I actually posed this question in Rick444's earlier post. This may be a dumb question, but if a person tests posibve for HCV and has a VL how could that be diagnosed as Acute? What test would confirm this?
Not a dumb question at all. The diagnosis of acute HCV is a tricky one, I believe. It involves the diagnosis of HCV with a positive RNA result, along with patient stated risk factors. The patient can also have certain characteristics; fever, jaundice, and *extremely* high liver enzymes *may* be present. In other words, the patient *might* present with symptoms, where with chronic HCV, the disease is essentially asymptomatic. The acute phase only lasts up to six months after exposure; after that, it’s considered chronic. There is no actual test, other than an HCV RNA that will diagnose acute HCV; that’s why it’s unusual to find.
Acute stage is a time period of approximately six months after being infected. Because the majority of people have an asymptomatic acute phase, most end up being diagnosed in the chronic stage after a routine blood test or perhaps trying to donate blood. Some, however -- I include myself-- had a symptomatic acute stage (fever, jaundice, etc) -- so the diagnosis was easy. The acute stage is also characterized by sky high liver enzmes (could be in the thousands) and often intermittent viremia meaning that the viral count can go from UND to detectible to UND and so on. 40% of women and around 15-20% of men will clear the virus naturally during the acute stage.
And, Jim you also were acute?
Everyone with Hep C is acute during the first six months. In my case, I had a symptomatic acute stage while most have an asymptomatic acute stage. The difference with Rick is that he has an opportunity to treat during the acute stage while I didn't because Hepatitis C wasn't "discovered" back then. For that reason I ended up treating close to 40 years later in of course the chronic stage.
Probably should modify my first sentence somewhat to read that everyone who has chronic Hep C had an acute stage during the first six months. There are also some who clear the virus naturally during the first six months and therefore once they clear they no longer have Hepatitis C. Also, at least one study shows that more people than previously thought actually clear the virus naturally *after* the acute stage and possibly even years later although statistically still quite a minority.
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