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Interpreting LFTs - Should I get tested for HIV ?
Oct 19, 2008

Hi Doctor Barbara,

This is a long question but I would be extremely grateful if you could give some of your precious time to give me your valuable advice.

I had a recent HIV exposure, where the risk as evaluated by doctor Bob was essentially non-existent, but he told me to put my question in the hiv and hepatitis co-infection forum for further clarification.

After 1 month of the my exposure, I had the following symptoms: fever, lack of apetite, tiredness, nausea. The physician told me to undergo Liver Function tests, and my results were:

Total Bilirubin: 6.2 mg/dl Conj. Bilirubin: 4.1 mg/dl Uncon. Bilirubin: 2.0 mg/dl SGPT(ALT): 3920 IU/L SGOT(AST): 3680 IU/L ALKALINE PHOSPHATE: 356 IU/L TOTAL PROTEIN: 8.7 g/dl ALBUMIN: 5.1 g/dl GLOBULIN: 3.6 g/dl A/G Ratio: 1.41:1

After about 10 days my results were:

Total Bilirubin: 3.8 mg/dl Conj. Bilirubin: 2.10 mg/dl Uncon. Bilirubin: 1.66 mg/dl SGPT(ALT): 187 IU/L SGOT(AST): 245 IU/L ALKALINE PHOSPHATE: 292 IU/L TOTAL PROTEIN: 7.0 g/dl ALBUMIN: 4.1 g/dl GLOBULIN: 2.9 g/dl

After another 3 weeks my results were:

Total Bilirubin: 1 mg/dl SGPT(ALT): 47 IU/L SGOT(AST): 41 IU/L ALKALINE PHOSPHATE: 138 IU/L TOTAL PROTEIN:7.3 g/dl ALBUMIN: 4.6 g/dl

I also had jaundice after about 2 weeks from the start of the symptoms, and lost about 4-5kgs. Now after 2 month of start of symptoms and 3 months after the last encounter, I feel fit, but have not regained my strength completely, also I have pain sometimes in my stomach region, but not very severe.

My doctor told me that I have acute viral hepatitis. I asked him about whether I have Hepatitis A,B or C, so he said that it was most probably Hepatitis A, and that testing for which hepatitis it is was not required. I did not discuss with the doctor about my exposure because I was thinking that I had taken all the precautions while having sex. But now I find the symptoms of HIV very similar to mine and I have started to worry whether something went wrong during the sex like vaginal fluids touching my penis accidently after condom removal.

Based upon my tests and other symptoms, what will you suggest to me, whether I should go for HIV tests at 3 month mark or I should leave the fear behind because my risks were "essentially non-existent" and I just had viral hepatitis which is cured[It is difficult for me to get tested due to some reasons, please suggest tests only if you think it is absolutely necessary]

Thanks in Advance.

Response from Dr. McGovern

It appears that you have limitations in testing due to cost so I will comment as follows.

If you have no exposures for sexually transmitted diseases, and this may be the case since you used condoms, I would not recommend HIV testing.HIV infection does not usually cause a severe hepatitis.

If you are aware of others who also got hepatitis A, I would be more happy with that explanation of your infection. If you suspect there could have been another exposure, ie, unprotected sex within the past 3 to six months, injection drug use, etc...then I would encourage you to get a Hepatitis B surface antigen and a hepatitis C antibody.

Always a confusing subject, so far
Is this conclusive? You are the only one that can help.

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