Congratulations on your new baby. If your tests have all come back negative you have nothing to worry about. I had hep. C for 20 years before I found out I had it. Then I had no symptoms at all for over 3 years after that. There are many reasons why a person, child or baby may have a spider angioma. I didn't have any hep. C caused ones until I was infected for over 26 years. Then laser treatments dissolved them. Ask the pediatrition about those on the children.
My hepatologist told me that after 20 years of sex a married couple has only a 5% chance of spreading it from one partner to the other in unprotected sex. It is a blood borne illness.
Ok, hold up a sec. Are you saying you have NOT told your wife you are HCV +? That's kind of an irresponsible and selfish thing to do because, if nothing else, you guys are supposed to be joined in that old, sickness and health, richer and poorer, etc etc. And she is going to be mighty pissed that you didn't give her the benefit of the doubt in trusting her to understand. HIV transmitted via sex makes up the very smallest segment of HCV transmission and is not very common at all. So your worries about your wife thinking you cheated on her are entirely unfounded - or should I say, the HCV is not the evidence. (If you've been cheating on here anyway then so be it, but your HCV status is almost certainly not a product of that).
Now. The one thing your fam does need to make certain to do is not to share toothbrushes, nail clippers, anything that can transmit microscopic amounts of blood. And if you and your wife take part in sexual practices like anal sex, you need to wear condom as blood to blood transfer is easier with sexual activity of that nature.
Very probably though, your wife and baby are just fine. Many people never know how they got HCV. Some even get it from medical facilities who re-used old needles unbeknownst to them. So please tell your wife, and it will prob make you both feel better for her to get tested but I think the two of you are going to be just fine (with the exception of you probably having to go through this very fun treatment at some point - another reason to tell her, cause you will need her support.) Oh and please, kiss that darling baby for me!
HIV transmitted via sex makes up the very smallest segment of HCV transmission
UGGGGGGGGGHHHHHHHHH!!! Can you tell I still have a monstrous headache? I meant to say HCV transmitted during sex makes up the very smallest segment of HCV transmission. Cross out the HIV, didn't mean to mention it at all. Just have a migraine that won't let go.
No. What I said was that I think I MAY have contracted Hepatitis, due to the symptoms I listed and my initial risk. Since then, I haven't slept with my wife (as she's pregnant, it's been convenient to do that), and I've been really careful around her and my kid.
So far, I've continually tested negative for HBV and HCV. If I were to get a positive result, I'd let her know, of course. I haven't told her because I didn't want to worry her while she was pregnant, and I've been trying to work out if I'm being irrational or not. I have told her that I'm concerned about Hepatitis, but haven't gone into any more detail. I take your point about HCV not being sexually transmitted. Now I've looked into it, I know that. Unfortunately, people need educating on that matter, and I didn't want to upset her in her pregnancy.
Now we've had the baby, I've had a chance to sit down with her today to tell her. She's been great. But I'm still really worried about possibly infecting everyone (which is alarmist, I know, as my test results have been negative ... so far). But my 'symptoms' are getting worse. That's why I was wondering what the chances are of passing it on in a home setting. Since I've had my suspicions, I've taken all the normal precautions re: toothbrushes, razors, etc. We don't share those anyway. I
'm really worried. The doctors at the hospital have said that my baby looks a little jaundiced, which I know isn't uncommon, but seems like another coincidence to me.
Based on what you said, the chances you have Hepatitis C are extremely low, but even if you did have it, the chances that you passed it to your family are even lower -- but since you probably don't have it, the chances you passed it to your family are even lower than low, meaning you're being a bit neurotic. But understandable, many of us are, especially when blood, family, pregnant wives, and little babies are involved.
If it were me, I'd stop worrying and continue on with your blood tests (for peace of mind) until you're out of the "window" period where Hep C might not show up. The two types of tests you want are the PCR (for viral load) and an antibody test -- and probably best to have the tests administered by a liver specialist (hepatologist). Not because you are likely to have Hep C, but because you have slightly elevated liver enzymes and that should be looked into. As to your child, I imagine the jaundice will be followed up by the doctors.
BTW transmission of Hep C is blood to blood, but not very efficient unless IV drug use, transfusion, etc. Sexual transmission is uncommon and in the U.S. condoms are not even suggested for monagamous couples, although certainly a personal decision. It's a good idea not to share personal items like razor blades, tooth brush, etc -- but that's a good practice regardless if someone has Hep C or not.
