Dear Dr HHH,
I have had a strange mono-like illness for 3 and a half months. During that time, my symptoms have improved a lot but I still don't feel great. My symptoms have included swollen glands, night sweats, and fatigue, all of which have improved alot but not gone away completely. I was on the site in December inquiring a lot about HIV. I have been to several doctors (4) and had multiple blood tests for many illnesses over these nearly 4 months. Tests have included HIV (4 times over three months), Mono/EBV (also 4 times over three months), Hepatitis A & B (once about 2 months after onset of symptoms), Syphilis (twice), Lyme's Disease, Cat Scratch Disease, TB skin test, 2 Metobolic panel tests, 1 Hepatic Panel test 1 month after onset of illness, and CMV. All of these were negative and normal. I also recently had a CAT scan of my chest and neck which showed all of my lymph nodes to be within the normal size range. Just the other day however, my latest doctor (#4) noticed some elevated enzymes in my liver. He did a blood test for Hepatitis (all forms) and is specifically looking for C and D. This has me very worried. I also had an ultra sound done of my liver. I am going to see him Tuesday for the results of the blood test and the ultra sound. I am very nervous and wanted your opinion on the chance of being positive for Hepatitis C (and A & B). I have never had a blood transfusion and have never used drugs. I am, however, homosexual but only engaged in anal sex (with a condom) one time in my life. Since seeing the doctor yesterday, I have developed some discomfort in the liver area of my abdomen (burning sensation), but I must wonder if it is anxiety induced, since I have had no pain there before. Here are some specific questions on my mind as I await results; thank you for your time:
1. Can EBV, CMV, and similar viruses cause swelling ("hepatitis") of the liver separate from the specific A, B, and C viruses?
2. Is a negative Hepatitis A & B test 2 months after last sexual encounter (and 7 weeks after symptoms began) an encouraging result against those types of Hepatitis? (In terms of false negatives and window periods for A & B)
4. Can EBV, CMV, and similar viruses other than Hepatitis cause irregular liver enzyme levels?
5. Overall, which Hepatitis is less desirable, B or C?
You led a lengthy anxiety-laden thread a few weeks ago and I will not permit another one to develop this time. No online doctor can come up with new ideas not already addressed by 4 different doctors. I am not a hepatitis expert. Your symptoms suggest anxiety more than anything esle. So only very brief responses: 1 and 4) Yes, EBV and CMV can cause hepatitis with abnormal liver enzyme tests. 2) I don't know which specific tests you have had; ask the doctor(s) who ordered those tests whether you can rely on the results. 5) HCV causes prolonged infection with potentially severe future liver damage more frequently than HBV; but treatment for chronic HCV is somewhat more effective than HBV. It's a toss-up which one would be considered more serious.
I suggest you stop searching online about your symptoms or these infections. Follow up with your own doctor(s).
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