Is further Hep C testing required?

[terry425]

Hi Drs,

I've previously had consultations with Dr Sean regarding HIV testing post PEP and Hep C. I received a negative HIV Duo and INSTI test result 12 weeks post PEP, 16 weeks post exposure - a huge relief as I was suffering extreme anxiety.

I had a 16 week Hep C test at GUM - negative along with normal liver function test. They test my liver function because my enzymes were deranged upon completion of PEP (ALT and GGT). They normalised a  weeks later but then I was diagnosed with gallstones/cholecystitis and each time I get biliary colic attacks they seem to be raised (ALT and GGT).

They were raised prior to the Hep C test and have been raised again since, following a bad attack of biliary colic on 23rd Jan requiring hospitalisation again (AST, ALP, GGT raised – ALP and AST were not raised on previous occasions to my knowledge). GUM told me I don’t need further testing for HIV as I had my 12 week post PEP negative and that Hep C would have shown up by now – they made no mention of retesting or the impact of Hep C on an HIV test. Do I need further Hep C testing given my negative 16 week Hep C test with normal liver function test? The normal liver function test was a bit of a happy surprise but then when it elevated again last week I was disheartened.

I'm asking as despite the negative Hep C test and normal liver function at 16 weeks I have had fluctuating liver enzymes since my exposure and again since the Hep C test at 16 weeks. I've talked myself into thinking my gallbladder problems are Hep C (similar symptoms?). The hospital who take care of my gallstones told me to make sure my hepatitis testing was up to date which it is with the 16 week test.

Do I need to retest for Hep C and if so do I need to retest for HIV? I've read on the internet that Hep C can affect the validity of HIV tests. I'm leaving the country in April and I just wanted to close this episode prior to starting afresh abroad and want to stop giving this airtime and mindtime.

[Dr Mervyn Tyrer, MB BCh; Dip HIV Medicine, Freedomhealth London]

Hi Terry, I don't think we've met.....;-))....but I agree netirely with Sean...I see very many HIV and Hep C co-infected patients at the Royal Free Hospital which is a referral centre for complicated HIV and coinfected patients. This has all got entirely out of hand for you and completely out of proportion....you are not HIV positive, you are not hepatitis c positive and in all likelihood you were not exposed i the frst place....so relax and move on. I can see where Sean is coming from in saying that you should test again but thats because he is concerned about this dribbling on NOT because he thinks you have eiother of these illnesses. Mervyn

[terry425]

Hi Dr,

Sorry for being a pain. If you think the 16 week Hep C negative is conclusive then thats good enough for me and I wont bother with other tests. I take it from your previous answer you do think its conclusive?

If you do then I'll shut up about this and get on with packing and other 'non medical' things...I think the fright I got has turned me into a bit of a headcase regarding this but i'm happy to draw a firm and final line under it!

Thanks again

[Dr Sean Cummings]

Golly Terry, I had thought we'd managed to put this one to bed for you.

I think you need to have a further test for both HIV and Hep C - NOT because I think you have either of these because I am absolutely certain that you do not, but because you are still fretting about it so much.

You do not have HIV or Hep C.

You do have troublesome gallstones and an associated cholecystitis - which needs surgery.

So, have a further test for each - so that you can close this off for good.

very best, Sean