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Do I have HCV?
Jul 24, 2005

I am a 22 year old asymptomatic male. I recently had a routine blood test and I have an elevated ALT of 56 (where I got my test, normal levels are 10 to 45).

I am extremely worried I might have chronic HCV, which is characterized with slightly elevated ALT. The only possible risk factor I have is heterosexual sex. I have (stupidly) had unprotected sex with 5 girls over the past year, and I briefly had anal sex (really lubed up, for less than a minute) with one of them. I have never been diagnosed with any STDs.

I understand that the female-to-male risk is low. I also understand the risk is higher if one of the partners has HIV. Does this mean that if my elevated ALT is due to HCV, I likely have HIV too?

I have a high CD4 count (not that this matters) and I have never had ARS-like symptoms. But of course, without a test, I can't prove I don't have HCV or HIV or both.

I am mostly worried because I can't find any evidence that my ALT could be due to anything else. My BMI is 25 or 26, a little high--but while many Americans are overweight very few have elevated ALT. My AST, triglycerides, and cholesterol are all within normal range. I do not drink much. I had a friend who works in ultrasound look at my liver, and while he said there was a little shading it is not definitively "fatty."

I know medications can cause elevated ALT, but I only take Excedrin only occasionally and have tried ephedrine for weight loss sporadically. I hadn't taken any Excedrin in the 2 weeks or so before my test.

I just don't think any of this, besides HCV, is enough to explain an ALT almost twice what most people have. If I have HCV, I'll never be able to get insured, and if I have HIV along with it my life is definitely over.

Am I justifiably worried--and is there anywhere I can get anonymously tested for HIV AND HCV?

Thanks in advance for your response.

Response from Dr. McGovern

In your home state, call your public health department to find out where you can get anonymous testing. I think you will feel much better after that.

Once you get your negative results, continue with 100 percent safe sex practices. It is awful to be in such a bind of anxiety.

Dr. McGovern

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