Diagnosed with hep C today
Apr 14, 2010
I have been diagnosed with hep C today. I have hiv as well. My CD4 are at 490. I am not sure what my hiv viral load is. Can you tell me the difference between acute and chronic infections? When does acute become chronic? Is the acute infection curable? Is the chronic infection curable? I think I was recently infected. My liver enzymes are at 41. NO idea what my HCV viral load is at this time. Would my immune system be able to clear the virus on its own? Should I start therapy?
Response from Dr. McGovern
If you think you were recently infected then it is VERY important to get serial testing of your HCV RNA (viral load) over the next several weeks. If your viral load is less than 100,000 then that would be very suggestive that indeed your infection was recently acquired (McGovern, Journal of Infectious Diseases 2009).
Most likely you will need treatment because the chance of clearing the infection on your own is lower when you have HIV infection. However, I would still get at least two viral loads before making that decision since you do have good CD4 counts.
If you have persistent viremia, I would treat you with PEG interferon and ribavirin to maximize your chance of a cure. Your provider will also be checking your genotype. However, in acute infection, your chances of cure are better than in chronic infection, regardless of genotype.
Best regards for a positive outcome! If you do go on treatment, remember to take your medications faithfully - you should do well.
Once cured, protect yourself from any future exposures through safe sex and no sharing of any kind of drug paraphernalia.
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