[Question #4649] HIV test and acute HEP c infection.

80 months ago

Hello Doctors,

I had a high risk exposure (unprotected anal sex with an HIV positive) 6.5 weeks ago and tested negative with the fourth generation test.

But now I am more than petrified that my test is not accurate (fourth generation).

However, I read from Doctor Bob at thebody that, "The only potential case of delayed HIV seroconversion involved concurrent acute hepatitis C infection." and, 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."

Now I'm really concerned that my HIV test won't be accurate because of what Doctor Bob said, assuming I have Hep c. So my questions are as follow:

1.If I have acute HEP c infection, would it in any way affect or delay the production of antibodies?

2. If I have acute HEP c infection, would it in any way affect or delay the production of p24 antigens?

3. If I have acute HEP c infection, and assuming it affects or delay the production of antibodies, would it affect the result of my fourth generation test?

4. If I receive treatment for HEP c, and had another risky exposure, would the treatment delay seroconversion? because I read in a site that antiviral treatment delay seroconversion.

5.If antiviral treatment for hep does delay seroconversion, does it in any way affect or delay the prodocution of antigens in the body?

6. does anything at all (tests, medication, infections (like acute hep c), drugs, therapy) affect the fourth generation test? especially the production of antibodies?

80 months ago

And assuming that doctor Bob is correct in that acute hep c delays seroconversion. is the reason because delay in the production of antibodies or the production of antigens? meaning, would it have any effect on foruth generation test (if his speculation is correct)

80 months ago

one last thing: If acute HEP c was infected the same time as HIV, would that slow down the production of HIV antigens for HIV in any way?

Edward W. Hook M.D.

80 months ago

Welcome to the Forum. I hope I can help you. The reports that hepatitis C might somewhat delay HIV seroconversion are almost 10 years old when tests were not so good as they are now and when less was known about acute hepatitis C. With the passage of time. Most scientists have come to feel that IF,acute hepatitis C delays HIV seroconversion OR vis versa, it is EXTRAORDINARILY rare and not something to worry about. If you had acquired one or both infections, tests would almost certainly be positive at this time. Thus:

1. You don't know you have hepatitis C and it is unlikely that you do. If you did, the likelihood of it delaying HIV seroconversion is astronomically low.

2. No, there would be no delay in antigen production

3. No

5. This is a speculative what if question which is unrelated to your situation

6. Sure. Cancer chemotherapy or steroid medications might theoretically delay antibody development. If you are not receiving cancer chemotherapy, high does steroids, or medicines designed specifically to suppress the immune response this is not a concern.

I believe you are going down a path of "what if" questions which are irrelevant and not important. I strongly advise you to believe your six week test results for both infections and move forward without continuing concern.

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80 months ago

Thanks for the response Doctor.

Sorry Doc but I am really concerned and petrified that I could be HIV positive after my risky exposure.

1. if the theory (that HEP c delays HIV seroconversion or vice versa) is correct, then why, is it because there would be too much work for the immune system to produce antibodies?

2. If there is a chance that HEP c affects seroconversion, is there ANY chance that it could affect HIV antigen production (applying the same logic as question 1)?

3. So, if there is a chance that acute HEP c could affect HIV antibodies, is there a chance they could affect the fourth generation test. (because from what I understand P24 will still be present if antibodies did not develop correct?)

4. Why would not HEP c affect HIV antigen production if it could possibly affect the antibodies?

Thank you so very much indeed doctor!

80 months ago

Also, for future knowledge: does taking antiviral treatment for HEP c affect antigen or antibody production? It is really important for me to know doc.

Edward W. Hook M.D.

80 months ago

Your flurry of rapid fire, repetitive questions suggests there is a major,anxiety component to your concerns, perhaps,further fueled,by ill-advised internet searches. If so, I recommend you get a grip on yourself, as well as recommending that you stay off the internet.

1. There is little scientific basis for the solitary case report that you are using to feed your anxiety. Getting onto the complexities in the basis for antibody responses to multiple pathogens is a doctoral-level, HYPOTHETICAL discussion far beyond the level of this forum.

2. I already told you that the sort of co-existent infections you are worried about would NOT impact antigen production

3. See previous response- NO

Of course hepatitis C treatment would affect antigen production. It stops the virus from replicating.

I suggest you take a deep breath. Appreciate that your current anxiety is based on the rare case reports which are unsubstantiated with current high-quality scientific research. Your chance of having HIV and or hepatitis C is far lower than your chance of being struck by lightning today. "What if" questions really are not helpful. EWH

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80 months ago

Thanks for the recommendation doctor. I profusely apologize; I just could not sleep tonight and you are bringing incredible relief to my heart. I will certainly stay away from the internet.

Two more questions:

1. I just want to know, if you could tell me briefly sir, why would HEP c potentially affect HIV antibodies and not HIV antigens? (I would REALLY, REALLY appreciate it if you could elaborate on why there would be no effect on antigens if I acquired HIV and HEP c simultaneously.

2. I was asking if I took antiviral treatment for HEP c, would it affect either HIV antigen or antibody production? (For future knowledge)

Thank you so very much for your answer

Edward W. Hook M.D.

80 months ago

Final responses. As per forum guidelines this thread will be closed without for the replies after this reply.

Antigens are the proteins that are on the surface of the virus thus, with the virus is present antigens are present. If two viruses are present in the same person because they are infected with both viruses, the presence of the each virus would be independent of the other. Tthere is no scientific or medical reason for the viruses to interact.

Your second question is repetitive. Treatment of hepatitis C would reduce the amount of virus present. When virus is not present there is no stimulus for antibody production.

This concludes this thread which will be close shortly. There will be no further answers. In addition should you come back with further repetitive, anxiety driven questions, your questions may be deleted without a response and without return of your posting fee.

I really think you are worrying entirely too much about something you saw on the Internet that has proven not to be a realistic concern. I hope you will move forward without continuing concerns. EWH

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