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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
          
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Please I need your advice
Jun 29, 2012

Dr, I have a friend who found out to be HiV positive since 1999. He has been tested for Hepatits C a couple of time in these past 13 years. The last test he took was on January of 2009 which came back NEGATIVE. His doctor asked him to take another Hepattis C test last month (medical routine) and it came back POSITIVE. He is waiting for Qualitative PCR results. In case he has not exposed himself to HCV since 2009, would it be possible that all these tests taken over these past 13 years were false negative due to HIV/HCV co-infection? I mean, as his immune system gets better, could this be the reason he now shows Hepatitis C antibodies which were not detected before due to his immune system status? Back in 2009 his CD4 count was already over 500 and his HIB viral load was undetectable. What do you think doctor? He is so confused! Thanks so much! Best regards!

Response from Dr. McGovern

I would suspect this is new infection, but he will need to see his viral load to be sure. If negative, he would have cleared his HCV but that doesn't occur too often.

We don't usually see false negative HCV testing in HIV infected patients unless the CD4 count is <100 cells.

After he gets his viral load back, he should talk with his doctor to see if there are any signs that this could be recent acute infection - such as a low viral load (<100,000 IU/mL).

If his viral load is high, he probably has more chronic infection that occurred between 2009 and now. He can wait for better therapies most likely, but should have good follow up with someone who knows a lot about coinfection.



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