Hepatitis C Occult Infection

Last updated: February 2022

What is a Hepatitis C Occult Infection?

Occult hepatitis C virus infections (OCI) exist when there is a presence of the hepatitis C (HCV) RNA found in liver and in blood cells at the same time that there is an absence of detectable viral RNA in tests. There are currently two known types of OCI are recognized: seronegative OCI (anti-HCV and serum HCV-RNA negative) and seropositive OCI (anti-HCV positive and serum HCV-RNA negative). Currently, it is unknown whether the two types occur for different reasons or require different treatments.

How many people have Hepatitis C Occult Infections and how did they get them?

It is currently unknown how many people have occult infections. This is because many people who have them are unaware. In many cases, the virus is at such a low level that tests come back with negative results, which leads patients to never know the virus remains in their blood. In addition, there are often no symptoms of an occult infection that would alert the person that something may be wrong.

It is not currently known how or how many ways occult infections occur, however there are currently two main theories. Some research shows that some bodies thought to be able to rid themselves of a hepatitis C infection are only able to remove the majority of the virus but not the entire virus, leading them to have an occult infection. Other research shows that some patients who test negative after 8-12 weeks on hepatitis C medication intervention may not be cured but may instead have moved from having an active virus within their blood to having an occult infection.

How do I find out if I have a Hepatitis C Occult Infection?

If you are concerned that you may have a hepatitis C occult infection, it is always best to bring this to the attention of your doctor or to visit a clinic. There, you can discuss why you are concerned, as well as having your medical history reviewed for any indication of risk or of having a low-level virus in your blood. If your doctor is concerned, they will test your blood and possibly run liver tests in order to obtain the information necessary to either diagnose a hepatitis C infection, to diagnose an occult infection, or to reassure you that neither is occurring in your body.

During the time in which you are concerned, just as during all other times, it is important that you take universal precautions. This protects you from interacting with the blood of others’ and it keeps you from exposing others to your blood. These behaviors include avoiding coming into contact with others’ blood by avoiding it or wearing gloves and a mask when interacting with blood and blood products. It also involves using clean needles if you are involved in IV drug use or if you are being tattooed. If you have questions about universal precautions, you can always contact your local doctor, clinic, or speak with the pharmacist at your local drug store, as all medical professional are trained in this and will be able to answer your questions.

What should I do if I have a Hepatitis C Occult Infection?

If your doctor has diagnosed you with a hepatitis C occult infection, they probably also talked with you about what the next steps are. If you cannot recall this information, do not be upset; it is very common for patients to hear upsetting news and become too busy processing the information to pay full attention to whatever is said next in the doctor’s office. If your doctor handed you information, you can read that to find out more about your diagnosis or perhaps even whether the doctor referred you to another doctor or whether a future appointment is made. If you remain uncertain or are finding yourself with questions, you can always contact your doctor’s office and request to speak with a nurse or with your doctor.

After a diagnosis, doctors are often choosing between two treatment paths. They may discuss them with you to gain your input into which you prefer or they may tell you which they recommend and explain why this is the best option for you. One treatment path is to do nothing at the present time but to periodically run liver and blood tests. This option is often chosen if the doctor decides that the occult infection is minimal and poses little risks to the body. In some cases, monitoring whether there is any increase in infection or increase in liver damage is preferable because it is less risky than administering antiviral drugs, which pose their own set of side effects and risks. The other treatment path is to provide antiviral drugs, with the goal of minimizing or removing the hepatitis C virus within the body. Some doctors and/or patients feel more secure in treating any viruses right away out of concern that leaving them alone could lead to problems later. When considering which treatment method is best for you, your doctor will consider all of your medical history, any other medications you may be taking, and other personal details that are specific to your body and your life. Treatment plans and methods may be different from patient to patient based on each person’s needs. If you are uncertain or uncomfortable with the recommended treatment method, you can always discuss your concerns with your doctor or request a referral for a second opinion.1-7

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