HIV and Hep C worry

Hi Drs,

I had an incident with a man in a sauna in london mid september, had a little to drink and whilst I can remember mostly everything, I do remember getting up to change the condom and cant remember if I put a new one on. It was anal sex and I was the active partner (circumcised). I was prescribed PEP (58 hours post) completed the course as prescribed. Baseline HIV test was negative and LFT at the outset were normal. upon completion of PEP (mid October) my liver enzymes were deranged (ALT - 375 GGT - 846), had LFT weekly after this and trended downards until normal or only very slightly elevated. To help my nerves I had an HIV DUO test completed 26 days post completion of PEP - negative. Since then I have experienced severe abdominal pain and was diagnosed with gallstones, being hospitalised in mid december and again over christmas and again last week (currently awaiting cholecystectomy).

Blood regularly tested in hospital, ALT has been slightly elevated again at 60 and I am concerned that it could be Hep C particularly as it was so elevated post PEP and with the symptoms of abdominal pain, loss of appetite, fatigue etc. I had Hep C testing at 6 weeks and 8 weeks (i think) which came back negative but I understand this was too early. Despite my negative HIV test at 26 days post PEP, I have recurrent conjunctivitis for the past month (lasts 5 days, always affecting the same eye), never had conjunctivitis in my life and desperatly worried that it's HIV.

Is there a big chance that I am infected with HIV and HepC? Would being infected with Hep C cause my 26 day post PEP HIV test to be a false negative? Do you feel I should be concerned?

I'm feeling very low at the moment with all this worry, its driving me insane and cant help feeling that HIV and HepC are to blame for the gallstones/abdominal pains/hospitalisations and conjunctivitis. Lost 1.5 stone since mid dec. It all seems to be too much of a coincidence.

Any views?

[Dr Sean Cummings]

Hello...again,

I think we've spoken on the telephone about this - or there is someone else with an identical story.

My view is that the deranged LFT's were due to your cholecystitis - and whilst this is relatively unusual in a young man, it is certainly not unknown or bizarre. There may have been a contribution from the PEP as this will frequently cause a minor alteration in LFT's = which is the reason we do the "safety bloods" in people on and completing PEP.

Conjunctivitis is common, although if I remember correctly it was a sub-conjunctival haemorrhage originally with your pharmacist helpfully throwing other more threatening diagnoses into the  mix.

Our experience is that if you have a negative DUO test after completion of PEP with no other exposures in the interval then we have not seen anyone subsequently become HIV positive at the 4 month post PEP test.

I really do not believe you are Hep C or HIV positive.

The modern third generation Hepatitis c tests will correctly identify most people early on irrespective of their HIV status.

You can prove that  by doing both HIV and HEP c RNA PCR tests. These are ultra-sensitive tests which will pick up miniscule quantities of both viruses.

I think you have lost weight because of your cholecystitis which in itself is a severe illness and also because you've had an unpleasant and worrying time.

As I believe I said on the phone to you, I really do not believe you are HIV or Hep C positive.

very best wishes, Sean

[terry425]

I had the conjunctivitis diagnosed at the hospital, would this change your opinion on the HIV issue? Sorry to trouble you.

[terry425]

I had the conjunctivitis diagnosed at the hospital, would this change your opinion on the HIV issue? Sorry to trouble you.