|Very much worried and confused, Please help me to woo hoo
Apr 7, 2010
Dr Bob , Please help. I have contributed $35 for noble cause you are doing . I have question regarding coinfection , please explain if my understanding is correct. If at all there is coinfection both virus will go on replicating (HIV and Hepatitis C). If immune system is weak then antibodies will not be formed or form later. If antibody is not formed then DNA PCR by 21 weeks will definitely detect HIV virus as it must have replicated a lot and if antibody is formed antibody test will detect it by 21 weeks. Is it possible that Hepa C and HIV stop replication of each other or its just that immune system does not produce enough antibody when coinfected. If former is the case probably scientist will try to find cure out of it. I had negative antibody test and DNA PCR for hiv at 17 week and negative antibody test for HIV and Hep C at 21 weeks. Can I woo hoo?
| Response from Dr. Frascino
If someone is co-infected with HIV and hepatitis C, yes, both viruses will replicate.
If the immune system is "weak", the virus could replicate faster.
HIV DNA PCR (qualitative) does not rely on antibodies, but rather detects a piece of the virus' genetic material.
The concerns about delayed HIV seroconversion have been blown way out of proportion. This phenomenon occurs only rarely (see below).
Yes, I would consider your negative antibody tests out to 21 weeks and undetectable DNA PCR test at 17 weeks WOO-HOO-able.
Thanks for your donation.
Confused after reading some Hep C and HIV answers and questions!(HEPATITIS C AND DELAYED HIV SEROCONVERSION, 2010) Mar 8, 2010
I had written to you previously and made a donation of $50, all I could afford, sorry. I'm a mother of three and now I am really terrified. When reading some of the answers related to Hep C delayed seroconversion with HIV, noticed you suggested that the person tested out to 12th months and obtain a HIV PCR as well as HEP C RIBA. In my case, I have had numerous symptoms, such as neuropathies, sore throat, tonsilitis, malaise since a clinical exposure from my preceptor. I have tested out to 9 months with HIV ICMA (non-reactive)and one ELISA at 31/2 (negative) Did at seven months an Hep C antibody test which came out to <0.1 (negative being from 0.0 to 0.8) and an HbsAg Hepatits B antigent at seven (negative). My question to you dear Doctor is, Do I as well need to test out to 12th months on Hepatitis C, and if so, with which test and do I need the HIV PCR test as well? Thanking you in advance for your sincere and professional opinion.
Response from Dr. Frascino
Your repeatedly negative HIV-antibody tests (ICMA and ELISA) out to nine months are definitive, conclusive and WOO-HOO-able. HIV is not your problem. No way. No how. Your negative hepatitis C antibody and negative HBsAg (hepatitis B surface antigen) indicated you do not have hepatitis B or C. Consequently, hepatitis would not be causing delayed HIV seroconversion. The bottom line is that no further HIV testing is warranted, based on this event. Please note the only potential risk for delayed seroconversion involves acute hepatitis C and HIV. See below. You have absolutely no indication of having acute hepatitis C or HIV.
Dr. Bob, can i woohoo, please answer? Will donate. (HEPATITIS C AND DELAYED HIV SEROCONVERSION, 2010) Mar 7, 2010
I have had one time unprotected sex with a stranger in the past, she told me that she had a boy friend in the past, who goes to prostitutes all the time. After that i got HIV1/2 antibody tested 3 times, upto 7 months past the exposure. After 3 months of the exposure i got tested for Hepatitis C, it was negative. The reason i got tested for Hep C is that i read in your forums that it might delay hiv seroconversion.
Now i did not get tested for any other STD's other than HIV and Hep C.
Now i am worried that i might have some sort of other STD's and probably that would have delayed HIV antibody production or my HIV antibody test was not accurate?
Does Herpes have any effect on the HIV1/2 antibody tests, or delay seroconversion? Deos Gonnorhea or Syphilis or Hep B or Chylamidia or any other STD's if i had it, do they interfere with my HIV 1/2 antibody tests by providing a false negative or delaying the seroconversion period? Please please answer, thanks for your time, and a donation will be on the way.
