Hepatitis C

My boyfriend has hepatitis C. I know it can be transmitted through sex. My question is, how long after the first time we had sex should I wait to be tested? I mean, I'm sure that it wouldn't show up immediately.

[Lady E]

Catching HCV via sex has a very small percentage..I think it's only 1-2%, but it can happen. Tho I must say, that I am married and my husband has never contrated HCV. Remember that it is transmitted through the blood. So keep your personal things such as razors, nail clippers, toothbrushes etc. isolated from your boyfriend's things.
I really don't know what the gestation period is to be able to detect hcv, but I'm sure that someone else here will chime in with that information for you.
Best of luck.
-E

[HCA]

You are  wrong-it is not  transmitted by hetereosexual sex.
http://janis7hepc.com/sex_and_hcv.htm#SEXUAL%20TRANSMISSION
Read the article above or any number of other studies.
Unless you have mixed blood with your boyfriend for some reason you don't have it!

[Bill1954]

Although the subject of sexual transmission in regards to HCV remains a controversial and highly debated subject, this particular study abstract from the American Journal of Gastroenterology is interesting.

http://tinyurl.com/258a2l

"Dipartimento di Medicina Interna, Universita di Modena e Reggio Emilia, Modena, Italy.
The risk of sexual transmission of hepatitis C virus (HCV) infection was evaluated among 895 monogamous heterosexual partners of HCV chronically infected individuals in a long-term prospective study, which provided a follow-up period of 8,060 person-years. Seven hundred and seventy-six (86.7%) spouses were followed for 10 yr, corresponding to 7,760 person-years of observation. One hundred and nineteen (13.3%) spouses (69 whose infected partners cleared the virus following treatment and 50 who ended their relationship or were lost at follow-up) contributed an additional 300 person-years. All couples denied practicing anal intercourse or sex during menstruation, as well as condom use. The average weekly rate of sexual intercourse was 1.8. Three HCV infections were observed during follow-up corresponding to an incidence rate of 0.37 per 1,000 person-years. However, the infecting HCV genotype in one spouse (2a) was different from that of the partner (1b), clearly excluding sexual transmission. The remaining two couples had concordant genotypes, but sequence analysis of the NS5b region of the HCV genome, coupled with phylogenetic analysis showed that the corresponding partners carried different viral isolates, again excluding the possibility of intraspousal transmission of HCV."


It's important to draw you're own conclusions from this abstract; furthermore, remember that the 'methods' section' in the full text article may have additional info unavailable in this abstract. Of particular interest are the conclusions at the bottom of the page: "... Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners..." This seems to correlate with the current U.S. CDC recommendations.

In your case, and for peace of mind, I would get tested anyway. A relatively inexpensive antibody test is widely available; I would wait ~90 days or so for antibodies to develop. If this is too long a wait, PCR tests for the presence of HCV serum RNA are also available for additional cost; they will detect the presence of the HCV virus in a more direct fashion.

Best of luck to you, and remember that unprotected sex is also considered a vector for other diseases including HIV.

Take good care, and let us know the outcome, OK?

Bill

[GoofyDad]

All couples denied practicing anal intercourse ....
or they claim it just slipped.....

I've always wondered why the caveat is always includedd concerning monagamous couples. I suspect that's simply an artifact of the the study designs. They study monagamous couples because of the control afforded by that group, and hence the findings apply only to monagamous couples.

[jmjm530]

From what I understand, both the STD rate as well as the rate of "higher risk" sexual practices is higher among non-monagamous couples and apparently both could account for a difference in transmission.

-- Jim

[aquarius64]

i have also read that it is easier for a woman to contract it from a man than vice versa.

[misty718]

I've had hep-C for over 30 years (although somehow I'm still stage 1 with low viral load). Been married over 20 of them. My husband recently tested negative and my doctor says the virus isn't transmitted through sex. So try to relax, Onyx. If I were in your position and wanted to be tested anyway, I'd wait a year or more. Just an opinion.

[Bill1954]

Just wanted to say hey to you guys while both of you are in the same spot. I've been keeping really busy lately, and haven't had/made time to stop in as much as I'd like to.

