I read a previous post and understand coinfection with hepatitis can delay seroconversion of HIV. Would HIV infection delay hepatitis C sero conversion, and if so how much? I have some major concerns.
I am currently at 9 1/2 weeks still with ongoing symptoms (icterus, rash, fatigue, hot skin with no fever, etc.) My 4 week post exposure Hep C test and Syphillis test was negative, and my enzymes were not really elevated.
I am preparing to repeat tests but very fearful about not finding the cause of this. How soon should I consider retesting for Hepatitis C before I can be confident in the results?
The presence of HIV infection in the body may delay hepatitis C seroconversion, meaning the development of hepatitis C antibody (Ab). So, people living with HIV infection may not seroconvert/develop hepatitis C antibody right away. Most people living with HIV develop the hepatitis C antibody in about 12 weeks, but even 6 months, 9 months, and a year after becoming infected with hepatitis C, the hepatitis C antibody result may still be negative in a small fraction of people (an example of one study demonstrating this is Emma Thomson's study for the journal called, AIDS, 2009, volume 23 number 1, pages 89-93. This was a study of HIV-infected men in the U.K. with new hepatitis C infections and how long it took for hepatitis C antibodies to be detected in their blood).
The fact that your liver enzymes were not really elevated may be reassuring. However, liver enzyme levels do not rise to a very high level with a new hepatitis C infection in everyone, and the highest levels may not be present the day a person gets her/his blood checked.
For people with HIV infection who may have a new hepatitis C infection, if the hepatitis C antibody is negative, the best next test is the HCV RNA. This means checking in the blood for the hepatitis C virus itself. This should be checked at least 2 times, over time, a period of weeks, because the level can fluctuate, go very high and to non-detectable levels, with a new hepatitis C infection.
Remember your doctor knows best. If your HCV RNA remains negative, talk with your doctor about checking you for other explanations for your symptoms.