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Hep C+HIV+HSV2...
Jan 29, 2008

About a month ago I was diagonosed with a primary HSV2 infection. I have been married for 3 years and together with my husband for 4. They performed a blood test and found out he was an asymptomatic carrier. He also tested positive for Hep C. After my doctor found that out, he ordered a HIV test and we discovered we were both positive! I have only had 6 sexual partners in my life! We have a two year old daughter as well... What are the concerns with having Hep C and HIV at the same time... as well as Herpes? My head is spinning now. I can't believe this is all happening. I was tested for HIV in June of 07 and was negative as well as in June of 05 when I was pregnant. The doctors believe that my husband has been positive for 3 or four years and it took a really long time for me to contract the disease. Is this common?

Response from Dr. McGovern

It is surprising that it did take this amount of time to become HIV positive. You may have some special host factor that was partially protective.

As for HCV coinfection, you will want to have HCV RNA testing to see if you have virus in your blood. If you do not, then I would have testing once more time, and if negative, you have probably cleared this virus on your own.

If the HCV RNA test is positive, then you should also have testing for HCV genotype. If you know that you were recently infected with HCV then you probably will not have significant liver disease since this usually takes years to develop.

I suspect you will not need HIV treatment right now. If this is the case, you can consider treatment for HCV while you do not have to worry about taking a multitude of other medications. On the other hand, you could put off therapy and see how the new drugs for HCV develop over the next five years.

If you wait, I would suggest careful follow-up and consideration of a biopsy over the next few years to be certain that waiting is a reasonable option. The other data I would put into my equation, would be your HCV genotype. If you have genotype 2 or 3, I would consider therapy now, check an HCV RNA at 4 weeks, and if non-detectable, I would just treat for six months.

Finally, get vaccinated for hepatitis A.

My best wishes the health of you and your husband. Remember that HIV is a chronic disease now. The drugs are so much better and you will do extremely well.



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