From the ongoing banter, it sounds like you both are adapting well to SVRland; I hope that's the case anyway. I wish you gents well, and hope you both continue to post thought provoking info here at MH.

Take real good care,


Bill

[GrandOak]

HCV is blood bourne, meaning infected blood must come into contact with your blood in a manner that allows the virus to enter the remainder of your bloodstream.

It is erroneous to say that it can not be transmitted by sex because it can when blood is present in a manner that would allow for viral exchange.

However, because it is strictly a blood bourne disease, it is not generally considered an STD given the assumption that most folks are not into some of the acts where blood exchange is a high possibility.

[GoofyDad]

Nice to hear from you. I don't post a whole lot anymore...but I do poke in to see what's going on. Th little one has taken up snowboarding and so I'm through your way periodically on the way to Donner. I always think of you on my way through. Often stop for a late and a hot cocoa at that esspressoo bar and pizza place in Old Auburn. Take care big guy, keep fighting the good fight.

[jmjm530]

Good to hear from you Bill. Forgot exactly where you are in this whole d*mn process. If I remember correctly, you had some cognitive issues during tx, hopefully that's improved some.

All the best,

-- Jim

[chcnme]

Hi Onyx. If you're worried and want to get tested, here is a link that tells you about seroconversion. Also, if you want to get tested you can call the health department and they'll tell you about testing.

SOURCE http://www.cdc.gov/std/treatment/2006/hepatitis-c.htm

EXCERPT:  Persons newly infected with HCV typically are either asymptomatic or have a mild clinical illness. HCV RNA can be detected in blood within 1

[Bill1954]

Goofy; be careful up there at Donner! Someone stepped through the ice yesterday and is currently feeding the fish... If you feel like it, give me a shout next time your through this way. Auburn is up Hwy 49 about 45 minutes from here. I hate to do this to MH, but don't know how else to get this across to you. Try wdotkeyesatattdotnet if you like; let me know if that works?
Best to you and li'l Goof,

Bill

Mr. Jim!
You're still hanging in there, huh? I do stick my nose in here from time to time, but rarely stop to post (anything substantial, anyway). To bring you up to speed, I'm currently treating with Peg-Intron/riba after my last bout with Pegasys and subsequent relapse. My new doc w/Cal Pac Med Center didn't have much good to say regarding the efficacy of Infergen, so we decided on SP's poison, lol. My assigned dosage is 150 mcg/Peg with 2000 mg/day riba for a total of 72 weeks (with doc's knowledge I'm squeezing the peg vials for all there worth, though. I'm actually getting about .68 ml, or 202 mcg weekly out of the vial.)

Currently on week 20, undetectable per bDNA at 4 weeks, <5 IU/mL by TMA qual at 8 weeks. I seem to be tolerating treatment much better this time; to date I've experienced almost no noticeable sides, other than some minor dry skin issues on my hands (nuisance stuff for the most part). I almost hate to come in here and post good news regarding Tx sides, because I know how many folks in here are struggling/have struggled through this cr@p. It's important to note that I haven't forgotten how lousy I felt during last treatment, and I'm not trying to belittle or disparage those that *are* having problems.

Personally, I'm not sure what to attribute the improvements to. Some relevant thoughts are:
I've managed through diet modification and exercise to lose about 65-70 lbs. This is turn reduces my insulin resistance, helps me maintain tight blood sugar control, and probably adds countless other benefits as well. In terms of cognitive function, I was a basket case last time; had a hard time even typing in here. This year, I've enrolled in classes at the local community college, and am involved with other community projects as well. Whether any of these things are in play now or not remains to be seen; however this seems to be quite tolerable so far. I continue to exercise about 2-2.5 hours daily, which might help with the depression?

In any event, I hope you're living large as well, guy! Enjoy life when you can, we know now how precious it really is, huh?

