Forum on Hepatitis and HIV Coinfection

HCV exposure

Sat, 18 Apr 2015 12:09:59 -0400

Q: Dear Ms. Taylor, I would like to ask you following: I have protected sex, however under recreational drugs with an HIV positive man, I am positive as well. I am not sure whether he has Hep C. Therefore I went after 36 days for HCV antibody test which was negative. Doctor said, if I would be infected it would be already shown in the test as antibodies even after such a short period. Is it true? I am affraid since from January I have chronic flue, neverthless without presence of other accute HCV ...

A: There can be delayed development of the hepatitis C antibody in people who are infected with HIV. For example in a study by Dr. Emma Thomson, a tiny fraction of men living with HIV developed hepatitis C antibody over a year after exposure to hep C. So no a negative hep C antibody result at this time does not exclude new hepatitis C infection. The lack of symptoms does not mean a person did not catch hep C, as we typically don't feel anything when we catch hep C, or symptoms are mild and non-spec...

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HCV Antibodies exposure

Sat, 18 Apr 2015 12:06:29 -0400

Q: Dear Dr. Taylor, I would like to ask you following: I have protected sex, however under recreational drugs with an HIV positive man, I am positive man as well. I am not sure whether he has Hep C. Therefore I went after 36 days for HCV antibody test which was negative. Doctor said, if I would be infected it would be already shown in the test as antibodies even after such a short period. Is it true? I am affraid since from January I have chronic flue, neverthless without presence of other accute ...

A: There can be delayed development of the hepatitis C antibody in people who are infected with HIV. For example in a study by Dr. Emma Thomson, a tiny fraction of men living with HIV developed hepatitis C antibody over a year after exposure to hep C. So no a negative hep C antibody result at this time does not exclude new hepatitis C infection. The lack of symptoms does not mean a person did not catch hep C, as we typically don't feel anything when we catch hep C, or symptoms are mild and non-spec...

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Hiya. HEP C.

Sat, 18 Apr 2015 11:53:23 -0400

Q: My friend just found out he has HEP C . Well me and him lived together for about 6 months we must shared towels and drank from the same plastic bottles shared lots of cigarettes and even at times used the same nutmeg grater to grinding down solid cannabis resin we smoked that together as well, dose any of this put me at risk for HEP C?

A: There is no risk with household contact unless you shared toothbrushes and/or razors. Hep C is not spread through casual contact, sharing eating tools or towels or any of ways you mention.

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how curable is it

Sat, 18 Apr 2015 11:48:19 -0400

Q: 74 years old ,diabetic with hcv load 4.3 lakhs. and genotype 3 , prescribed sofosbuvir -400mg (hepacinat) and ribuvarin for 6 months. do u think it will cure at all?

A: This is an evidence-based recommended treatment regimen for genotype 3 when this is the first treatment regimen (no prior interferon). Per the AASLD/IDSA guidelines:Recommended regimen for treatment-naive patients with HCV genotype 3 infection:Daily sofosbuvir (400 mg) and weight-based RBV (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 24 weeks is recommended for treatment-naive patients with HCV genotype 3 infection.However currently genotype 3 remains a challenge to cure. The chance of cure with t...

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Immune or not?

Sat, 18 Apr 2015 11:20:43 -0400

Q: I am entering nursing school and either need to receive the Hep B series or show proof I had the series done. I got the series in 1992 or 1993, I requested a titer to be drawn. My lab result showed the test they drew was a Hep B Core Ab, was this the right test? It shows negative, no number value shown.

A: The correct test is hepatitis B surface antibody. Surface antibody confers protection against hep B. The core antibody being reactive or positive means we have been exposed, nothing more. Negative result means you have not been exposed to hep B.

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Cut Off Value of ELISA

Sat, 18 Apr 2015 11:11:24 -0400

Q: My mother ELISA test value regarding Hepatitis C is 2.24 while the cut off value is 0.2. What would you suggest regarding the health of my mother. Regards,

A: The next best step is for your Mother to see if her doctor can order a confirmatory blood test, a test for the virus itself. This is the hepatitis C RNA by PCR, or hep C viral load. If there is hep C virus in the blood, your Mother is infected with hep C and should be evaluated further. If there is no virus in your Mother's blood, she cleared the infection and does not have hepatitis C.

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will i be cured?

Tue, 14 Apr 2015 23:07:33 -0400

Q: i am 75 yrs old hemodiyalysis patient,chronic diabetic , diagonised with hcv viral load of 4.3 million now being given sofasbuvir and ribavarin for 24 weeks.will it work for me?