Do report back and let us know how things turn out with you and the little baby.
All the best,
thanks for your reply.
My LFTs were taken 3 weeks after the incident, and only very slightly raised - I believe that ALT was 50 instead of an upper limit of 40, GGT was about 10 pts above the upper limit, and the rest were normal. The doctor at the time said that it was probably just a blip, and didn't seem concerned. I had the tests repeated at 8 weeks post-exposure and then again at 14 weeks (when my itching began), and they all came back within normal limits.
What confuses me at this point is that all my family are showing symptoms. This makes me believe it may be HepB, as it is more contagious. But from what I read, a HBsAg blood test would show positive well before I've tested negative.
Is it too late to have my little baby vaccinated against HepB? I read somewhere that Immun Globulin would offer some protection within 2 weeks of exposure. Is that right?
I have a slightly different take on your situation. I am a believer in symptoms having some underlying basis, and also I really raise some red flags when LFT's are abnormal, for no known reason. If you had not been drinking heavily prior to your abnormal Liver function testing, and if you are not gaining lots of weight, working out physically in a more dramatic manner, etc., then I think that continued testing and monitoring would be wise.
My feeling, having read hundreds of studies, personal accounts, and observing the HCV histories of several friends, as well as my own....my feeling is that this virus does not ALWAYS play exactly by the book. If you look at posts above regarding Cirrhosis development near age 65 being the norm for HCV carriers...which now contradicts everything we have been told about HCV progression, you can see that HCV knowledge is a work in progress. There are questions remaining about whether HCV persists in minute amounts after successful treatment (SVR), questions about 'Occult HCV' which infects some individuals without registering any antibody responses on blood testing, and sometimes shows no measurable viral load in the blood....yet it is in the liver, causing ongoing damage. Yes, there are many grey areas regarding HCV, regardless of how adamently some people may proclaim that everything is 'cut and dried', and very simple to understand. Cure is different from cure, undetectable does not always mean virus-free, and now we find out that cirrhosis MIGHT just progress more according to age, rather than individual history, or unique personal attributes. Things are always being uncovered when it comes to HCV.
Back to your issue, I think that if you continue to be symptomatic, and you do have a suspiscious set of symptoms that MANY early-on HCV sufferers describe, then you will want to probe further. It may not be HCV, and could be another 'liver-damaging' virus, or some other infection, or illness entirely. But, I would continue to try to rule out HCV, by not only having the standard HCV antibody tests done, but possibly a super-sensitive HCV PCR (or Viral Load) test. This would indicate if there is ANY virus, even in minute amounts, in your blood. As seen in many with Occult HCV, there is a remote chance that one can have the disease, in the blood/ liver, or just the liver, and have NO antibody response on standard HCV blood testing. I would also regularly monitor your liver function with inexpensive LFT' s, which will tell you if there is a possible catalyst at work in your system causing fluctuating or mildly elevated enzymes. It could end up being something viral in origin, and could even possibly be an occult HCV, but the liklihood should be very small.
As far as symptoms, listen and observe very objectively. Many of us complained for decades of similar symptoms to lots and lots of different doctors, only to be told we were overwrought, or hypochondriacs, or depressed, or just having anxiety. In due time, we all discovered, one way or another, that we actually had a viral infection, that was causing all of our so called 'imaginary' symptoms. I am a big believer that symptoms usually mean something, and that doctors ALWAYS tend to explain away anything they can't easily determine on their own. If they don't know what it is, then it is in your head!
I wish you well, and suspect that your odds of having HCV, in any form, are very low...but do the due diligence anyway. You need to find out what is going on, and find some peace of mind. Try to be very low key about your family members symptoms. Make sure you are not planting any thoughts or suggestions in their minds, and then just observe quietly for a few months. If you hear similar complaints, out of the blue, from them over a period of time, and their symptoms appear to objectively be real...then I think you really do need to keep investigating and testing. Symptoms don't appear for no reason in most cases.
My best wishes!
Good to see you posting again.
