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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
           
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Hep C
Oct 9, 2008

I recently had a reactive hep c test of 9.37, had additional testing and ultrasound of the liver and spleen. The specialist says that I had it but have no active disease at this time. mild scarring in my liver which could also be from radiation from hodgkins disease treatments 17 years ago. My question is am I still contagious? Can it activate again? Do I need to continue blood tests for it? Would it make my spleen grow? Thank you for you insite.

Response from Dr. McGovern

I would want to check your hepatitis C virus level and your genotype before I decide what to do about your treatment.

Patients with genotype 2 or 3 infection have relatively "easy to treat" disease in that the duration of treatment is shorter and the success rates are high (about 65 to 70%). I usually offer treatment to a patient with those genotypes without a liver biopsy and often check the viral load response at 4 and 12 weeks. If the treatment is not working, then I simply discontinue it.

I usually get a liver biopsy in a patient with genotype 1 infection, unless they have a low viral load. Again, if the patient has mild disease, I still offer treatment and check a 4 and 12 week HCV RNA level. If there isn't a good response I stop therapy.



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