Take good care,

Bill

[sfbaygirl]

Good to see you post and glad to hear your sx are better than before. Sounds like many of us here are at CPMC. Great place! I was talking to someone the other day about my brain fog. Mid tx, it was so bad that I thought I would never be able to think again. It is so much better now at week 41/72. I am not sure what it is either, but possibly the liver is healing and the encephaly is getting better? NOt sure, but I sure am happy about it! I grew up in Tahoe and my mom lived in Placerville for years. So I know the area well. I have forgotten your stats, my brain ain't that great! LOL, but it is nice to know someone retreating is having a better experience than the first time.

[Bill1954]

Hi there, and thanks for the good words.Yeah, CPMC is quite an interferon mill, huh? Man, big pharma has got to love that place! Seriously though, they really have a good, dedicated team there; I personally can't speak highly enough about them. I see them at their outreach clinic in Sacto; by that I mean I see the NP's, I guess the doc's are busy with the more pressing cases? Here are my 'quick stats' for reference, BTW:

52 year old Caucasian male
Genotype 1a
Grade 2, stage 3/4
Hepatosplenomegaly per U/S
185 lbs
Diabetes M. type 2
Dx with HCV 12/04
Treated with Pegasys/ Copegus total 56 weeks, from 2/05 through 3/06.
Slow viral response at 12 week assay, so increased riba from assigned 1200 mg/day to 1800 mg/day.
Became undetectable to <50 IU by week 20.
Relapsed within 30 days post Tx.
9/15 06-begin re-treatment with Peg-intron 150 mcg/week, ribavirin 2000 mg/day.

Sorry to hear you had problems with thought process as well- it can be a disturbing experience. For what it's worth, everything seems to have returned to normal within 2-3 weeks post-Tx. This time, as I mentioned above, is much better.

Goodness, a small world, huh? I lived in South Lake Tahoe for years, then moved down to Rescue, over here on the west slope about 1987 or so. Beats shoveling weather in the winter all to h_ll!

Sounds like you're currently doing better, and knocking down the weeks to boot. I took a chance and left my e-mail for Goof above-- gimme a write if you like, and take good care of yourself--

Bill

[HCA]

Ref. your response.
As no scientific study would state that heterosexual transmission is technically impossible I consider that;
'The authors concluded that 'the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null.' is tantamount to discounting it as a risk.
I have read other papers on this topic and do not recall any citing specific instances of proven sexual transmission between monogamous heterosexual couples.
I would be interested in any sources with actual cases quoted to the contrary as opposed to refusing (correctly and responsibly) to totally dismiss the scientific possibilty regardless of what appears to be a virtually unquantifiable incidence.
Show me cases and I will amend my view.
I nontheless had several long term partners tested when I was diagnosed after a 20+ year infection,and would encourage anyone to do the same.
I shall continue to correct posters who come to the forum believing it is an STD-thats the last perception any of us wish to encourage.

[ladybug52]

I was just sitting back waiting for you to respond to this thread! My personal opinion is that chances are very minimal but still a chance. I guess we just have to sort thru all the info and make our own decisions. How are Janus and Janice?
BTW, do you think if a person is in a monogamous relationship for 30 yrs they need to take precautions still if only one partner (me) has tested positive?
Just wondering.

[sfbaygirl]

I am really glad we communicated and hopefully have soothed the bad feelings. Mine have. Nice to meet you and sincerely wish you the best! UK huh? Next time you come to SF, perhaps we can meet up.

[sfbaygirl]

I went to high school in So. Lake Tahoe, graduated 1969. Yup, remember shoveling my car out every day! Funny, but good memories. Thanks for saying to give you a shout, I had already copied your address! I actually had been wanting it for awhile when you posted months ago. Talk to you soon.

Linda

[ladybug52]

Glad you dropped by. Haven't heard from you since the Hgb scare a few weeks ago!
Take care.