A: There are limited data on safety and efficacy of sofosbuvir in people on hemodyalisis. Ribavirin can last a very long time in the body when on dialysis so you need to be monitored very closely (blood tests for hemoglobin frequently to detect and address anemia, low red blood cells). Using these meds when we are on hemodyalisis is best done with an expert physician.

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Testing for Hep C

Sun, 12 Apr 2015 11:55:33 -0400

Q: I have hep c.My Dr.sent me for a CT Scan canceled my liver biopsy.From test already done results show low platlets,enlarged spleen,esophogeal varices veins.She has told me she thinks I have cirrhosis.So she only had me go for CT.Will that show how much scarring I have? Shouldn't I have the biopsy too?I have issues with my stomach also severe gastritis,which she is treating with meds.Is there a point when meds won't be given for hep c? Is that when the only option is a liver transplant?

A: When physical exam, blood tests, blood test calculations (sometimes called non-invasive tests) imaging studies such as CT already indicate cirrhosis, there is no need for biopsy. Your results do suggest cirrhosis with portal hypertension (high blood pressure around the liver affecting surrounding internal parts of the body). I would talk with your doctor about getting hep C treatment as soon as possible. Cure of hep C can help reduce risk of progressing to liver failure (fluid in belly called as...

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HIV coinfection with Hepatitis A, B, C

Sun, 12 Apr 2015 00:18:05 -0400

Q: HelloDoes simultaneous coinfection of HIV with one of hepatitis viruses (A B C) prolong the window period of HIV detection?Thank you

A: There is evidence demonstrating that HIV-infected persons can have a delay in development of hepatitis C antibody -- so prolonging the window of hepatitis C detection via hep C antibody (delayed antibody development).I am not aware that simultaneously infection though delays HIV detection.

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hepatitis b carrier

Sat, 11 Apr 2015 20:50:41 -0400

Q: i am 29 year old n could u tell me the diet for hepatitis b and can i go for hep a vaccinethanks in advance

A: People with hepatitis B should avoid all alcohol (and tobacco). Avoid taking vitamin pills for vitamins A, E, D, K and iron although eating foods containing these vitamins and iron is fine and important for good overall health. People with advanced liver disease (swelling in the legs and belly from hep B) should follow a low salt diet. Yes hepatitis A vaccine is recommended for people with hepatitis B and for any type of liver disease.Remember that the term, "carrier," is an old term, and that h...

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Please I need help can anti hbc and hbsag be negative at the same time in escape vaccin mutant

Sat, 11 Apr 2015 12:54:55 -0400

Q: hi my girlfriend have hepatitis b so after I know that I get tested for hepatitis b panel my results was hbsag negative and anti hbc igm negative and anti hbc total negative and anti hbs >1000 immune to hepatitis b I had a vaccine 12 years ago in school 3 shots what do you think

A: These results suggest that you do not have hepatitis B infection and are protected against hepatitis B, good news.

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HEPATITS B

Fri, 10 Apr 2015 23:10:06 -0400

Q: HBS AG RESULT REACTIVE 3656.48 CUTTOFF VALUE 1.0/HBE ANTIGEN NON REACTIVE 0.081 RESULT CUTTOFF VALUE 1.0/HBE ANTI BODY POSITIVE 0.211 CUTTOFF VALUE FOR POSITIVE 1.0/HEPA DELTA VIRUS ANTIBODY NEGATIVE 1.536 CUTTOFF FOR POSITIVE 0.684 PLZ TELL ME ABOUT THIS

A: These results suggest that you have chronic hepatitis B virus infection.Talk with your doctor about getting tested for HIV and hepatitis C. Talk with your doctor about whether or not you have scarring in your liver, your other liver blood tests, and whether treatment is indicated now or now. Treatment for hepatitis B right now is not always necessary. Talk with your doctor about how to reduce the risk of passing along this infection and getting your household and sexual contacts tested for hep B...

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ritilan use fatigue

Fri, 10 Apr 2015 23:00:57 -0400

Q: Dx.with hep c 6 years and work ft 50 plus hours. So extremely tired... insomnia chronic 4..5 hours maybe sleep a night.i have been reading ritilan can be used to offset fatigue...Your thoughts

A: It sounds as though you may be tired due to sleep deprivation more than due to the hep C. I would ask your doctor to evaluate and assist with limited sleep rather than using a stimulant to offset your sleep deprivation. There may be ways to help get you more sleep which is what you may benefit most from. I am sorry you are experiencing this, sleep deprivation is agonizing. Regarding the hep C, talk with your doctor about treatment to cure you of the virus.

