What does a reactive Hepatitis C (HCV) antibody test result mean?

From the Guidelines

Hepatitis C antibody reactive means that a blood test has detected antibodies against the hepatitis C virus in your body, indicating you have been exposed to the virus at some point in your life, but it does not necessarily mean you currently have an active infection. This is because antibodies remain in your bloodstream even after the virus has been cleared 1. According to the 2020 guidance from the American Association for the Study of Liver Diseases-Infectious Diseases Society of America, a positive HCV-antibody test indicates current (active) HCV infection (acute or chronic), a past resolved infection, or rarely a false positive result 1.

Key Points to Consider

• A reactive HCV-antibody test requires a follow-up test called an HCV RNA test (viral load) to determine if you currently have an active hepatitis C infection 1.
• About 15-25% of people naturally clear the virus without treatment, while others develop chronic infection.
• If you test positive for active infection, highly effective direct-acting antiviral medications can cure over 95% of cases with 8-12 weeks of treatment.
• It's essential to follow up with a healthcare provider promptly after a reactive antibody test to determine your current infection status and discuss appropriate next steps.

Next Steps

• Quantitative HCV-RNA testing is recommended prior to initiation of antiviral therapy to document the baseline level of viremia (i.e., baseline viral load) 1.
• HCV genotype testing may be considered for those in whom it may alter treatment recommendations, such as persons with a prior HCV treatment failure 1.
• Persons who have a reactive HCV-antibody test and a negative (not detected) HCV-RNA test should be informed that they do not have evidence of current HCV infection, but they are not protected from reinfection 1.

From the Research

Definition of Hepatitis C Antibody Reactive

• Hepatitis C antibody reactive refers to the presence of antibodies against the hepatitis C virus (HCV) in a person's blood, indicating that they have been exposed to the virus at some point in their lives 2, 3, 4, 5, 6.
• This does not necessarily mean that the person is currently infected with the virus, as the antibodies can remain in the blood even after the infection has been cleared.
• A reactive result typically requires further testing, such as a viral load test, to determine if the person is currently infected with HCV.

Implications of Hepatitis C Antibody Reactive Result

• A hepatitis C antibody reactive result can have significant implications for a person's health and treatment options, as HCV can cause chronic liver disease and other complications if left untreated 3, 4, 5, 6.
• The presence of HCV antibodies can also impact a person's eligibility for certain treatments, such as ledipasvir and sofosbuvir, which are commonly used to treat HCV genotype 1 and 4 infections 2, 3, 4, 5.
• It is essential to consult a healthcare professional to determine the best course of action after receiving a hepatitis C antibody reactive result.

Treatment Options for HCV

• Ledipasvir and sofosbuvir are effective treatments for HCV genotype 1 and 4 infections, with high sustained virological response rates (SVR12) in clinical trials 2, 3, 4, 5.
• The combination of ledipasvir and sofosbuvir has been shown to be well-tolerated and effective in patients with advanced liver disease, including those with cirrhosis 4, 5.
• Other treatment options, such as daclatasvir and asunaprevir, may also be effective for patients who have failed previous treatments or have specific resistance-associated variants (RAVs) 6.