I don't think our takes are that dissimilar even thought we don't share many of your "occult" concerns, and by this I mean "concern" as opposed to "existence" which is another topic best left to weekdays :)
We both recommend additional testing re HCV (antibody and viral load) to be 100% sure, and both recommend follow-up with a liver specialist because of the elevated enzymes. We also both acknowledge that his chances of contracting HCV from that bar exposure (factoring in neg testing since) are very slight.
As to the rest of the family members, I do agree no reason to alarm them in any way, or "plant thoughts" as you say. What I do think should be done is to treat the symptons for what they are, i.e. have his son examined re the light stools and certainly the baby re the jaundice. In the very unlikely event that "UK" does end up testing positive for HCV, then of course those symptons should be reevaluated.
You should ask your doctor -- or the liver specialist -- on the baby vaccination question. My guess is that your exposure situation will have no impact on whether they recommend a vaccination to the baby or not.
thanks for your advice.
DD, I hadn't thought about occult HepC. Does this really happen often? I am very concerned about my own problems, but at the moment, my main concerns are obviously for my wife and family. I understand that HepC (or any disease) often behaves differently between people, and I must admit that with such wide-ranging advice, I am finding it hard to make sense of it all. My doctor dismissed hepatitis when I told him of my concerns, and it was all I could do to convince them to do a Hep screen. I did ask about a PCR test, but was told that they don't do those routinely.
As an update, the doctors are going to run some tests on the baby tomorrow. I'm hoping that it's 'normal' newborn jaundice.
A further question, if someone could help me, is that in cases of newborns who have hepatitis (B or C), do acute symptoms present immediately (ie. after 2 days), or do they follow the normal course of infection, incubation periods, etc? Would 2 days be too soon to be jaundiced from hepatitis B or C?
It's a damn shame that your first months with your new baby are going to be dominated by a fear of having hep c and, worse, the ridiculous idea that you have actually already transmitted the virus to your wife and your newborn son. Your route of transmission into your body-- cuts ???? from checking your blood sugar-- seems totally implausible. Is it really that messy when you check your sugars? Forget about the spiders-- that is late a disease symptom; you are not going to get those within months of exposure. You or your family might have them, but they are not going to be a manifestation of liver disease this early after exposure. One slightly elevated liver enzyme test out of three tests is completely meaningless. Stop holding on to that result as indicating that you have hep c. In the absence of other data, it is an absolute joke to conclude from a slightly elevated enzyme test that you are carrying the hep c virus.
Jim - I agree with the bulk of your post, but this comment does not match my personal experience...
"BTW transmission of Hep C is blood to blood, but not very efficient unless IV drug use, transfusion, etc."
I had minimal blood to blood contact with my assaliant (home invasion / knife attach), however, I contracted Hep C (confirmed baseline test that I was Hep C clear on day of assault). I don't think it takes much blood to blood contact at all, and certainly does not need injection for Hep C to pass on. I remember a doctor telling me that Hep C is much easier to catch than HIV (100 times easier, or something to that effect), if you are exposed to contaiminated blood.
Since you are diabetic it is possible that the slight rise of LFTs is the result of NAFLD, a condition that is becoming very common as a source of chronic liver disease, even cirrhosis.ALTs are normally only elevated as a result of hepatic injuy, but can also be caused by muscle injuries, then the AST is typically higher and a concomitant rise in LDH would be present.
Regarding the mechanisms of transmission, here is an authoritative summary of this somewhat complex topic:
Epidemiology of hepatitis C in the West.Alter MJ.
Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Most hepatitis C occurs among young adults with high-risk behaviors or lifestyles. Although the most efficient transmission of HCV is through large or repeated percutaneous exposures to infectious blood, transmission also seems to occur through occupational exposure, sexual activity, household contact, and perinatal exposure. The risk of transmission in these settings is most likely dependent on the titer of virus as well as the type and size of the inoculum and the route of transmission. The apparent inconsistency of results between studies is probably a result of the small sample sizes, in that insufficient numbers of infectious persons are included, as well as the variations in methodology and serologic testing. Although HCV may be inefficiently transmitted by inapparent parenteral or mucosal exposures, the high rate of persistent infection with HCV creates a large reservoir of persons who are infectious to others.
Your child should be vaccinated against HBV. One less disease to worry about, in particular since you are a worrier.
