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Returning From Iraq Hep C Positive
Jun 5, 2007

Hello, I returned from service in Iraq 2 weeks ago and had contact on a regular basis with Iraqi locals. About a week after being home I had blood work done, my ALT level was 87 and all other liver test were in the normal range. I was then tested for Hep C and it came back positive. I am returning to the lab tom. For I guess the test to confirm if the the Virus is still present? I spoke with a nurse friend that told me that my ALT level was low and I may have cleared the virus?? I phsically feel great and am in probably the best shape of my life and have had no symtoms to speak of. Mentally I am a mess, I am trying to adjust to normal life again and now have to deal with this. My question is what are the chances I cleared the virus and for someone with ALT levels as low as mine, how long would you recommend treatment if I do still have the virus?

Response from Dr. McGovern

I would get HCV RNA testing to see if you still have the presence of virus. I would not necessarily say that you are clearing the virus based on a set of low abnormal liver function tests. Also you want to get HCV RNA to be certain that this antibody test is not a false positive test. HCV is not easily transmitted through sex.

If you have presence of virus, then you will need further testing of HCV RNA to see if it persists. If so, you will need further follow-up.

If you think you were infected within the past 12 to 16 weeks, I would let your physician know that.

If you were possibly infected earlier, I would simply get routine follow-up and testing. Not everyone with HCV develops hepatitis. Not everyone with HCV needs treatment.

The good news is that if you did got infected recently, there are new drugs on the horizon that will be hopefully available in 3 to five years. And that is plenty of time for you since liver disease, if it occurs, takes many many years to develop.

Keep alcohol consumption down to a minimum for now until you know more.

Welcome back home. Would not stress about this aspect. You have years to figure it out. As I stated above, the most important issue is to let your physician know if you think you got infected within the past 3 months. If so, early treatment could be considered, since this is about 95 percent effective. However, we still don't even know if you have virus in your bloodstream, so all of this is premature.

Hepatitis A
ambiguous test results

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