[HCA]

Let's get to the nitty gritty-I called you a hysteric for telling someone who's doctor was prepared to prescribe Procrit the following;
"What kind of DR. do you have? Is he a Hepatologist? This I doubt. Your Hgb should be taken care of soon, there is NO REASON to wait for below 10. Gawd, I am tired of saying this. A good Hepatologist would not make you suffer this way. Also you PCR dropping "nodes"? Do you mean logs? This guy doesn't sound like he is up on the latest studies."
This didn't look like a very balanced view to me-you didn't have enough information to fire off both barrels.The 'nodes' reference was obviously the patients error not the doctors.
Anyway I accept that you meant well,and factoring in that I am having a lousy time on treatment (HGB 8.5 despite max Aranesp and half dose riba,plus other sides) I will accept that I have a short fuse right now.
Let's draw a line under this one!

[sfbaygirl]

I am so sorry to hear about your sx! I didn't know. I did aranesp too, I think my dr gave me two doses at a time. What is he saying about your 8.5? Where was it before and what week are you on? I am feeling sad I let off on you now and am sorry, I have been feeling really hurt by your comments all week and finally said something. I suppose I should have said it sooner. I don't always have a great way with words, but was concerned, as I am now for you, that Dr's don't give Aranesp soon enough. I may have chastised her dr, but don't remember that...if I didn't, I would! After so many weeks and so many new people who have no idea about rescue drugs, cutting tx meds etc, I do get upset about their having to suffer. You are correct, perhaps it is my own experience with a lame dr. but I wish someone had shaken me up and guided me. A few tried and I waited and thought my dr. would come through. He continues to not understand anything about Hep C.

I know what you mean about the patience, if you have read my posts today you can tell people are trying to save me from committing criminal acts of violence! Of course I do tend to exagerate (I think you noticed!) but mainly to make a point.

I don't know you well and would like to know your stats and weekss and Dr. info.  Let's get to know each other and be buds, I would like that much better than feeling like I am such a bad person and me thinking you are one too.

Linda

[jmjm530]

I agree there is no reason to necessarily wait until hgb 10 but also agree that you gotta cut someone slack if hgb is below 9 or their house almost burned down. HCA, have you discussed with your doctor switching to Procrit. Never really researched this out, but anecdotally people here seem to do better on Procrit and it seems easier to tweak since it can be administered once or twice a week. Hope you start feeling better soon. SF, sorry again about the fire. When it rains, it pours or in your case burns.

-- Jim

[HCA]

Thx your reply.
My story briefly-male age 57 next month.Geno 1a/1b.Possible early cirrhosis.
Treated three times-non responder.
Fourth time went UND between 12 and 24.Did 48 relapsed when treatment ended April last year.
Started again 6th Nov-UND at week 7.
I am extremely sensitive to riba induced anemia.Doc thinks I am getting full theraputic value from small dose because of way it accumulates in my system,but we don't know for sure.
We are monitoring me on a weekly basis.If I hadn't had EVR I would have quit.Previous treatments were bearable but this one has hit me hard.
Seeing doc (top specialist) this week.
What's happening with you?

[HCA]

Jim,
Have the procrit T-shirt! Used it last time-stonking doses too!
Procrit from day one on current treatment,switch to Aranesp as HGB plummeted.Neither really work for me.Also taking iron (prescribed).Iron levels normal.Baseline HGB healthy.
Have been described as the most susceptible patient to Riba induced haemolytic anemia my medics have ever known.
The quality of life equation looks skewed right now-how many of my limited number of good years do I want to waste on treatment?
Because of the RVR I am like a rat in a trap,locked in for the duration,unless they pull me off.
I could tough it through to 48 but fear another relapse.
Difficult situation,and all such a waste of my time living a kind of semi-life.
There are others here having it worse-not too many,but some!

[HCA]

Error in my post above-have had EVR,UND at week 7,not RVR as stated.

[jmjm530]

I assume when you say "iron levels normal" that your medical team has tested your iron stores as well as serum iron, i.e. Ferritin and TSAT which are not part of most routine panels ? If iron stores aren't adequate than maybe you need even more iron supplementation.

Yeah, understand your predicament but being undetectible at week 7 has got to be motivating factor. Have you thought about B12 injections? I took them for awhile on tx, not sure if they helped but in theory they might. Maybe when you see the top doc, ask. Cheap enough, I think like around $2 a shot if you get an rx for the B12 and give the injections yourself.

