Hi Doctor:

I'm HIV+ and have been vacinated for Hep A & B. What are the synptoms of Hep C through sexual contact? Can I be cured of Hep C? And how long should I wait for treatment. ? I don't go back to my ID specialist until May. My CD4 count is about 500 and my viral load is undetectable now.

Good questions. 1. I am glad your physician vaccinated you. This is very important.

2. HCV can certainly be transmitted sexually. There are more and more case series of men who have sex with men who have contracted HCV - this is usually associated with traumatic sex and with concomitant STDs.

Side effects of acute HCV can include right upper quadrant pain, fatigue, nausea, vomiting, lack of appetite and jaundice (turning yellow). Some patients have no symptoms at all.

3. If a patient gets HCV acutely (eg, it just happened) serial HCV RNAs should be drawn to see if the patient clears the virus own its own. If not, immediate therapy is best.

If a patient has chronic HCV, then the first step is to see if the virus is present in the blood. If so, I tend to get a liver biopsy in those with genotype 1 infection. I don't feel as strongly about a biopsy in a person with genotype 2 or 3 infection.