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HepC transmission if undetectable after 4 months
Jul 23, 2013

Hello,

I was infected with hepC 1B. Treatment ribavirin+interpheron made me undetectable after 6 weeks, again after 4 months. Besides, my doctor told me I had a genetic marker stating curing was favorable.

I am dating a new guy, and we want to do it bareback. We are both HIV+ and do regular tests and have high CD4. I need some feedback about this.

Thanks

Response from Dr. Taylor

I am glad that your hep C treatment is going well. If you can try to complete the treatment for your best chance of cure.

The safest thing to do it to wait to be sure you are cured. This will take some time, as this means your hep C should be undetectable 3 months AFTER the treatment has ended (until recently we waited 6 months from the end of treatment to consider someone cured, as a rare few relapsed between months 4-6). There can be hep C virus in the genital tract (for example in semen) and we cannot say for certain that nondetectable levels thus far in the blood correlate with nondetectable levels in the genital tract.

Also do not forget to consider, discuss and get tested/evaluated for other infections such as syphilis, gonorrhea, chlamydia, HPV/genital warts, herpes.

Remember also if you achive a cure, you can catch hep C again. HIV-infected men going bareback with someone with hep C is a VERY EFFICIENT way to catch hep C again -- with re-infection rates in Europe being reported between 25%-30% of HIV-infected gay men and other men who have sex with men, in some settings. Oral sex should not spread hep C unless there is bleeding (but can lead us to catch other sexually transmitted infections).



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