Response from Dr. Frascino
Your repeatedly negative HIV and hepatitis C tests are definitive and conclusive. No additional HIV or hepatitis C testing is warranted at this time.
You did not read the archives carefully! The only potential case of delayed HIV seroconversion involved concurrent acute hepatitis C infection. (See below.) This you clearly did not have. Other STDs have not been shown to alter the HIV seroconversion window.
Stop worrying, get informed and start WOO-HOO-ing, OK?
Follow-up Question about Hep C and HIV Coinfection (DELAYED SEROCONVERSION: HIV and Hepatitis C coinfection 2009) Jun 9, 2009
Dear Dr. Bob, Thank you for your prompt response. I will be making a donation at www.concertedeffort.org tomorrow. I have just a couple of questions I meant to ask previously.
My risk event occurred as a result of a sexual assault from a man from China. Is it possible that the DNA PCR would not pick up a non B subtype, which could be found in a person from China. Also, wouldn't the antibody test window for both HEP C and HIV be delayed beyond six months?
I am awaiting one more CBC and HEP C and HIV RNA PCR. I will let you know the outcome.
I wan't to woo-hoo, especially after what I have been through. Thank you for your time and expertise.
ATC, Ph.D., MSW
Response from Dr. Frascino
Would the DNA PCR miss subtypes found in China? No.
Would the window be delayed beyond six months due to hepatitis C and HIV? No. You don't have HIV or hepatitis C. (See below.)
You are awaiting another CBC, hepatitis C antibody-test and HIV RNA PCR. This is a waste of time, effort, blood and money. The results will unquestionably be negative.
Stop testing. Start WOO-HOOing. If you can't, you should seek psychological counseling to help you cope with your irrational fears.
Dr. Rob, your input please? (HEPATITIS C AND DELAYED HIV SEROCONVERSION) Mar 29, 2009
Dr. Bob, I have a question about HIV and Hepatitis C coinfection. I am finding conflicting information on the internet regarding whether coinfection would delay HIV seroconversion. Several sites and articles are stating that it would, but they all cite a 1997 journal article about health care workers with delayed seroconversion. I wasnt sure if other factors may have contributed to late seroconversion in these health care workers (such as PEP). Further, since this article is rather old, I was wondering if the newer tests would pick up HIV antibodies regardless of HCV coinfection. I am wondering how long after exposure do I need to wait in order for my test to provide a conclusive antibody result and rule out HIV infection. My exposure is that i have been involved in unprotected sex one time with a unknown partner. Later i came to know that the partner was with a promiscous guy(who sleeps around with prostitutes) before me. I have got tested after 3 months after the exposure and the HIV antibody test result is negative. Can i forget about this and move on? or Do i still need testing?
I have also read in the medhelp archives that Dr. HHH and Dr. Edward Hook of medhelp say that the HIV/HCV coinfection has no effect on the window period of HIV. Also what is meant by a coinfection, should the person be exposed to both the virus at the same time or same exposure? or does that mean they have already one virus and is exposed to the other one? I am promising donation. Dr. Bob i am so tired to read all the information on the internet about this topic. I am very scared. Also does any type of Hepatitis i mean Hepatitis A, B or C coinfection with HIV delays the window period or is it only Hep C with HIV coinfection? Your comment on this will help me a lot. Thanks for your precious time. Please answer.
Response from Dr. Frascino
Your worries are unwarranted. (See below.) Yell WOO-HOO and as Tony Soprano says, "Fuhgeddaboutit."
curious (SEXUAL TRANSMISSION OF HEPATITIS C)(HEPATITIS C AND DELAYED HIV SEROCONVERSION)Dec 31, 2008
Hey Dr. Frascino,
First off, thanks for everything you do. Your hard work and dedication to all of us who need answers doesnt go unnoticed. You are a great person. I have a couple of questions.
What is your oppinion on hepatitis c as an STD. Ive heard that it's not and I also heard that it is. Ive been tested for HIV 4 times and all the other stds twice out to 8 months after any possible exposure, but my doctor never included Hep C. Is that something that should be a worry from sex or do you feel it's more of a drug injection disease from blood to blood contact?
