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Did I get the wrong tests?
Jun 7, 2004

I had a potential exposure to hep b and hep c about 10 weeks ago. I have had night sweats, rash on torso, yellow stools and fatigue for several weeks. The doctor tested me for hepc and hep b antibodies at about 8 weeks and did a liver function panel, all were fine. After doing some reading it appears that this test might not have been appropriate given the time frame. Could you please give some suggestions.

Response from Dr. McGovern

I think that you did the right thing by going to your physician to be tested when you were concerned about an exposure.

In terms of the "appropriate tests" I would counsel you as follows:

1. Hepatitis C: Most patients develop antibody to hepatitis C by 6-8 weeks after exposure although on occasion a patient can become HCV seropositive up to 5 months later. Early on after exposure to hepatitis C, sometimes the antibody will be negative and the virus can be detected in the bloodstream. Usually when virus is detected, liver function tests are abnormal. Since you were tested about 8 weeks after exposure, you most likely would have had antibody or abnormal liver tests by then. You could always ask for re-testing if this is still weighing on your mind, but I suspect you will still be negative.

2. As for hepatitis B, the incubation period is somewhat longer with the majority of patients having symptoms within around 3 months although on occasion a patient may have onset of illness up to 6 months later. The testing should include hepatitis B surface antigen and hepatitis B core IgM antibody. I specify hepatitis B core IGM because this specific antibody comes up in acute infection only.

I hope this is helpful. Dr. McGovern



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