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please answer Hep C question(s)
Mar 30, 2014

Dr. Taylor -

Thank you for the service you provide here. It is such a help to so many.

I am HIV+ male, 45, Caucasian, undetectable, very healthy with excellent numbers in all areas. Non-smoker, non-drinker, no drugs, regular exercise, etc.

I am trying to get "clarity" on Hep C. I recently may have had an exposure, and I am obsessing about this.

When reading some things online - it seems that the new treatments have rendered this disease essentially as treatable / successfully dealt with as syphilis or gonorrhea has been. In other words - you don't want it, but if you have it - you are most likely going to be fine. (By the way - I have excellent insurance.)

But - then there are other articles which make it seem like this is a very, very major potentially life threatening situation.

Obviously - I need to get tested - though my possible exposure (long story - but unprotected anal receptive) was extremely recent.

So - bottom line (no pun intended) - if it is the worst - and I am positive for Hep C - with excellent insurance - HIV+ (but my doc says I am healthier than him) - what is the prognosis with the new meds, etc. And are they essentially available now for those of us lucky enough to have excellent, top tier insurance?

Thank you for bringing clarity. The Internet is sometimes just TOO MUCH INFORMATION.

Response from Dr. Taylor

Hep C is a curable infection. The new medications are increasing the chance of cure for those with access. Cure is beneficial and reduces the likelihood of liver-related illness and death.

However being infected it not something to take likely. Taking medications is never easy. Adherence matters. The chance of cure is not 100%, although the medications are getting better and better. Spreading infection to others before one is cured is a concern. The hep C virus likely has impact beyond the liver. Some hep C meds interact with HIV and other medications and thus are not an option.

The different messages you are getting may have to do with the fact that hep C can be much more aggressive when we have HIV. Hep C is now a leading cause of illness and death for people living with HIV when HIV is well-controlled with HIV medications. Also, while most people with hep C alone, without HIV, die of something else other than hep C -- because so many people in the US have hep C, and were infected years ago, the number of deaths due to hep C now exceeds the number of deaths due to HIV in the US. The epidemic among baby boomers, those born between 1945-65, is now peaking, as people infected years ago are now becoming ill.

So please do get tested. If you do NOT have hep C, talk with your doctor about how to reduce your risk. If you are infected I recommend treatment leading to cure.

Remember that there are data indicating that catching hep C after age 40 may accelerate the liver scarring process. If cured, we can catch hep C again and again...I am concerned that insurance companies may limit the number of times they pay for expensive medications.

Please talk with your doctor about 'contact tracing' -- that is, seeing if your sexual contacts may be contacted. Talk with your doctor about how to reduce the chance of spreading HIV and hep C with your sexual partners. All best to you.

Hep B treatment
My alt is a higher pls help

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