Also, if someone is infected with multiple viruses at the same time will the body's immune system still be able to make antibodies for each virus in a normal amount of time? Or would they be delayed significantly? If infact I dont have Hep C, do you feel 8 months negative HIV test is conclusive even though i had a positive mono spot test and EBV titers about a month after my possible exposure to someone of unknown status?
And lastly I have more of a scientific question. Why is it that we are not able to cure the HIV virus yet we are able to use current medication to bring someone's viral load from a very high number to undetectable in the blood? How can we kill off so much of the virus but not be able to completely rid it from the body?
Im sure you are a very busy guy but if you could possibly answer me I would greatly appreciate it, if not no love lost. I hope you are having a great holiday season. Stay well.
Oh and how would i go about making a donation?
Response from Dr. Frascino
1. I've discussed the sexual transmission of hepatitis C many times in this forum. Check the archives! As an example, I'll reprint below some information form the archives pertaining to this topic.
2. If someone is infected with several viruses simultaneously, the body's immune system will react to each virus individually and simultaneously. The immune system is very capable of multitasking! There has been some concern about hepatitis C and HIV coinfection causing delayed seroconversion. I've discussed this multiple times previously. See below.
3. Regarding a cure for HIV, we have a whole chapter devoted to this topic in the archives. Check it out! Briefly, the reason cure is so difficult is that HIV attaches itself to CD4 cells, which are part of our immune system, the very system that is designed to help us fight off invading germs. The virus is very clever. It actually inserts its genetic material into human cells and uses these cells as virus factories to make more virus, which then infects more immune cells. HIV can also hide in places that drugs can't get to. I'll reprint some information about finding a cure below.
Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).
I REALLY NEED YOU!!!! (HEPATITIS C AND DELAYED HIV SEROCONVERSION) May 20, 2008
Dr. Bob, I asked you awhile back if HEP C would delay HIV seroconversion.
You said that HEP C would not delay HIV seroconversion! However, Dr. McGovern of the body says that HEP C will delay the HIV window period and that someone who was exposed to both should wait until 6 months to 1 year!!!! Before getting a result!
What's up with that????
Now I know my risk (sharing dollar bill to sniff cocaine) was a low risk incident but what should I do????
I got tested for HEP C at 14 weeks....NEGATIVE!
And HIV at 15 and 17 weeks!!!! NEGATIVE
What should I do???? I think that I am ok and then I hear this stuff!?
Response from Dr. Frascino
No, you don't really need me! What you really need is to pay more attention to what both Dr. McGovern and I have told you on multiple occasions: You are HIV negative. I may need to put a restraining order out on you if you continue to ask your same question over and over again in multiple forums. Come on guy! Give it up! Accept the truly wonderful news you're HIV negative and give other worriers a chance to have their concerns addressed, OK?
This is the last time I'm going to go over this information with you, so pay attention! The Centers for Disease Control has published guidelines for health care workers who sustain a significant occupational exposure to a patient coinfected with HIV and hepatitis C viruses. (This is a far cry from snorting coke through a rolled-up Ben Franklin!) The health care worker guidelines for occupational exposure to coinfected patients suggest HIV-antibody testing at baseline, six weeks and twelve weeks after exposure. There is a caveat, however: If, and I must stress this "if," the health care worker develops acute hepatitis C infection, then and only then (I also stress the "then and only then") would additional HIV-antibody testing be recommend. In this case, and only in this case, are HIV tests out to 12 months recommended. Put another way, if the health care worker does not get ill with acute hepatitis C infection, additional tests would not be recommended!
You have tested hepatitis C negative out to 14 weeks. You do not have acute hepatitis C infection. Hence even if you were a health care worker with documented significant exposure to a coinfected patient, you would not need additional HIV testing. I just can't make it any plainer or clearer than that. Those are the facts, plain and simple. How you choose to live with the incontrovertible evidence that you do not have hepatitis C and that you are conclusively HIV negative is now up to you.
So, I'm signing off on this case permanently. If you require additional reassurance, you can either reread my many (too many) responses to your repetitive and ongoing unwarranted worries or you can seek psychological help. Your problem is not virological; it's psychological!
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