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hiv and hepc

Fri, 10 Apr 2015 22:55:39 -0400

Q: I found out I had hepc 12 years ago. I have had it for 40 years now. From age 25 to 65. That was when I used iv drugs. I had a biopsy 12 years ago and it showed Genotype 1a with mimimal scarring...stage 1 grade 2 I believe after 30 years. I don't drink at all and liver tests are ok. I decided not to do treatment and wait and see. Now I am hiv poz also so I worry more. I am UD with average CD4. Did I do the right thing by waiting since all seemed ok at the time? I still don't want to do hepc t...

A: Ask your doctor about whether there is scarring in your liver and if so, how much. Hep C can progress over time, so it is likely that you have more than stage 1 scarring now. There are new safe, effective treatments active against genotype 1a to discuss with your doctor. There are benefits to being cured of hepatitis C. It is wonderful that you do not drink alcohol, this is most beneficial with hep C and HIV.

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cirrhosis

Fri, 10 Apr 2015 22:51:44 -0400

Q: After ct scan of my liver 18 months back my liver was ok except a small infection of my gall ways got chronic hbv since 1980 and tested hiv+ early '89 how can in 18 months my liver went to cirrhosis 4 scale from 1to4my internist says it's cause of using fibroscan, he was surprised over the bad outcome and said only fibroscan can test cirrhosis and a liver biopt. Taking truvada against hbv and hiv combined with isentress

A: A CAT scan cannot exclude cirrhosis, meaning we can have cirrhosis and have it not show on a CAT scan. This is why we use physical exam, blood tests, fibroscan and liver biopsy to diagnose cirrhosis. CAT scans of the liver can show other things such as tumors and the size and shape of the liver and spleen.Sometimes cirrhosis is obvious on CAT scan but many times it is not.I agree with your doctor that the fibroscan likely detected cirrhosis that the CAT scan could not. Isentress Truvada is an ex...

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quantative vs qualitative pcr(hcv)

Tue, 07 Apr 2015 00:38:55 -0400

Q: What is difference between hcv quantative pcr and hcv qualtative pcr? If hcv rna pcr quantative is undected then it will be possible to negative of hcv rna pcr qualitative ?

A: The qualitative test tell us yes or no -- is there really hepatitis C virus in the blood?The quantatative test gives us a number -- how many hep C viruses in the blood? There used to be more of a difference between the 2 tests, when the lower limit of detection differed between the 2 tests. So sometimes if the level of virus was low, the quantitative assay (type of test) could not detect the virus, and we could get a false negative result. It used to be that to diagnose low levels of virus, the ...

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hep b or hiv

Tue, 07 Apr 2015 00:13:09 -0400

Q: Pls i really need to know as i am dying of guilt and anxiety, i was recently diagnosed with hep b and 2 months later my doctor says its no longer infectious as can be obtained from my blood test result. However d blood test recorded low wcc which made her suggest an hiv test. Am scared could this be hiv or anxiety as my tongue recently got coated white. Pls i nd help asap. Its been 7mnths since i had sex unprotected

A: HIV and hepatitis B virus infection share overlapping routes of transmission (can be spread in some of the same ways). So if we have one of these infections, we should get tested for the other.All people with hepatitis B should be tested for HIV. All people with HIV should be tested for hepatitis B. Please talk with your doctor and do get tested for HIV. It is better to know one way or the other. If you are not infected with HIV, talk with your doctor about how to lower the chance of catching H...

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my hep c came back positive reactive

Sun, 05 Apr 2015 18:01:29 -0400

Q: what does hepc positive reactive..(*1.49)

A: This means you have been exposed to hepatitis C virus infection. There is an 80% chance you have chronic hepatitis C and a 20% chance you cleared away the infection spontaneously within the first 6 months after being exposed.The next step is to ask your doctor for a blood test for the hep C virus itself, HCV RNA by PCR. If you have virus, you likely have chronic infection. If your exposure was within the past 6 months, there is a small chance you may clear away the infection on your own without ...

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virology hepatitis A

Sun, 29 Mar 2015 22:04:14 -0400

Q: I got a positive result for testing hepatitis a virus total ab and a negative result for hepstitis a virus igm test i need to know how much my liver is infected?

A: This is good news. This means you are protected against hepatitis A and have not been recently exposed to hepatitis A. Your liver is not infected with hepatitis A.

