TRULY DESPERATE FOR GUIDANCE

[GODPHM]

Dear UK Doctors,

Had unprotected sex with CSW from Africa last week of Sept 2012. I tested for HIV, STDs and Hep serologies at 11 weeks (In the US at a large teaching hospital)

Hep B Core Ab, IgM Negative
Hep B Surface Ab, Qual Negative
Hep B Surface Ag Negative
Hep C Antibody IA Negative
All Liver enzymes were normal
HIV 1&2 (EIA) Non-rective

I see your web site where you state that these results are conclusive for HIV and other infections. However I developed some discomfort in my r side abdominal section where the liver is located -this started 1-2 weeks before the testing above. I decided to retest for all these diseases again at day 180 (6 months from exposure) and all these labs were normal with the exception of my AST and ALT that were elevated (doubled from the upper limite of normal) - 90 and 130 respectively.

Hep B Core Ab, IgM Negative
Hep B Surface Ab, Qual Negative
Hep B Surface Ag Negative
Hep C Antibody IA Negative
All Liver enzymes were normal
HIV 1&2 (EIA) Non-rective

I am going crazy with the thought that I have developed Hep B or C or that this could represent a co-infection with HIV. I do drink wine regularly and take NSAIDs almost on a daily basis for lower back pain + I am overweight by 10-15lbs.

PLEASE help me

[GODPHM]

Thank you for your expertise and for taking the time to answer my post Dr. Cummings.

I went to see my regular doctor (non-HIV/STD or Hep expert) and she did not find anything abnormal in my physical exam outside my discomfort in the RUQ region. She did order several test for autoimmune problems- All already cameback negative. She said that basecause of my high-risk exposure, a Hep C RNA load should be done (this is pending now). She also said that if this is positive this would mean I have acute Hep C and simply the Ab  testing I had at 12 and 26 weeks post exposure missed it. She talked about HIV co-infection and sugegsted for me to be retested for HIV again (if indeed Hep C RNA is positive).

My doctor does not have the expertise you have in the area. Therefore, I would like to ask you if you have seen someone developing liver enzyme abnromalities with a negative Hep C Ab at 6 months and then becoming Hep C + by RNA or a repeat Ab test. I am in a momogamous relationship for more than 15 years and have never had sex outside. Dont have tatoos and have never done drugs or shared needles. I am afraid as I am having unprotected sex with my spouse since my first set of tests were negative.

Unless it is alcohol +/- fat liver +/- NSAIDs use, it is difficult to ignore the fact that I had an unprotected sexual exposure and 6 months later I am developing elevated liver enzymes.

Any final thoughts?

[Dr Sean Cummings]

Hello

Thanks for your post.

You have conclusively ruled out infection with the diseases you have tested for. You do not have them.

You need to go and consult with a doctor and take their advice about what tests, if any, you need to do now. But to repeat, the tests you have had have established that you do not have any of these conditions.

kind regards, Sean