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Acute hepatitis-B infection as possible seroconversion
Mar 1, 2000

"The acute illness linked to HIV seroconversion may be confused with other acute illnesses, and differential diagnosis includes secondary syphilis, acute infection with hepatitis B or A, Epstein-Barr virus, cytomegalovirus, or toxoplasmosis, roseola, and other viral infections. HIV infection can be distinguished from the acute illness of influenza because conjunctivitis and coryza, common with respiratory tract infections, are uncommon with acute HIV infection.

HIV infection is not as common as many other infections in the differential diagnosis.(36)

Thus, many persons with suspected primary HIV infection due to a possible exposure ultimately will not have documented HIV infection as the explanation for the acute illness."

I found this fragment on the URL

http://www.lycos.cs.cmu.edu/wguide/tools/pgview.html

and have the following question: since the incubation period for hepatitis-B is 60-90 days, is it possible, taking into account the knowledge from the above fragment, to get hepatitis-B from an encounter with an HIV+ person in

the month preceding the acute infection with hep-B, and as such can this hep-B be a sign of seroconversion to HIV+? I mean: in this case can the incubation period for hep-B be different than the usual incubation period of 60-90 days or can this never be the case?

My doctors have not been and are not very helpful in this!? Can you believe it?? It's as if they are sleeping! They are less worried than me, how come!!?

In other words, when hep-B is a sign of seroconversion is it possible there is no incubation period attached to it?

For example, when one sleeps with an HIV-infected man on day X can one have acute illness of hepatitis-B on day X + a couple of days, or on day X + 2 or 3 weeks, or a month, even when this is not the usual incubation period for hep-B? But is with hep-B as sign of seroconversion and acute illness the incubation time less or not relevant? If this is impossible, and the incubation time ABSOLUTELY NEEDS TO BE at least 60 days, then one must have received the hepatitis-B from another person.. earlier (at least 60-90 days), isn't it?

Second question: so the above fragment proves that acute hepatitis-B can be a sign of seroconversion? Or does it say that HIV+ is wrongly seen as hep-B!? And when hep-B is seroconversion, does it 'wait' 60-90 days though, to make

you sick?? I ask this to find out more about my hep-B infection 3 years ago. I have never found out who I got it from. The boy I 'suspected' had had no (& never had) hep-B up to 4 months before my acute hep-B illness. But suppose he was HIV+, could this have given me hep-B?

Hopefully you understand my question and know the answer.

Thanks for your help!

An at times desperate girl

Response from Dr. Feinberg

People can certainly pick up hepatitis B or C at the same time as they get HIV. Actually, hepatitis B is many times more contagious (easier to get) than HIV. So it is possible to get both, either or neither from a sexual contact. I don't know of any data about co-infection altering the typical incubation periods, and think you are more hung up about this detail than you need to be. First of all, incubation periods are always given as a range of possible times, and there will be people whose disease onset is earlier or later than the usual range.

The gist of the fragment is that many illnesses, especially acute viral illnesses, are similar enough in the way they affect people to be confused with one another. Hepatitis B (or C) is not a sign of HIV seroconversion, it is a sign that you now have hepatitis B (or C). The person you get hepatitis B from does not have to be feeling sick from it. Some people get "subclinical" infections, which means they don't have symptoms associated with picking up the germ. Some people have chronic hepatitis B which means they can give it to others but may not feel sick. This is precisely how hepatitis B (and HIV) continue to be passed along-- if the 'giver' felt really sick, s/he wouldn't be out there having sex!

It's likely that you'll never to able to identify who you got hep B from, and that's not even what is important. If you've had hep B, then what you need to know is if you're chronically infected and a "carrier" who can give it to others. This is readily determined by blood tests.

And if you're concerned about HIV, then get an HIV test as well.


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