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Diagnosed today with Hep C
Sep 7, 2009

I have had HIV for a few years now and have been undetectable with a high CD4 count (745 at last draw). For the past three months my liver enzymes had been elevated to three times the high normal for ALT and ASL. My MD performed a Hep C test which I just found out today is positive. I don't use drugs (terrified of needles), which makes him think this might have been sexually transmitted. I go in for an HCV viral load test in a few days. Given that my CD4 count is so high, he seems to think that I may have cleared the virus. What is your opinion? Is this even possible?

Response from Dr. McGovern

Many good questions.

1. Yes, HCV can be sexually transmitted. It is not common among heterosexual couples - about 1-2% per year....However, there have been documented outbreaks among men who have sex with men for several years now - in Europe and the US.

2. I would follow your HCV RNA for about 8 weeks and if you do not clear the virus, I would definitely start treatment right away for your best chance of clearance. I would prefer pegylated interferon with ribavirin - dosed according to the type of genotype you are infected with.

3. Persons with HIV can occasionally clear acute HCV infection - but it is not common.

If you have not been vaccinated against HBV and you have not been exposed, I would get vacccinated.

Best of luck!



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