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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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How do you know if you're conifencted?
Jan 11, 2009

Hello Dr. I know that this particular topic has been covered over and over but I need a bit of clarification. On the topic of HCV delaying the production of HIV antibodies, you said that HIV testing beyond 3-6 months is only warranted IF and ONLY IF the patient "becomes ill" with acute HCV infection. However, experts also acknowledge that most people who develop acute HCV infections show no symptoms. With that said, how would I (or anyone else for that matter) know if my HIV antibody test at 3 months is valid unless I also take an HCV antibody test? Are you saying that the only way to know for sure is to test for both HIV and HCV? Thanks for your response.

Response from Dr. McGovern

Whether someone gets testing for HCV will depend on many issues, such as whether it is known if the source patient is HCV infected or not.

Remember, this issue of late seroconversion for HIV, in the setting of acute (new) HCV infection has only been described in about one or two cases in the entire literature - a rare event to be sure - and only occurs if a person gets two infections at once - this is also uncommon.

I wrote previously that "HIV testing beyond 3-6 months is only warranted IF and ONLY IF the patient "becomes ill" with acute HCV infection...The phrase "becomes ill" can mean symptoms themselves or abnormalities of liver function tests, which may prompt further testing for HCV. It could also mean HCV seroconversion or detection of HCV RNA. It is difficult to cover all the possibilities because what the clinician tests for will depend on the risk behavior, the source patient, the patient who is being tested, etc...

If you have any concerns about your testing, speak to your medical provider about all issues of concern so that your anxiety about this issue can be addressed - either by further testing or counseling about the risks that are pertinent to your particular case.

Chronic vs Acute

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