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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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May 17, 2002

Dear doctors,

First, i would like to start by saying i have read almost everything you have on your web site and I would like to say that i believe you are all god sent and your site is the most informative one i have been able to find! (and i have seen alot of Hep sites) My question is two-fold. First, I am NOT in an at risk group for Hep C or any other like infection. On a routien test for an adoption i had a hiv test and a hepatitis panel done. All came back NEG except the anti hcv, it came back reactive. A follow up test (RIBA) came back as inconclusive (reactive to only the HCV NS3 protien and nothing else). Doctor ordered PCR (qualitative), results were NEG no virus detected. My family practictioner is telling me he thinks i have a like protien that these tests are reacting to and that i have never been infected with HCV. Please tell me, what do you think is the true reading of these tests? Do I, or have i ever had Hep C? My second question is, I am a wildlife Biologist so i undergo pre-exposure rabies vaccinations. During my testing for Hep C i had recieved two of my three vacciens for rabies. Does a rabies vaccien contain or produce a protien that is like or can be mistaken as HCV NS3 protien? If you cant answer this last question, as it is quite an odd question, could you refer me to someone who may be able to help? No one in my doctors office can answer this for me. I am very anxious to know what exactly is wrong with me and why i have this rouge protien. Thank you very much in advance and I desperatly await your reply.

Response from Dr. Fried

In the absence of risk factors (low-risk population), indeterminate RIBA, usually indicates a false-positive anti-HCV. This is supported by the negative HCV RNA. RARELY, you still could have been exposed but spontaneously cleared HCV. Obtaining one additional HCV RNA test several months after the first is reasonable and if that is negative, I generally don't pursue it any further.

If I find out anything about cross-reactivity with rabies vaccine, I will post it at a later date.

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