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264121 tn?1313033056

Hep C Qs Re Treatment/Testing

Due to issues of fidelity with a partner I had over a year ago (we have not had sex for a year) and due to the fact that I have normocytic anemia which may be immune related (I use epogen) I have been having my physician give me an HIV and Hep panel every month just to be on the safe side.  I'd planned to stop once I was a year out from that relationship.  All tests had come back negative so far(Also, I have been immunized against Hep A & B about three years ago).  At any rate, my last test was 6-21-07 and it was also negative for HIV and HepC.  On 7-1-07, I was raped.  I knew who the assailant was, although he was not someone I was seeing.  I also knew him to be an IV drug user.  So a few days ago (this past Monday actually) I repeated another HIV and HepC test.  Unfortunately, my HepC test came out positive.  (Thankfully, the HIV test did not).  

The test performed was a high signal-to-cut–off (s/co) ratio.  My reading was a 65.1 which is apparently a very strongly positive number for less than two months out from the date of exposure?  This is the only possible exposure to HepC that I've had, and remember, I have all of these documented negative tests going back every two or three months for well over a year, probably for two years or so.  

Also, I am quite ill.  I began to get sick about a month or so ago with nausea, stomach pain and bloating and also just a much smaller amount of urine, which seems very concentrated and much darker in color than usual.  I am also very tired suddenly.  Initially, I attributed the fatigue to my anemia, but my red blood cell counts are fine.  I am trying to get a specialist to see me so that I can get on a combination therapy as I understand that the window for doing this at the beginning acute onset of hepatitis c is fairly narrow, and I am lucky to have known I contracted it so quickly.  Unfortunately, all of these gastros and hepatic specialists have waiting lists and it is so difficult to get in without waiting two weeks to a month.  You would think they would understand my sense of urgency, but its as though I am talking to a wall.  I have been unable to find online information as to why my ration is so high so fast, does anyone else have a clue?

Thanks in advance for any help.  Btw, I am close to both Huntsville and Birmingham Alabama.  And yes, I have pressed charges, in case anyone was wondering.
28 Responses
186606 tn?1263513790
I am an acute as well, in week 23 of treatment. The widest window for an acute is six months and my doctor, Dr. Gish in San Fran, likes to start at three months for acutes if possible.

Not to put my nose in it, but if the incident was very bloody and involved open wounds, i'm told that you can aggressively begin viral replication.  In my case, I became acutely ill after a surgical procedure.  My procedure was november 23 of last year and i had acute symptoms approximately six to seven weeks later.

I would ask others on the board to ring in on hepatologists in the area who receive email or phone calls and might be able to assist in an acute window.

Deb
Avatar universal
First, my condolences regarding the violation and the Hep C diagnosis.  Hep C transmission via sex is rare but it appears that you are the exception to the rule.  1st, retest.  There are false positives out there.  Second, treat ASAP as it's so new you have a very high chance of cure.  I think you'll be in good shape if you can get treated within 6 months of exposure.  And yes, the GI's take their sweet time getting around to seeing you.
264121 tn?1313033056
Deb, it wasn't really bloody - but I abrade easily internally, and my immune system is apparently just nonexistent.  When I became sick, I didn't associate it with hepatitis, I've just had no idea why I've been so sick lately.  I chocked it up to my normal anemia issues, and though that maybe I had a virus or something (but certainly not THIS virus!)

I went in to do routine blood work and asked for an HIV and hep panel to go along with it because I wanted to be on the safe side due to the rape, but I never expected either of them to be positive.  Believe it or not, in this podunk town in which I live, they did not offer me any prophylactic medication or testing at the E.R. when they did the rape kit on me, even though I asked for both.  There is also no rape or crisis counselor here.  It was a pretty demeaning experience all the way around.  All of the literature I've been reading says that it would be optimal to start combination therapy in the first thirty days after exposure, if not, then after the first sixty days, and failing that, within the first ninety.  I'm already eight weeks out and sick, I don't want to wait any longer than I have to wait if I want to have any shot at clearing this virus.
186606 tn?1263513790
BTW, i forgot to mention that a lower viral load helps, as with acutes.

Also, I was a RVR at two weeks of treatment and it is because i was an acute, i'm told.
87972 tn?1322664839
I’m saddened by your story. I wish there was something I could say to make things better; all we can do sometimes is continue to move forward.

I’m in California, and not familiar with LA Hepatology. I’m assuming that you’re currently being cared for by your primary care physician. Although the antibody test you were given has a high s c/o score, it still only tests for antibodies.

INSIST on a Nucleic Acid Test; this will be generically known as HCV RNA PCR, or possibly bDNA, TMA testing. These test results are extremely accurate for the presence of active HCV virus; without positive PCR results, you really can’t be properly diagnosed with HCV. The PCR results will need to be *carefully* analyzed by a qualified and experienced medical doctor due to your possible acute status; there may be some fluctuation in viral load because of this.

I’d advise you to e-mail several top-notch Hepatologists for their opinion, even if they are out of your area. They may be able to guide you. Several come to mind:

Dr Robert Gish, California Pacific Medical Center, San Francisco
Dr Douglas Dietrich, NYC
Dr Ira Jacobson, NYC
Dr Mitchell Shiffman, Duke University, NC ?

Here is Dr Gish’s telephone: (415) 600-1020

Others here will hopefully chime in with the other doc’s contact numbers.

Your right regarding a limited time to deal with this as a possible acute case- make the best you can of it.

Again, sorry this occurred—

Take care,

Bill
87972 tn?1322664839
Be sure to request hard copies of all labs, correspondence, etc. that you generate from here on out; they will help you remain informed as well as additionally benefit you if this case goes to trial. Medical privacy laws vary from state to state; make sure that your doctors cc you on the lab orders.

Again, I’m sorry to hear of this attack,

Bill
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