|Hep c and hiv???
Jan 11, 2009
Can acute hep c be asymptomatic? so, for that reason if there is a possible co-infection with hiv, can seroconversion delay? And should we wait 12 months for testing hiv if we have both hep c and hiv and if hep c is asymptomatic? or should we get test for anti hiv and anti hcv at 3 months?
| Response from Dr. McGovern
There seem to be ongoing cause of concern regarding this issue of late serconversion for HIV in the setting of acute HCV infection. I would like to address this rare event and put it into perspective. I would also like to address the much more global issue of testing for other infections, that should be considered.
And yes - Hepatitis C can be asymptomatic (show no symptoms).
You should discuss with your doctor, which infections you need testing for after a potential exposure. With your physician, you can discuss in detail your particular concerns. It is really difficult to make a broad general statement that is good for everyone since decisions about what to test for will depend on various factors. I can make broad general statements about particular issues, but specific questions need to be addressed in detail with your provider.
This decision of what to test for will depend on the risk - injection drug use, sexual exposure (what type), or other exposure. It will also depend on the source (if the source is known to be chronically infected with hepatitis C or hepatitis B, etc...). It will depend on whether you were successfully immunized for hepatitis A or B in the past. It will depend on your symptoms and physical examination. It will depend on prior infections (eg, if you were already exposed to hepatitis B and cleared it in the past).
And furthermore, there are other infections to consider besides hepatitis viruses and HIV for certain exposures. For example, for sexual risk, you may also want testing for syphilis, chlamydia, or gonorrhea - this wouldn't necessarily be a concern for injection drug use without a history of unprotected sexual exposure.
So finally, if your doctor decides to test you for hepatitis C and HIV based on discussion of your risk...You will need HIV testing at 12 months IF and ONLY IF you also develop acute (new) HCV infection as well as determined by either symptoms or lab testing at the 3 and six month time points. This recommendation is based on a few RARE case reports of late HIV seroconversion in the setting of acute HCV infection.
The best general advice I can give everyone is to have safe sex and do NOT share injection needles or "works". Be safe! Stay healthy! Get immunized for the infections we have vaccines for.
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