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RE: Time Critical 4th Try I Respect Your 2nd Opinion
Feb 21, 2005

First, I would like to thank you all for everything you are doing for everyone. I wrote in a week or two ago and you mentioned you would feel better if I had RNA and liver function test added to the acute hep panel that I had done. Here are the results, HEP C RNA <615. If this was an acute infection what are the odds that it would be that low? Is this with the negative antibody test at 12 weeks conclusive or should I have done the PVL? Here is my liver function test results:

Albumin 4.7 Alk Phos 80 Sgpt-ALT 33 Sgot-AST 25 Billirubin .7 T. Protien 7.2

I had jaundice under my eyes for a week, chronic diarrhea for three weeks that resulted in hemorrhoids, nausea, white coating on tongue, night sweats without a fever, gurgling stomach, stinky yellow or dark stool, itchy skin, one swollen lymph node under throat, and a low temperature 97.6. All of this went on for about three and a half months now I just feel fatigued. I had an acute hep panel ran that included antibodies for Hep A IGM, B Surface Antigen and core IGM, Hep C antibody, and HIV antibody test at 12 weeks. The RNA and function test is at 15 weeks; I am trying to make sure I do not have a co-infection of Hepatitis and HIV. To get the acute HEP treated before it goes chronic. I was told by the liver foundation that if Hep B was there to get the vaccines and that may help me clear the virus but it was not likely that anything is there or it may have cleared already. All of this worry comes from a three male SA on another male and my doctor is blaming everything on anxiety or influenza. The symptoms went through stages and finally cleared after 14 weeks except the white coating on my tongue. My doctor will not do anymore tests unless I pay for them because he does not think insurance will pay and he put me on Ambien and lexapro for sleep an anxiety. What do you think? Should I quit worrying about HIV and hep C? I did not go to the doctor until the 12th week and he missed many of my symptoms because of this. Would anxiety cause all of this? If there is no Hepatitis then my HIV test at 12 weeks could be conclusive.

Response from Dr. McGovern

Although you report jaundice, it does not appear that it was related to any of the hepatitis viruses that we know of since the following should have been present: 1. hepatitis A IgM 2. hepatitis C antibody positive or 3. hepatitis C antibody negative with presence of HCV viremia (ie HCV RNA present) 4. hepatitis B surface antigen positive with core IgM.

Your hepatitis panel is very reassuring. Dr. McGovern



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