoimmune diseases (possibly what you have), giving a false positive result.

In general vaccines are VERY SAFE, and the diseases we use them to protect them against, are VERY DANGEROUS and can kill us. So the benefits of vaccination far, far, far outweigh the risk.

All best to you.



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