[Medical Q&A] Hepatitis C has been cured, why is the hepatitis C antibody still positive?

Planner: Chinese Medical Association

Reviewer: Ye Qing, Chief Physician, Tianjin Third Central Hospital

In the outpatient clinic, people often come to the doctor with hepatitis C test results to consult: "Doctor, my hepatitis C has been cured, why is the hepatitis C antibody still positive? Wasn't this treatment in vain?" The answer to this question depends on the specific situation.

Hepatitis C is a public health problem worldwide. With the launch of more and more highly effective, short-course direct antiviral drugs, most hepatitis C patients can be cured after 3 months of treatment. After hepatitis C invades the human body, the body will produce hepatitis C antibodies, which may accompany a person throughout his life. Therefore, in judging the treatment effect, it is not dependent on hepatitis C antibodies, and hepatitis C antibodies do not have a protective effect on the human body like other antibodies. Therefore, after the hepatitis C antibody is found to be positive, it is necessary to perform hepatitis C virus RNA testing (hepatitis C virus quantitative testing) to determine whether treatment is needed. If the hepatitis C virus RNA test result is positive, it means that the body is infected with hepatitis C virus and the virus is replicating. The doctor will provide targeted treatment to the patient based on the genetic typing of hepatitis C; if the hepatitis C virus RNA test result is negative, it means that after treatment, there is no active hepatitis C virus in the body, or in other words, although the patient's hepatitis C antibody is positive, it is no longer contagious. This is clinical cure. In another case, if the patient has not received treatment, the HCV RNA test result is also negative, which means that although the patient has been infected with HCV, the body's immunity is very strong, there is no active virus in the body, and the patient has recovered. From this point of view, simply based on the positive HCV antibody, it cannot distinguish whether there is still virus infection at present, but only indicates that the patient has been infected with HCV. If the HCV antibody is positive and the HCV RNA test result is negative, it means that the treatment is effective and the patient is in a clinically cured state.