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Hepatitis C transmission from a HIV positive Man
Mar 11, 2012

Dear Dr. McGovern, I am a hiv positive gay man with undetectable viral load on Atripla. Recently I had unprotected sex with another hiv positive gay man (whose HCV status is unknown, but he had multiple sex partners and he was doing drugs), not thinking that I was putting myself at risk for HCV transmission (I was engaged in both receptive and insertive sex). I am vaccinated against HBV, do you think I need to ask my doctor to order a HCV RNA test for early detection and treatment, in case I am infected with HCV?

Response from Dr. McGovern

Yes I would definitely recommend testing for HCV with both an HCV antibody and liver function tests. If your antibody is non-reactive or if your LFTs are normal, I would still follow up on testing.

If there is any abnormality whatsoever on your liver function tests, I would follow with an HCV RNA right away.

You are at risk since MSM can transmit HCV sexually, particularly in the setting of trauma or other STDS (like syphilis).

I would also get tested for other STDs such as chlamydia, syphilis, etc...

If you have new HCV keep in mind that prompt treatment (if you don't clear the infection on your own in a few weeks) is very effective.

Should I start treatment based on current test results?
Concerned what should I do

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