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confused about hep c
Feb 21, 2011

Hi dr. McGovern, Ive some more questions about my case. Im 48 old man, on 2010 between the last weeks of September and the whole month of October I had a severe illness during which I was very tired, exhausted, having anorexia, severe headaches, without any fever, my case went into phases for a week or more I become very ill and some other days I feel better but not my normal, I took paracetamol and 2 courses of tamiflu (75 mg bid for 5 days and 75mg od for another 10 days)after awhile I felt better and gradually restored my health, but I became easily tired and less than my normal. during that time I did not have any lab work except ESR which was 15 mms (n=10mms). During November and December I was ok, but I was not able to rest during these few months for much work. on January/4/ 2011, I had my 1st liver enzymes AST 154, ALT 98 (many months ago they were normal as well as my serology screen -ve),I checked enzymes every few days, they were decreasing into AST 51, ALT 69,then ,AST 30, ALT 59, then AST 22, ALT 49 (ASTn= 0-40, ALTn= 0-38), on mid-January I checked serology antiHCV , HBsAg was (-ve) , also HCV RNA PCR qualitative and quantitative (not detected). Im terrified as doctors told me it couldve been hepatitis, and antiHCV can be negative for up to 6 months, also, HCVRNA can disappear and may later appear. My questions are : what was my illness what to do to know. should I got retested for hep c & at what time intervals & how many times tests should be repeated.

Response from Dr. McGovern

If you HCV RNA is nondetectable, yes it is possible that you could have cleared your infection, but at this point, I would expect your HCV antibody to become positive, especially if your LFTs are trending down. Your infection should declare itself by now.

I would recheck your HCV antibody and get a HB core antibody IgM to determine if this could have been recent hepatitis B infection. Also check a Hepatitis A IgM to see if you recently had a food/water-borne illness.



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