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Household contact with Hepatitis B positive

Sun, 29 Mar 2015 22:01:58 -0400

Q: Hi,My brother has hep B. I use his razor. Will I be infected with the Hepa B virus?

A: Hepatitis B is found in many bodily fluids, is contagious, and can be spread when a person with hepatitis B lives in close quarters with people who have not been vaccinacted. Household contacts of persons with hep B should be tested for hep B (surface antigen blood test). If this test is non-reactive, then vaccination is indicated.

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HIV/HBV coinfection

Sun, 29 Mar 2015 20:12:32 -0400

Q: I was diagnosed with AIDS in 1994. In August of 2014 I was diagnosed with Hep B and a viral DNA of over 16 million copies, liver cirrhosis and an enlarged spleen with varicies. The doctors I am seeing are having trouble controlling controlling the HBV infection. I am currently taking Tenofovir and Entacavir to try and combat the illness. My current Viral DNA is of 700,000. I am scared. While the doctors tell me the cirrhosis is somewhat controlled it is hard for me to trust them. After all they ...

A: I am sorry that you are having difficultiy with your hepatitis B and resultant liver disease.There are a number of things once can do with cirrhosis and portal hypertension (enlarged spleen with swollen surrounding veins, called varices).Continue to work with your doctors to control your HIV. Maintaining a non-detectable HIV RNA (viral load) is beneficial. Sometimes the CD4+ (T) cell count goes down along with the platelet count when the spleen is enlarged; if this happens, as long as your CD4% ...

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husband Hep B positive worried for baby

Tue, 24 Mar 2015 12:49:58 -0400

Q: hi! My husband is Hepatitis B postive. Can I be infected with Hepatitis B with household contact? Hope to receive your feedback since I'm pregnant now, I'm worried that I may pass it to my baby....

A: If your husband has hep B and he is the father of your baby (you have had a sexual relationship with him), you are at high risk for having caught hepatitis B unless you were previously vaccinated. Hepatitis B is easy to catch from all kinds of sex with an infected parnter, and from living in close quarters with someone who has hep B. Please talk with your doctor about getting tested for hepatitis B. All women should be tested for hep B in pregnancy ideally. If a woman who is pregnant is infected...

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Don't understand the RNA quantasure test results.

Sun, 22 Mar 2015 22:31:26 -0400

Q: I just finished my 12 weeks of HCV treatment with Sovaldi/Olysio and my Dr called to say I was UND. But, when I received my copy of the results they showed that I was <1 IU/ml detected. My baseline at start of treatment was 1,300,00 IU/ml. My blood work for everything else came back well in the normal range. I was stage 2 fibrosis with fatty liver and a high iron count. No other high risk factors. Is this really an untectable result or should I be worried about this small amount still being dete...

A: Ask your doctor to check your HCV RNA 12 weeks after you stopped the treatment. If your result is undetectable, you were cured. Even if at end treatment there is detectable virus, peeople have been cured, according to a recent study in CID. Utility of Hepatitis C Viral Load Monitoring On Directly Acting Antiviral TherapySreetha Sidharthan, Anita Kohli, Zayani Sims, Amy Nelson, Anu Osinusi, Henry Masur, and Shyam KottililClin Infect Dis published 2 March 2015, 10.1093/cid/civ170During hepatitis ...

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hep b surface antibody and hep b surface antigen.

Sun, 22 Mar 2015 22:26:25 -0400

Q: I have a question i have my patient health summary and on it it says hepatitis b surface antibody and beside that it says reactive abnormal and then below that is says hepatitis b surface antigen and beside that it says nonreactive so the question here would be why does the one say reactive abnormal could you tell me what that means?????

A: These are good results, indicating that you do not have hepatitis B virus infection but have protection against hepatitis B. The surface antigen being reactive is the test result indicating infection, and the surface antibody being reactive indicates protection against hepatitis B.

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Is it possible to get hep b after being vaccinated?

Sat, 21 Mar 2015 23:58:36 -0400

Q: Is it possible to get hep b from unprotected sex with an infected person when both of them are already vaccinated?

A: If both people have been successfully vaccinated -- meaning they were vaccinated BEFORE they acquired hepatitis B and completed the vaccine series over the recommended time frame and developed protective antibody after vaccination -- then NO, they cannot get infected. The hep B vaccines is safe and effective at preventing new hep B infections upon exposure.Sometimes people had hep B already when they were vaccinated; in this case, the vaccine does no harm but does not get rid of the hep B nor p...

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