Exposed to hepatitis C. Now what?
May 9, 2012 1:34 PM   Subscribe

On Friday I got a call from my primary care physician saying that my HCV AB EIA QL (Hepatitis C) test result came back reactive. The same test in August 2011 was nonreactive. I am waiting for the referral to the GI department to be processed so I can find out what happens next. In the meantime I'm freaking out.

They say this means I was "exposed to" hepatitis C, not necessarily that I "have" it. In the research I've done since then I have learned this means I may have already had acute Hep C and cleared it, or it's possible I do actually have chronic Hep C, and I would assume that's what the GI department will determine.

I have several tattoos that were done between 1991 and 2009 (some done in the US, some in France, some in Australia), in 2009 I had a hysterectomy in Australia and gallbladder removal in the US, in 2010 I had MRSA. I have been in 3 long term, committed relationships since 1994; in my current 2 year relationship we have had threesomes with two partners (both female, once with the first one, several times with the second, most recent was in December. Regular STD testing before, during and since with both partners.)

Is there a way to know exactly when and how I was exposed? If I don't have it, am I at greater risk of contracting it? Should I give up alcohol or make any other dietary/supplement changes? Does lack of a gall bladder have any effect on any of this? How do I need to go forward with future sex partners (or past, for that matter?) What do I need to be asking my doc or the GI dep't? Anything else I'm forgetting or need to know?
posted by thrasher to Health & Fitness (15 answers total)

You don't even know that you were actually exposed. It could very well be a false positive. I'd wait until they confirm it for sure before you get way ahead of yourself.
posted by empath at 1:40 PM on May 9, 2012 [2 favorites]

It isn't going to hurt you to skip alcohol and avoid uprotected sex with new partners for the next few weeks just in case, until you have a chance to meet with a specialist, have more accurate tests, and know what's actually the situation. Lots of detailed info here.

Best of luck to you.
posted by Sidhedevil at 2:14 PM on May 9, 2012 [2 favorites]

My mom got a false positive once. Relax.
posted by St. Alia of the Bunnies at 2:16 PM on May 9, 2012

First, wait until you get more information to know what your actual current status is.

No, there isn't a way to know exactly when and how you were exposed, but if you had a negative test in 2011 and a reactive one now, that helps you narrow down the time frame, certainly. HCV is hard to transmit sexually, but easier via shared items like razors or toothbrushes or nail files, if there's blood exposure.

If you don't have it, you're not at greater risk of contracting it, unless of course you're engaging in behaviors with people who have it. I'm not sure I understand this question.

The most cautious approach until you know more would be to be a nice to your liver as possible, so no drinking, but again, you may want to just wait until you know more. If you do have HCV, and your recent negative test was accurate, then you're very early in disease progression and it takes some time for liver damage to develop.

I don't know how lack of a gall bladder would affect this -- ask your doctor.

If you do have HCV, yes, that's something to tell sex partners.

Some people spontaneously clear HCV after exposure. Some people don't. There are good treatments available now and they're getting better by the month, pretty much. There's loads of good info out there on HCV, which I'm happy to point you to, although googling has probably found them for you.
posted by gingerbeer at 2:17 PM on May 9, 2012

You should tell sex partners, but the odds of being infected sexually are so low that the CDC doesn't even recommend condom use in couples where one is infected and the other isn't. That's pretty darn low! Apparently, it doesn't live in semen or other sexual fluids and requires blood contact.

There are also exciting new medications in the pipeline and close to approval. Even if you do have it, the chances of being actually cured— and being cured without having to deal with interferon, which can be grueling and is currently part of many treatment regimens— are better than ever.
posted by Maias at 2:25 PM on May 9, 2012 [2 favorites]

What everyone else said, but I'd also like to point out that you do have the chance to lead a full, active life with Hep C. But yeah, you should probably cut out the drinking until you know.
posted by the young rope-rider at 2:35 PM on May 9, 2012

A good friend of mine had a false positive on that test once, and was given the impression that wasn't uncommon. Don't panic.
posted by Coatlicue at 2:44 PM on May 9, 2012

One more vote for "it could be a false positive, relax if you can" -- I had a false positive hep test last year, and nobody in my doctor's office seemed terribly surprised when we got the real results.
posted by The corpse in the library at 2:45 PM on May 9, 2012

This does not necessarily mean you have contracted Hep C. The same thing happened to me when I was a freshman in university. In my case, my doctor ordered an additional test (RIBA) to confirm the (incorrect) results of the first test (EIA). If I'm not mistaken, you've undergone the first, EIA, test, but not the second, RIBA, right? This is an absolutely necessary second step.