Take care and hope you feel better soon.

-- Jim

[sfbaygirl]

So you are on your 3rd go around? Did you dr. say anything about extending due to your high risk catagory? So sorry you relapsed? You say you are a non responder, but if you cleared at 12 and 24 it sound like you are a responder. Are you going longer this time? Different INf? How much Riba are you taking and what is your weight? We have posters that are really sensitve to Riba like MBB. He had to get transfusions and really suffered. Hope we get a replacement for Riba for you guys.

Have you had a biopsy? Fibroscan? Where are you txing? ARe you working? Hate to be so nosy, that is me, sorry! What week are you on now?

My stats are week 41/72 (I hope) Had anemia early on dropping 16 to 11 in less then 4 weeks. Started aranesp, it worked and I no longer have to take it. I think Jim's idea of tweeking the Procrit is a good one, can't do that with Aranesp.

My big problem is that at my week 10 PCR (first one) my dr said I was UND. After reading it many times, I decided this was NOT the case. I was actually between 75-200 IU/ml, therefore leaving me with a detectable at week 12 (cuz' dr said I was UND) Had a 20 week  UND, but according to recent studies, I should tx for 72 weeks. I am angry that because of the lab screwup, I dont' really know what my PCR was at week 10, can't go back. HR and I called the lab together, but got a techie that we both now feel told us what we wanted to hear--I was UND at week 10. HR says the test is contradictory and can't be both UND and detectable. Anyway we are going to call the lab back soon, see if we can probe any more uselful info out of them. I amy sue! At least for the extra 6 mos. of meds and tx. Sx are bad, I am horizonal most of the time, my riba rage is worse than ever, skin stuff, hair, etc. Good news is the brain fog seems better. Have gone to CPMC and have another consult MOnday. CPMC says he suspects early cirrhosis, although my fibroscan shows stage 1 or 2 and biopssy 6 years ago shows stage 1 grade 4. I am 55 live in No. CA and have 5 kids and 7 grandkids. I am a teacher, but no longer work at the moment (thankgoodness, couldn't do it!) and have been through the ringer on tx. Since the the sx come and go, I don't think much about what used to be...try to keep positive, although sometimes I really feel like throwing in the towel.

[jmjm530]

If your vl test was sensitive, I'd think a week 7 und is as much RVR as EVR. I was non detec at week 6 (blood drawn day before 7th shot) and my doctor pretty much treated it as an RVR.

-- Jim

[sfbaygirl]

Wanted to add that I think we both have good reason to have short fuses, for sure! I try to be good, but it doesn't always work, you know?

I am really sorry to hear about your tx situation and hope you find some answers and solutions. Have you have other opinions? I think if I were on my 3rd go around I would probably need a cage and to think I am only on the first one!

Have you checked out that new Riba replacement drug? I suppose hard to do now that you are already in the midst of tx.

Hey maybe we ought to get some rubber bats or pillows and swing them at each other, that way we can let it out on each other and then laugh about it!

[HCA]

This is my 5th go round!
Three times non-responder.
One time relapser.
Current treater.
So five in all!
Yes different IFN-last time Roche,this time SP-but alternating between the two.Roche easier to tolerate, but I got to UND on SP.
It amuses me to think that alternating might confuse the virus.
I am 187lbs.Started riba 1200mg-now down to 600mg.
Monday will be dose 13.
Had fibroscan-10.5.
Had BX three years ago-bridging fibrosis.
I am retired businessman.Live alone,one grown up son.I am in U.K.Visited S.F last year
We have similar age and disease progression profiles.
Sounds like you'll tough it to 72.Understand your frustration at not being sure when you went UND.You could go  to 60 weeks maybe-72 is not a magic figure.
Best wishes!

