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"Is my HCV back again?"


I was infected with HCV, and its cured after treatment back 3 to 4 months,few days backi was sick and re-do some tests, i had a Anti HCV (Elecsys) which shows positive 110.1. Serum bilirubin 0.8 SGPT 36 SGOT 37 Alkaline Phosphatase 146 Does this mean that the virus is back? should i get tested for virus RNA?


This is an important question to discuss with the gastroenterologist that treated you for the infection. As you know, HCV is an RNA-based virus which causes inflammation of the liver, and over time can cause chronic liver disease and cirrhosis. There are a few different genotypes of the virus, some of which are more amenable to treatment with standard therapies (generally ribavirin and interferon) than others.

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Typically, response to treatment is monitored through intermittent checking of the viral RNA levels in the bloodstream as well as tests of liver inflammation (such as the ALT and AST). After the completion of antiviral therapy, if the viral RNA cannot be detected in the blood, then the patient is said to have "end of treatment" response. However, this does not mean that the patient is cured of the virus. A "sustained virologic response" means that 6 months after treatment there is still no detectable viral RNA in the blood. This means that a person is essentially cured of the virus, as the rate of any relapse is extremely low after this point. Even if the virus is undetectable by RNA, a person will continue to have a positive Hepatitis C antibody (Anti-HCV). This is a marker of past infection and represents the antibody response that your body has formed as a result of the infection. Just based on the antibody alone, it is impossible to tell if someone has had a relapse of the virus. The only way to tell is by looking at the viral load. If you have any further questions about the Hepatitis C virus, you should talk to the gastroenterologist that treated you for the infection.

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