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Acute Viral Hepatitis or HIV ?
Sep 28, 2008

Hi Doctor Bob,

Recently I had 4 encounters with prostitutes, all protected vaginal and oral(condom did not break). Also I inserted my finger(with no cut or bruise) in one other lady and also sucked(no lactation as far as I could see) breasts of 3-4 other women.

After 1 month of the last exposure, I had the following symptoms: fever, lack of apetite, tiredness, nausea. The physician told me to undergo Liver Function tests, and my results were:

Total Bilirubin: 6.2 mg/dl Conj. Bilirubin: 4.1 mg/dl Uncon. Bilirubin: 2.0 mg/dl SGPT(ALT): 3920 IU/L SGOT(AST): 3680 IU/L ALKALINE PHOSPHATE: 356 IU/L TOTAL PROTEIN: 8.7 g/dl ALBUMIN: 5.1 g/dl GLOBULIN: 3.6 g/dl A/G Ratio: 1.41:1

After about 10 days my results were:

Total Bilirubin: 3.8 mg/dl Conj. Bilirubin: 2.10 mg/dl Uncon. Bilirubin: 1.66 mg/dl SGPT(ALT): 187 IU/L SGOT(AST): 245 IU/L ALKALINE PHOSPHATE: 292 IU/L TOTAL PROTEIN: 7.0 g/dl ALBUMIN: 4.1 g/dl GLOBULIN: 2.9 g/dl

I also had jaundice after about 2 weeks from the start of the symptoms, and lost about 4-5kgs. Now after 1 month of start of symptoms and 2 months after the last encounter, I feel fit, but have not regained my strength completely.

My doctor told me that I have acute viral hepatitis. I did not discuss with the doctor about my exposure because I was thinking that I had taken all the precautions. But now I find the symptoms of HIV very similar to mine and I have started to worry whether something went wrong during the sex like vaginal fluids touching my penis accidently after condom removal.

Based upon my tests and other symptoms, what will you suggest to me, whether I should go for HIV tests at 3 month mark or I should leave the fear and believe that I really had acute viral hepatitis.

I will definately make a donation to support the great work you are doing.

Response from Dr. Frascino

Hello,

Your doctor should have run specific tests to determine exactly what type of "viral hepatitis" you are experiencing (hepatitis A, B, C). Discuss this with him.

If indeed your activities with your Naughty Ladies of Shady Lane were all "protected" and the latex condoms were used properly and did not break, your HIV-acquisition risk would be essentially nonexistent. HIV cannot permeate intact latex. No way. No how. (No John McCain. No Sarah "I can see Russia from my house" Palin.) If, for whatever reason, you feel you may have had an HIV-exposure risk, you should get an HIV test at the three-month mark. However, this is a separate issue from your acute hepatitis.

Thank you for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. By the way, we have an entire expert forum dedicated to "hepatitis and HIV". Check it out!

Dr. Bob



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