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Frightened Long Islander
Sep 10, 2002

Dear Dr. Dieterich:

Please help. In late-April, I had what I'm told was a low risk encounter (see Dr. Fried's response to "HBV/HCV in Water" on August 25, 2002. It was a sponge bath at a massage place (concern is that urethra or rectum could have come into contact with previous customers' bodily fluids on sponge).

Toward the end of May, I began experiencing discomfort on the right side of my trunk (approximately where my elbow falls when standing with my arm at my side). I also began experiencing discomfort on the right side of my mid-back. The discomfort since then (for last 3 months) has been mild but constant. I have not experienced any other symptoms.

When I first began experiencing the discomfort, I went to my doctor, and he took a chest x-ray, diagnosed the problem as muscular-skeletal, and sent me home. Two weeks later, I went back because the discomfort had not abated, and at my request, he ran kidney urine tests, and ordered blood tests including a CBC and hepatic panel. All tests were normal. In June, I also had abdominal and pelvic CT scans done, and those were normal as well.

My doctor then sent me to physical therapy, which did nothing.

As a result, I am going to be re-tested for Hepatitis B and C after Labor Day, and had the following questions:

1. If I had contracted HBV, would the HBsAg likely have been detectable 5 weeks and 2 days after exposure, and two weeks after onset of discomfort?

2. Does an HCV antibody test after 5 weeks, 2 days have any value?

3. Will the tests likely be conclusive 20 weeks after exposure?

4. Assuming HCV, would detection after 20 weeks be early enough for me to benefit from the high-success rate of early treatment?

5. Woul you recommend a good specialist on Long Island so I could promptly seek treatment?

I know this is a lengthy request, but I would be so grateful for your analysis.

Thank you.

Response from Dr. Dieterich

Hepatitis testing at 20 weeks would be very accurate. Doubt that you have it that is a very low risk exposure. If you do need treatment that would still qualify as an acute exposure. Dave Bernstein at North Shore is a good friend and and excellent hepatologist. Good luck! DTD



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