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HCV, HBV RNA PCR Tests
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HCV, HBV RNA PCR Tests

I'm experiencing strong symptoms of Hepatitis at 6 weeks post-exposure.  I took an antibody test for both HBV and HCV at four weeks post-exposure with negative results.  I've heard that tests for both viruses are only 90% accurate at 6 months at which point the infection is considered chronic.  I want to know well before the "chronic" point whether or not I've contracted either of these viruses so I can do whatever I can to fight off the infection (Bed rest, proper diet, no alcohol, etc) so it doesn't turn chronic.

1.  Will the HCV and HBV RNA PCR tests detect the presence of these viruses at this point such that a diagnosis can be made and treatment can begin?

2.  I've heard that men are 6 times more likely to become chronic carriers of HBV?  Has the reason for this been determined (Alcohol or drug consumption, homosexual transmission) or are men just less likely to be able to beat the infection?

3.  What can I do now to increase my chances of fighting off this virus so that I don't become chronic, other than the obvious of not drinking alcohol ??  Should I be exercising or be resting??  Should I be avoiding fatty foods or those foods high in protein??  

4.  If a diagnosis for acute HBV  or HCV does occur, should any type of medication be prescribed to me by my doctor??

Thanks for any help that any of you can provide !!

Justin
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Avatar_m_tn
1.  Will the HCV and HBV RNA PCR tests detect the presence of these viruses at this point such that a diagnosis can be made and treatment can begin?

--6 weeks to 3 months, so now you may or may not detect the HBV.

2.  I've heard that men are 6 times more likely to become chronic carriers of HBV?  Has the reason for this been determined (Alcohol or drug consumption, homosexual transmission) or are men just less likely to be able to beat the infection?

--Have not heard of it.

3.  What can I do now to increase my chances of fighting off this virus so that I don't become chronic, other than the obvious of not drinking alcohol ??  Should I be exercising or be resting??  Should I be avoiding fatty foods or those foods high in protein??  

---Be liver friendly:

    *  Avoid drinking alcohol. Alcohol speeds the progression of liver disease.
    * Avoid medications that may cause liver damage. Your doctor can advise you about these medications, which may include over-the-counter (OTC) medications as well as prescription drugs. It's especially important to avoid using acetaminophen (Tylenol, others), which can cause liver damage even in healthy people.
    * Eat the healthiest diet you can. Eat fresh fruits and vegetables, whole grains and lean protein. Healthy foods help keep you strong, give you more energy and support your immune system. If you're nauseated, try eating small meals throughout the day. Choose foods that are soothing and easy to digest, such as soups, broths or a plain baked potato. A registered dietitian can be especially helpful if you have weight loss or trouble eating.
    * Get regular exercise. Exercise helps increase your strength and energy levels.
    * Get enough sleep. Rest when you need to.

4.  If a diagnosis for acute HBV  or HCV does occur, should any type of medication be prescribed to me by my doctor??

Depends.  Many times as an adult you will fight off the HBV by your own immune system.

Best.
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Avatar_m_tn
Cajim,

Thanks for the great info; that is exactly what I was looking for.  BTW, the article that mentioned why men become chronic carriers six times as frequently is referenced below:

http://menshealth.about.com/cs/diseases/a/hepatitis_2.htm

My thought process was b/c of homosexuals, alcohol, etc.

Justin
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Avatar_m_tn
>>>My thought process was b/c of homosexuals, alcohol, etc.

I agree.
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Avatar_m_tn
Cajim,

One more follow up, if that's allright.

I recently stopped taking two forms of medication as I'm concerned that they may hamper my immune system's ability to fight this infection.  I take "Advair" for asthma and "Flonase" to shrink nasal polyps (spelling).  I believe both contain steroids that are localized for the region that they are supposed to treat.  I'm unsure whether I should start taking this medications again as my asthma is beginning to act up.  I can probably suffer through the impaired breathing if I have to as I don't want to impair my immune system's ability to fight off acute hepatitis.

Also, I take lexapro for minor depression and have for several years.  Any idea what type of impact this drug may have on the liver??

Based on your response, it sounds like lean protein is okay to eat, so I will stick with chicken and fish and stay away from beef.  Any idea how sugar affects the liver??

Thanks again for your help.

Justin
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Avatar_m_tn
Sorry.  Don't know enough to comment.

Members who know, please comment.
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Avatar_f_tn
Justin,

Corticosteroids such as those you mention suppress the immune system and may prevent your body from fighting off the virus.  THey are contraindicated for those with viral hepatitis.  Consult a doctor for alternatives.

Sugar is not great for the liver.  

