Q and A

Question

What does an equivocal HCV test mean?

I tested positive for HIV but negative for Hep-C 6 months ago.

I have not had any risk factors at all, since perhaps when I was infected with HIV but that was over a year ago.

However, in a new Hep-C test done last week, the results turned out as equivocal. And now an RNA test has been sent to confirm if there is any virus in the blood.

I just wanted to know if it is possible that the HIV antibodies may have interfered with the anti-HCV test therefore rendering the results inconclusive.

Or what other factors may make such antibody test equivocal?

Answer

Hello,

Thank-you for your question.

An equivocal Hepatitis C (HCV) test means that the antibody test did not produce a clear positive or negative result.

HIV antibodies do not interfere with HCV tests. If the CD4 count is low (below 200) there may not be enough antibodies for a clear result. This may also be the case in early stages of infection. This is called the window period- HCV antibodies take between 6-24 weeks to develop.

I am not aware of other reasons for equivocal test results with HCV. It is common for an equivocal antibody test to be followed up with an RNA test which will give a conclusive result.

Please follow this link for more information about testing for hepatitis C.

6 comments

  1. Roy Trevelion

    Hi Rupinder,

    Please let us know what an IDCT Test is testing for. This website is a resourse of information about HIV treatment for people who are HIV positive.

    An equivocal Hepatitis C (HCV) test means that the antibody test did not produce a clear positive or negative result.

  2. Rupinder

    Hi, my name is Rupinder. I need to know the meaning of my report result in IDCT Test as Equivocal.

  3. Rebecca McDowall

    Thank-you Greg for getting back to us, I am so pleased to hear about your negative result!

    Thank-you also for the information, which I’m sure many people will find very useful.

  4. Greg

    Hi,

    This is for future reference for anyone in my position.

    I received my RNA and second Anti-HCV results today. They both turned out negative.

    Apparently, Anti-HCV tests false positives and equivocal results do happen more often on people with HIV as there can be a cross-reaction to certain antigens. Moreover, other factors influencing this include recent vaccinations such as Influenza and Pneumonia.

    After and excruciating wait I can feel better now.

    Thank you Rebecca and I-base for your advice,

  5. Rebecca McDowall

    Hi Greg,

    I’m not an HCV expert but having looked at the UK HCV testing guidelines I can tell you that an equivocal test result is not uncommon. This is partly due to the poor sensitivity of the antigen test which produces a significant number of both equivocal and false positive tests. HCV antigen tests look for 4 antigens produced by HCV infection. A positive test result is shown when two or more antigens are detected. An equivocal test result means that only one antigen has been detected. According to guidelines with the most modern tests about 40% of equivocal tests are negative with the RNA confirmation.

    I haven’t been able to find information about other reasons for these results. If you are still concerned you can call the center where you were tested and ask them to explain your test results.

  6. Greg

    Thank you for your reply,

    I still don’t understand why the test would be equivocal since I don’t fit into either of the explanations. My CD4 is higher than 500 and I have not had any potential exposure to HCV for over six months, so I wouldn’t be seroconverting. Even if I was seroconverting my liver enzyme levels would then be skyrocketing, which they’re not as they are at normal levels.

    The waiting time for the RNA is killing me, and I just want to know what other explanations may there be for false-positives. I read somewhere that this is not very uncommon.

    Thank you,

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