Really don't know enough to comment about HIV, but "needlestick" with HCV is only around 1.8% http://www.hcvadvocate.org/hcsp/articles/Jensen.html Don't really know how much blood transfer was involved in your knife assault, but certainly sorry for all you had to go through.
I am a little sceptical on the research on transmission to be honest. It just makes sense to me that this disease has survived through milenium by simple blood to blood contact. Yes, it spiked with blood tranfusions, but it survived for a long time before that, even though blood is the only way to transmit. This indicates to me that it does not take much blood contact to transmit, the virus must be very efficient once it has its limited opportunity, otherwise evolution would have wiped it out. I expect every time there was a war (which was most of the time), along with poor hygene / surgery, etc., it just kept passing on.
At least, the war transmission idea matches my experience, that a couple of knife cuts, and close contact, will pass it on. Maybe needles are different from knifes in terms of how they cut?
Interesting area of speculation. This suggests 500-2000 year history.
Hand-to-hand contact during war, lack of hospital sterilization procedures, primitive blood rituals, and older medical practices such as blood-letting (thousand year old history) are just among some of the blood-to-blood transmission routes one can think of. As to "needle stick" I can only speculate that the low rate of transmission (as opposed to say IV drug use and transfusion) is because of either the smaller quantity of virus involved and/or the possiblity that the blood ends up in fatty tissue without hitting a blood source.'
I guess in my case, there were two people activley bleeding in close contact. At the outset, a doctor told me that it was hoped that as we were both bleeding, my new blood would flush his blood away. But this didn't seem to be the case. The event last about 15 minutes, there was a lot of blood (you can see a photo of me on my page, that journalist took), but my cuts were quite small. However, it did include cuts on my fingers, so maybe I touched his blood at some point (I really don't know and never will)? Perhaps with a needlestick the cut is so minute, I don't know though:-)
Oddly, I don't really get upset about the incident of transmision, and my family don't either. Something random is not really that hard to deal with, after about three months of jumpiness, I felt fine. I feel a lot more for people who have been in situations where they know the assialiant, or they were infected by a partner (even through drug use) or similar, it is much more personal then.
Sorry about your transmission route. At least you know how you got it, and that is a very small consolation but probably better than not knowing.
I know I got mine while in the army in 1974, as acute symptoms showed up in force in August. My army doctor spoke only Turkish, except for writing "grossly normal" on my evaluation, which included no liver function tests at all.
I think I got mine at the army barbershop. My unit was ninety percent paratroopers that had been in Vietnam, and I found out lots of them were I.V. drug users (didn't know that at the time, as I wasn't one and I.V. drug users in the army tend to be very secretive). Anyway, I noticed way more than one time that the day after my haircut (never got shaved by a barber in the army), I would have a razor thin scab at the lower border of my sideburn(s). I figure I jumped into the chair right after somebody with hep c and they used a dirty razor to accent my sideburns and that's how I got it. Barbers weren't concerned in those days about using sterile instruments. Anyway, sideburns scabs were something that happened pretty frequently and I can't think of any other times I could have had bleeding.
I'm really sorry to hear all your stories about transmission. I'm inspired by your strength.
I guess that I should take some comfort in the fact that there doesn't seem to be much anecdotal evidence of passing it on in the household to family members.
ok, all points to ponder...it could all be coincidence but you are not convinced. yes, diebetes can cause itching, spots, a few things, enyzmes up, a beer or two....baby's livers all kick in at different rate.
the thing is, you had a blood exposure and that blood doesn't dry out instantly, and it's going to bug you more and more especially if you keep it from your wife.
as terrible as it may be to tell her (she may not like you going to that pub anymore) how more terrible to keep her in the dark. Because if God forbid, you are right...then how do you answer that you knew and kept it from her. Also your babies may be fine, or have the virus and clear it on their owns, but meanwhile you are having no sez? How suspicious is that.
how bout some honesty? Like this has been plauging me and I know it's probably nothing and did not want to scare you but..........then maybe, she's admire you care about your kids and her...and not wonder down the road what else you might be hiding from her.
I agree the whole thing is unlikely, but still there was a blood contact. that's how my son got exposed, and it may have been in the birthing or nursing, there's a lot that is still unknown as to transmission conditions. Bottom line is, face your fears, it's better than living in a closet hoping no one sees that you're in there....trust me, she probably already knows something is bothering you.