Nov 12, 2009
Well, Dr. have you wever run into this?: I was diagnosed superinfected HIV/HCV/HBV liver biopsy done, stage II all in 6/07 put on Atripla + Ziagen which I never missed a dose .....now new labs came out (HIV ud since shortly after I started ART) My surface antibodies/antigen and core antibodies/antigen all 4 came out NEGATIVE last wk, for HBV, although all 4 were positive in 6/07, 7/08. My HIV specialist says my HepC treatment (interferon + ribavirin) plus Atripla and Ziagen did this. My readings, and my Hepatologist (who presided over my HVC treatment) say that that's impossible, I would always have the core antibodies core and probably the surface too. 2nd battery of tests confirm all HBV negative values AND THE HEPATOLOGIST NOW SAYS I SHOULD GET THE HBV vax "just to be safe" He says he can't explain it 'MAYBE THE PRIOR TESTS WERE WRONG" dOES ANY OF THIS MAKE SENSE??? THANK you
Response from Dr. McGovern
First of all congratulations on suppression of your HIV and your cure of HCV with interferon/ribavirin....
I agree with your hepatologist that I suspect the first set of labs were probably not yours....I also agree with immunization..However, I would pursue one more test - that of HBV DNA to be certain that you do not have occult infection. There is a paper that describes changing serologies in HIV infected patients with HBV...However, with improvement of your HIV status, I would expect you to gain antibodies - not lose them.
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