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Superinfected HIV/HCV/HBV
Feb 14, 2009

Thank you, Doctor, for taking this question. I was Dx with HBV and HCV in late 1999, HVC untreated, put on epivir 2000, later Hepsera in 2006 for HBV Dx HIV in 2007, on HAART, undetectable... began interferon/ribavirin for the HCV sept 2008, undetectable on Heptimax test after 4 wks (Genotype 2b), they say I have to stay on Interferon/rib for 48 wks since I'm coinfected. But the treating Heptologist says I never had HBV in the first place since I'm surface antibody, antigen, core ,DNA, all tests: negative. Can this be right? Should I be vaccinated for HVB? Thank you!

Response from Dr. McGovern

It appears that either your laboratory tests are discordant or that someone misinterpreted your HBV testing in the past. I would suspect the former reason is this issue since some HBVtest was positive in the past - and now all are negative. It would be helpful to get your old records and I would also get repeat testing for surface antibody. If your CD4 count is now above 350 cells, then this would be a good time to get vaccinated. Right now your T cells may be lower than usual from the interferon therapy. However, your CD4 percentage is probably the same or increased. I wouldn't worry about your T cell count going down since we know that this occurs on interferon treatment.

Also - since you had a rapid virologic response (no detectable virus at 4 weeks) you are in an excellent category for achieving a sustained virologic response for your HCV infection. Great news!



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