[Bill1954]

Just wanted to stop in and wish you well. I don't believe we've communicated before; I'm sorry you're feeling so crappy. The riba issue certainly seems to be complex.... here it appears that you hypo-metabolize; I, on the other hand can't seem to get enough to fill the tank. There's apparently a tremendous inter-individual variability regarding absorption/ bioavailability, with hemolytic anemia being the only (albeit crude) measure of serum levels available to us. If you have a moment, take a look at the following study abstracts:

"High-dose ribavirin in combination with standard dose peginterferon for treatment of patients with chronic hepatitis C", from Hepatology, 2005  http://tinyurl.com/2pzoml

and "Evidence that plasma concentration rather than dose per kilogram body weight predicts ribavirin-induced anaemia." from J Viral Hepatology, 2004 http://tinyurl.com/32rv5c

Interesting reading for poor saps like us. I'm currently taking 2 grams daily and my hemoglobin has yet to fall below 11.9. I did 1800 mg/day for approx. 10 months during last Tx, but relapsed within 30 days (prior Tx I didn't clear until week 20, however).

Your viral response this treatment certainly sounds at least cautiously optimistic; again, I wholeheartedly wish you nothing but the best results in this journey. Stay in touch and I hope you can hang in there for the duration.

Regards,

Bill

[HCA]

Just to reciprocate your good wishes!
I have already enjoyed the two articles you kindly flagged for me!
Pleased to see you have responded rapidly on your current regime (if I have understood correctly).You are certainly taking minimum chances if you intend to go to 72 weeks.
Intresting that you find the S.P more tolerable than the Roche!
I was quite cheered by the optimistic tone of your posts,and your pro-active schedule.
I am a daily gym man when not on treatment-I shall have to attempt a short stroll tomorrow as a token response to your impressive exercise schedule!
Kind Regards.

[sfbaygirl]

Rev; I totally agree with you again regarding transmission. Hitting a record here! How you doing?

HCA; I am not sure why you say you will continue telling others about something that is not proven to be true? There is a small chance that we can get HCV from sex. You have chastised me for being "a know it all" and being agressive about trying to help someone. I understand this is most likely what you are trying to do, but why then do you put those of us that do have some knowledge on the subject, perhaps different views, down? Stick to the discussion and support your opinions/ statements with facts instead  of arguing opinions. Everyone has opinions, it's only the facts supported by studies that you can use to support your case. Hey, we can all disagree, but calling names and discounting others facts without others doesn't help anyone. Use your studies and facts, leave the namecalling and put downs of me and others out of here.

[OnyxRose]

I contacted the CDC to find out the time period I should wait and they suggested 3 months. We are a monogomous couple, and I do understand what you're saying about the risk being very low, but he would feel some peace of mind as well if I were tested. Luckily, this, and pretty much all tests are covered by my medical insurance.

I also understand what was said about unprotected sex and agree with it. Before we had unprotected sex, we were both tested for all STDs and shared the results with eachother. My boyfriend is a tattoo artist and mentioned his having Hep C when he was talking about precautions he has to make while working. I had read somewhere that it was possible to transmit it through sex, so I asked him about it. He said that as far as he knew, it wasn't possible, but I wanted to check up on it. Every site I visited had numorous references to casual sex or promiscuous behavior as a higher risk factor, but that didn't answer my questions.

Thank you everyone for your input. I have to wait until the beginning of March for the test, but will let you know how it goes. I suppose my primary concern is that I have numerous other health issues that could cause my boyfriend to come into contact with my own blood. If I'm understanding correctly, I would have to come in contact with his blood though to get Hep C, right?

[HCA]

His blood would have to gain access to your blood and enter your bloodstream.
For examlple if he bled and you placed a little of his blood on your fingertip,made a little cut or scrstch in your own finger and rubbed his blood sample on your open wound infection could possibly occur.
Most infections are intraveinous though,where the infected blood is injected into the vein as in injection drug abuse,or in the old days ,blood transfusions.Snorting drugs from a shared straw or tube is also dangerous because of the blood to blood risk.
It's  always blood to blood.Bodily fluids such as semen and saliva do not contain active replicating virus and are not a source of infection.
I am sure you will test negative.

[OnyxRose]

Thank you HCA for your reassurance. I'm sure it will be negative as well. We haven't done anything like that and wouldn't.