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Can you transmit Hep C whilst "undetectable"?
Nov 27, 2010

Hi Barbara,

I am a HIV+ gay guy and last week I had unprotected sex with another HIV+ guy, where I was the active partner, and he was passive. After having sex, the guy told me that he was on Hepatitis C treatment and had completed 16 weeks so far. He said he was undetectable at week 4, but had since been told he was "negative". He was diagnosed in the acute phase.

I am now extremely worried that i could have caught Hep C from this guy. Can you confirm whether it is possible to transmit Hep C in this situation, as i was under the impression that nobody can be considered Hep C negative until they have gone 12 months after treatment without the virus returning? How much of a risk would you consider I have put myself in by having sex with this guy? I dont think there was any exchange of blood but you can never be sure...

Also, when somebody has finished treatment but remains undetectable, can they still transmit Hep C? Is it possible to remain undetectable forever, yet still have enough of the virus floating around in your blood to transmit the virus?

Many thanks in advance.

Response from Dr. McGovern

All good questions.

If someone does not have detectable HCV virus in their blood, he should not be able to transmit to you.

Although he hopefully has undetectable HIV, as you know, you can still have HIV in your genital secretions even if it is not in the blood. You don't want to acquire someone's else's strain... Best to use protection whenever possible.

Also be certain you are protected against hepatitis B with detectable surface antibodies in your blood...If not, you may need a repeat HBV vaccine series. Also Hepatitis A vaccine as well if you haven't had this in the past. Discuss this with your doctor.

Hope this information will keep you safe.....

hep c window period
low cd4 count and high viral load

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