Hepatitis C - Exposure

[dontworry_behappy1]

If you have been exposed to Hepatitis C - can you transmit the virus to someone else before you
clear the virus?  Otherwise, you get it and later find out you are one of the lucky 20% who cleared
the virus without having to go through hepatitis C treatment.  

[hrsepwrguy]

Ha, you found the study I did, I thought this was interesting also

investigators have described the viral dynamics of acute hepatitis as occurring in 3 phases: (1) pre-ramp up phase, also known as the eclipse phase (unknown duration), (2) ramp-up phase (lasting 8-10 days), and (3) plateau phase (lasting 45-68 days) (Figure 3)[5]. During the ramp-up phase, exponential growth of HCV occurs, with a doubling of viral load every 10.8 hours[5]. The ramp-up phase transitions to a plateau phase characterized by high-level hepatitis C viremia. Studies involving chimpanzees and humans have shown the plateau phase is typically reached within the first two weeks after inoculation of HCV via transfusion[7], but in some patients low-level viremia persists for up to 2 months before the virus even enters the ramp-up phase[5]. Serum HCV levels generally peak within 6 to 10 weeks of infection, regardless of eventual progression to chronic or resolved infection[8]. The HCV RNA levels can fluctuate widely in acute hepatitis C

http://depts.washington.edu/hepstudy/hepC/clindx/acute/discussion.html

[Idyllic]

This was an interesting question,
hrsepwrguy's post really sums it up nicely.  I guess I just assumed a person would be infectious during the acute phase since there are treatment recommendations for the acute phase and the chronic phase.

The initial phase when a person is exposed and the potential to clear the virus is called the "acute phase." The article in the link says it is "generally defined as the first 6 months of the infection." Later on it says, "Among those individuals who have spontaneous resolution of the HCV, it typically occurs within 1 year after infection. Although most studies have shown those who clear HCV without specific therapy do so within 12 weeks of the clinical presentation, others have shown a more delayed clearance that occurs after 6-12 months

- - - - -
'Several studies have helped to better define the optimal timing for initiating therapy in the setting of acute HCV infection. Recent data clearly demonstrated that initiating treatment during the first months after the diagnosis of acute hepatitis C provided substantial benefit when compared with delaying treatment for one year (SVR 100% versus 53%)[13].

Since many individuals clear HCV infection spontaneously in the first three months, some experts have argued that beginning treatment too early in the course of the illness might expose those individuals to unnecessary medications and side effects. Several studies have employed a strategy of delaying therapy for 8 to 12 weeks after disease onset and impressive SVR rates were preserved'

http://depts.washington.edu/hepstudy/hepC/clindx/acute/discussion.html

[hrsepwrguy]

I couldn't find anything specific but it would only make sense that if you are HCV RNA positive at the time, that you would be contagious, so I would think that you would be contagious during the acute phase until your immune system has completely resolved the infection, if you happen to be one of the lucky 20% that does clear on their own

3.  If I have viral hepatitis, am I contagious?

You may be contagious. It depends on which hepatitis virus you were infected with and the stage of your infection. Often, people with viral hepatitis can spread the infection even though they don't have symptoms. With Hepatitis A, you are contagious from the time you are infected until about 2 weeks after you contracted it. A person with Hepatitis B is contagious as long as the virus is present in their blood. Anyone who tests positive for the presence of Hepatitis C virus (HCV RNA test) should be considered contagious. The HCV RNA test may be performed as follow up to a positive result for anti-HCV.

http://labtestsonline.org/understanding/analytes/hepatitis-panel/tab/faq