[Question #6900] Hepatitis C Test Needed? More info

10 months ago

Hi, 


I had a question regarding hepatitis c and b. I think I’ve been vaccinated against hepatitis b, but nothing against c. I have read online that hepatitis c can be transmitted through anal. Is this true? Should someone who had received and given anal not too many times a couple years back be testing for hepatitis c? And if so are the results for hepatitis c tests reliable what is the window period? And best recommended tests? Can it be transmitted from a male to female through  unprotected vaginal? Should I be worried about this at all? 



Beyond this, another question, would a hemolyzed blood sample ever have an effect on a 4th generation CMIA hiv test? Or any sort of lab error result in a false negative? While I have no proof that there was an issue with the sample, I remember the nurse using a smaller needle (she said I have small veins and bruise easily), and she also remarked that the blood was very slow to fill the SST tube. I read these 2 things can lead to a hemolyzed blood sample. If the blood was hemolyzed, or even grossly hemolyzed, would the lab always detect that before analysis and testing? Could it cause interference with my hiv test results? Leading to a potential false negative? 



I understand that even if the blood drawn test was somehow incorrect, I could trust my finger prick insti test. But I also remember the nurse squeezed my finger while drawing the drops of blood, I contacted the insti test company and they said that they don’t recommend squeezing the finger as it may release other finger tissue fluids in the blood affecting the insti rapid results. 



I’m very very sorry if the second question is a repeated question. I please ask that you please consider answering. I tried my best not to ask, and held off for a while. But I don’t know where else to ask, my local health clinic is closed due to covid - 19. So I can’t easily access help or more tests right now. I please ask you to not delete this question, as I feel like answers to these questions can keep my anxiety in check until I seek more help. I won’t ask again. And I’ve decided to stop googling anything as well after this. 



Also, one of the things that has been scaring me is about untreatable form of hiv. Has there been a case where a person with hiv has complete drug resistance to all forms of medication? Making the strain effectively entirely untreatable? I was happy knowing that treatment is always an option for people, unless it’s not? 




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
Welcome back to the forum, but sorry you found it necessary.

First, the standard HIV blood tests are extremely robust; almost nothing alters the reliability of the results, including a hemolynzed blood specimen. These tests are highly automated and pretty much foolproof. Lab errors are exceedingly rare if they occur at all. (This indeed was a repetative anxiety driven question of the sort that often receives no reply. There is NOTHING you can think of that has any poissibility of altering the advice you have received about your HIV fears and your test results. So don't try it again. OK?)

Hepatitis C should not be viewed as an STD. The only sexual practices known to transmit hepatitis C virus are potentially traumatic (i.e. bloody) anal sex events. Heterosexual sex is basically risk free:  the heterosexual partners of people with HCV have no higher chance of a positive test result than anyone in the general population. (One estimate from a research group in Denmark is that unprotected vaginal sex with an infected partner transmits the virus no more often than once for every 190,000 events -- which is equivalent to having sex with infected partners once daily for 520 years before transmission might be likely.

However, current standard recommendations are that everybody should have an HCV blood test at least once, regardless of known or suspected risk. If you have never been tested, this might be a good time, since it's on your mind. (Or maybe the next time you have a doctor visit for any other reason.) But not because of your essentially zero risk sexual history.

I hope these comments are helpful. Let me know if anything isn't clear about hepatitis C.

HHH, MD
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10 months ago

Thank you for replying. I highly appreciate it. 



So with hepatitis c, what is the risk level if one has had anal before, not sure if bloody or not. Many years ago did have both insertive and receptive unprotected anal (msm). 



I have read that there is a cure for hepatitis c, is this correct? 



Regarding hiv, does ARV treatment work on all forms of hiv? Has there been a case where a person with hiv has complete drug resistance to all forms of medication? Making the strain effectively entirely untreatable? 



So hiv testing is done and negative. Test for hepatitis c in the future. Already tested negative for chlamydia and gonorrhoea, is there anything else you would recommend Testing wise? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
Almost zero risk for HCV from one such exposure. The MSM with HCV almost all are HIV positive, and almost all have had hundreds of obviously traumatic anal sex exposures, like fisting etc. 

All ARVs are effective against all HIV strains. HIV exposed to ARVs can become resistant to them, but that's one reason multiple ARV drugs are always used -- almost nobody is treated with a single drug. There are almost no HIV strains (maybe none at all) that are broadly resistant to multiple ARVs. This is nothing to worry about.
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9 months ago
Thank you very much! I will be following all the advice you and Dr. Hook have given over the past 3 threads and will be moving on without any further hiv or syphilis testing for the msm unprotected oral sex that I gave and received last year. I might get a hcv test later. Thank you once again for all the support, I think you really helped me get through this process, and reduced my anxiety. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Thanks for the thanks. I'm glad to have helped. But please note that repeated questions are discouraged. This should be your last on this topic. Thanks for your understanding!---