A researcher who posts here recommends "embedding" your lean proteins in veggies which slows digestion thus reducing the liver's workload.
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Avatar_m_tn
Thanks, zellyf, for the info.
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568322_tn?1370169040
In newly infected persons, HBsAg (Hepatitis B surface Antigen) can be detected during the first 3--5 weeks after infection.

BUT....

Do you realize that you can get Hepatitis B Immune Globulin after being exposed to Hep B so you won't get it?

Yes, I'm sure.  Here's what the CDC says about it....


"HBIG (Hepatitis B Immune Globulin) provides passively acquired anti-HBs and temporary protection (i.e., 3--6 months) when administered in standard doses. HBIG typically is used as an adjunct to hepatitis B vaccine for POSTEXPOSURE immunoprophylaxis to prevent HBV infection. For nonresponders to hepatitis B vaccination, HBIG administered alone is the primary means of protection after an HBV exposure."

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1.htm?s_cid=rr5516a1_e


Ask your doctor about it.  Obviously, you need to do it as soon as possible.

Regarding Hepatitis C.  The QUALITATIVE viral load test (the one that gives you negative or positive result) is very sensitive and will show positive soon after getting infected.

Treatment during the accute phase has a high success rate....about 90% success rate, I believe....and treatment is only 4 months.  But in all honesty, I have never seen anybody be treated during an accute infection....because your body can get rid of it during the first six months so most doctors prefer to wait and see if you'll clear the virus on your own.  

I would just like to add that if you believe you got Hep C sexually, you'll probably be fine.  Hep C is not really transmitted sexually.

Best of luck to you.
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568322_tn?1370169040
Advair is a combination of a steroid and a bronchodialator.  Talk to your doctor.  Maybe he can give you a bronchodialator without the steroid.

If you use a peak flow meter, use it often and call your doctor if your numbers are lower than normal.

Lexapro is one of the anti-depressants frequently prescribed for people with Hep C, so it should be okay.
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Avatar_m_tn
You mentioned:

"In newly infected persons, HBsAg (Hepatitis B surface Antigen) can be detected during the first 3--5 weeks after infection. "

This means that the ANTIGEN itself can be detected, not the ANTIBODY, correct??  I'm at 7 weeks post-exposure; so you are saying that the viral load test, RNA PCR, will still detect the virus directly at this point, correct??

You mentioned:

"HBIG (Hepatitis B Immune Globulin) provides passively acquired anti-HBs and temporary protection (i.e., 3--6 months) when administered in standard doses. HBIG typically is used as an adjunct to hepatitis B vaccine for POSTEXPOSURE immunoprophylaxis to prevent HBV infection. For nonresponders to hepatitis B vaccination, HBIG administered alone is the primary means of protection after an HBV exposure."

Does this mean that I can get a vaccination of HBIG at a time POST-EXPOSURE in order to prevent the development of Hepatitis B??  Does this apply to someone at 7 weeks post-exposure??  This is confusing.  If I've already been exposed to the virus and it's in my body replicating, how can HBIG help.  Is this because the HBIG provides anti-HBs to the body which the body can then use to fight off the infection??

I will look into using a bronchodilator only; I believe Serevent doesn't contain corticosteroids.  I really don't know what to do about the Flonase, however.  If I don't use it, then I'm so stuffy that sleeping becomes extremely difficult.  Do you know of any alternative medication to Flonase to shrink nasal polyps??

Thanks for all of the great info !!

Justin
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Avatar_f_tn
HBIG neutralizes the virus and severely limits its ability to replicate.  In small numbers HBV is less powerful than when it has been left to "colonize".

For now I would rely on simple saline nasal sprays.  Better to be stuffy than to end up with CHB.
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568322_tn?1370169040
The surface antigen usually appears first.

IgM antibody to hepatitis B core antigen (IgM anti-HBc): Positivity indicates recent infection with HBV (≤6 months). Its presence indicates acute infection.


" I'm at 7 weeks post-exposure; so you are saying that the viral load test, RNA PCR, will still detect the virus directly at this point, correct?? "

I said that a qualitative PCR for HEPATITIS C is very sensitive and shows positive soon after infection......with Hep C.


" If I've already been exposed to the virus and it's in my body replicating, how can HBIG help."

zellyf explained it nicely.  


" I really don't know what to do about the Flonase, however.  If I don't use it, then I'm so stuffy that sleeping becomes extremely difficult.  Do you know of any alternative medication to Flonase to shrink nasal polyps?? "

I'm afraid there's no alternative that will work as well and not contain a steroid.  But in my opinion, being able to breath takes top priority.  Plus, the steroid from Flonase acts locally with probably only a small amount being absorbed systemically.  Your doctor will be able to tell you for sure.  
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