My mother has Hep C (contracted it nearly 30 years ago) and please know, if you end up having the disease, that treatment has come so far over the past decade. I even know people who've successfully cleared Hep C through interferon treatments. Hep C is not a death sentence.

Until you get the results from the followup test, please take care of yourself. Take long bubble baths, read great books and surround yourself with awesome friends. You'll get through this, one way or another.
posted by Cat Face at 3:15 PM on May 9, 2012

Best answer: I'm an outreach worker whose primary focus is HepC education/prevention/etc. I am not a medical professional.

There is no way to know when, or how, you were exposed. Generally speaking, HepC is spread through blood-to-blood contact - which includes blood transfusions prior to the early 1990s (in my country, at least), surgeries in countries where sterilization is not guaranteed, non-sterile tattooing and piercing, injection drug use and sharing some smoking implements (like crack pipes), etc. HepC is quite hardy and will survive on surfaces, outside of the human body and under the right conditions, for up to 4 days. The way that someone 'gets' HepC makes no difference whatsoever when it comes to treatment or monitoring someone.

It's not considered a sexual transmitted disease - again, the virus needs blood-to-blood contact - but that's working under the assumption that everyone has straight-forward, 'vanilla' sex that never ends with scrapes, cuts, etc. We do a lot of education around that, too!

The virus shows up in blood tests, generally, 3 months after exposure. You're right that the initial test just tells you that you were exposed and not whether your body has already cleared it (and the positive result could also be an error!). The next test will be to check how much of the virus is present and, if it's there, to find out what genotype of HepC it is.

(It's worth noting that most doctors don't check for HepC when they do blood work, even if you ask them to test "for everything". We see a lot of patients who assumed they were being tested annually, but weren't; a big part of my outreach is getting people to go in for specific HepC testing!)

If you don't have it, you aren't at any greater or lesser risk of contracting it than anyone else and if you do have it there is no immunity built up after exposure (so, if you had it and cleared it, you could get it again through so-called 'risky' behaviours).

It's a very good idea to be kind to your liver while you're waiting for results - avoid alcohol, definitely, and try to eat well, sleep well, and avoid supplements/vitamins/etc. if you're able. But don't panic - HepC is a usually a very slow disease in terms of progression - many of our patients have had it for 10, 20 or even 30 years without knowing it. A good number of our patients choose not to treat it if they have it and just monitor their liver health.

In short - try not to worry. Get in for your follow-up appointment and, if you do have HepC, feel free to MeMail me with any questions. HepC is really quite common - estimated 1 in 12 people worldwide have it - and there are loads of supports, lots of information, the medications are improving by leaps and bounds.. and the cure rate is improving steadily!
posted by VioletU at 4:09 PM on May 9, 2012 [6 favorites]

Write down all your questions and take it with you to the appointment. I'm sure you will but just in case.
posted by Bun Surnt at 4:14 PM on May 9, 2012

Response by poster: Thanks all for your input, I really appreciate it. VioletU, I may be in touch.

Thanks again.
posted by thrasher at 6:09 PM on May 9, 2012

HCV antibody elisa has about a 1/3 false positive rate, assuming you are immunocompetent and at modest risk. It is very sensitive, so all the risky stuff you did 6 mo prior to your last test you can kinda forget about. Save freaking out of the follow-up test.
posted by a robot made out of meat at 7:44 PM on May 9, 2012

Response by poster: Update: I was given a liver function panel and an AST test and all results were "within standard range" though there's been no discussion about this yet with my doctor.
posted by thrasher at 3:24 PM on May 14, 2012

Response by poster: Further update: all clear. Thanks for your input folks.
posted by thrasher at 12:51 PM on May 27, 2012 [1 favorite]

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