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acute HIV and hep B
Jun 29, 2013

i am a 30yr old gay man, my predicament started in jan 3013, had 4 exposures through unprotected anal intercourse before i discovered that my ex had an STI hat he concealed from me ,he was commenced on treatment FOR HIS STI and screened and then he was found to be hiv positive, i was commenced on PEP for a month after my test was negative,and also screened for hep b, which was positive.my liver chemistry were normal.after completing the the PEP for a month was retested , i was negative then,but after the 3rd month went for the screening was told i was reactive,i had to screen for the hep B, the surface antigen came back negative this time around,but my liver enzymes were elevated. had a cd4 which was 380.i have since been placed on HAART. i would like to know if indeed i have cleared hep B?and what My chances are with my cd4 of 380?and how my cd4 could drop so low in 3montns of having hiv.i am not sick presently.

Response from Dr. Holodniy

It's not clear from your history if the HBV surface antigen was positive (or if there were other positive HBV tests like e antigen) to begin with and now with HIV treatment have become negative. A HBV DNA test can help resolve whether there is still active HBV infection. Since we don't usually get CD4 counts in people without HIV infection its hard to know what a person's normal CD4 count is (normal range 500-1500) and therefore how much it has dropped. Also during acute HIV infection, the CD4 will drop and usually comes back up once the immune system develops an immune response. Because you were started on treatment early, I would predict you will have a good response and see your CD4 counts rise fairly quickly.



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