Really Worried, Need some Advice Please :(

[scaredgrl85]

Hi Everyone,

Please if anyone has any advice I'd truly appreciate it.

I had unprotected sex in early April and contracted chlamydia. I've been tested thoroughly for all STD's including HBV and HCV.

Everything was tested to 3 months except for HBV and HCV- I tested these at the 8 week mark.

They tested me for the Hepatitis B surface antigen and that came back negative, and tested me for Hepatitis C anti-body and that was negative as well at 2 months. Are these conclusive?

I've been having the following symptoms:
Itchy right palm
Yellowish-Brownish Stool

Other than that, I feel fine. Is it possible that I contracted Hepatitis from my exposure. The itching is only on my palm, is itching associated with Hepatitis more systematic. Please anyone, I'm very worried.. I have an appt with an internist next week! Thank You.

[jmjm530]

The odds were slim to none to begin with on a single incident of unprotected sex. What's more you tested negative at two months post treatment. Unless you have highly elevated liver enzymes or something else liver related, I think you're worrying needlessly. Itching palms mean nothing other than you are probably more aware of everything going on in your body now that your dermatologist mentioned Hep C. BTW dermatologists know as much about Hep C as liver specialists know about zits. Nothing.

-- Jim

[debnevada]

your doctor is wrong in saying that HCV is in bodily fluids.

Only blood

[joachim2007]

one more thing, it is indeed very encouraging that your 2 month test is negative. Actually, most people who get infected will test positive witin 6 weeks. However, not all, that's why re-testing at 6 months or 12 months is recommended.

12 months is extremely conservative, of course, and will probably only apply to people whose risk was very high (exposure to somebody who is HCV+, or high risk exposure like needle stick) or who had indicative hepatitis symptoms (not itching palm)

- all of it does not apply to you, so you can already be very comfortable with your 8 weeks tests. All testing you may or may not do in the next months, are surely primarily recommended for peace of mind, not really a necessity. (And in terms of hepatitis/STDs, peace of mind is indeed good to have.)

[joachim2007]

to be honest, i think your statistical HCV risk is really extremely low (probably well below 0.1%, even if the other person was infected! (*).   And indeed, i share your doubt about your doc's remarks: HCV may be in "body fluids", but not in the required amount to cause an infection. It's really a classical blood borne disease. You need to have small wounds, direct blood contact, etc.

And i would not consider an itchy palm indicative for HCV (or any other pathology i am aware of)

However, i am not a medical doctor, and the comment about liver enzymes of your physician (who, in the end, is a medical doctor) raised my suspision.

So, i think this would be a starting point to get some closure on the issue: it is very easy to find out if your liver enzymes are ok or not. A cheap blood test. BTW, If a nurse suffers a needle stick exposure, they usually monitor the liver encymes every couple of months for a year. After that year, the final antibody test is done, and then one can forget it. (that's why i mentioned the idea in the previous post)

However, i understand, that this is probably too extreme for your case (needle stick cannot be compared to intercourse in terms of risk).

So, perhaps  just get a single blood test, to see what is behind the statement of your doctor (about enzymes), and if that's fine, just do the Hep B/Hep C antibody  tests at one year. (That's the time needed for 100% sure results - a PCR can give a 99% accurate "preview" already right now)

But, personally i am convinced that your problems are not from hepatitic C. The odds are incredibly much in your favor that you are not infected by neither.

But there is a difference between "reckoning" and "knowing", hence the testing, especially the follow up testing at 1 year. However, don't worry. Your symptoms do not sound concerning at all. So, i hope you will manage NOT to worry, and NOT spend the next months in worry!! It would be wasted time :-)

~~

(*) i use the <0.1% figure because HCV is more difficult to transmit sexually than HIV, and HIV has a per-exposure risk of <0.1 (see http://www.dcp2.org/pubs/DCP/18/Table/18.2)

[scaredgrl85]

My only exposure was one unprotected sex encounter, my dermo said that Hep C is transmitted in blood and body fluids but i've been reading otherwise. I'm so concerned. Right now, my symptom is my itchy palm and that's it. Is that enough grounds to say that I can potentially have Hep C? I have a negative HCV antibody test at 2 months. Please anyone comments?

[joachim2007]

first, i believe there is no reason for you to be scared. Yes, there can be a medical issue , but be aware, that if you keep cool and do the right things now, then all will be well.

So, if your doc thinks your symptoms are indicative of liver problems/hepatitis, i would recommend to:

- monitor liver enzymes, bilirubin, platelets, wbc (e.g. every 2 months, for one year). Any virus should be visible on this picture
- repeat Hep B and C antibody tests at 12 months post exposure (to be sure)
- if your physician REALLY thinks you have Hep C, then she might want to order a PCR right away, same could be done for Hep B (although most would think it's not really indicated, but on the other hand,  other than the costs there is no real risk associated to this test)

In case any of the tests show the slightest trouble OR your symptoms persist, you should see a  hepatologist or gastroenterologist for long term follow up. (e.g. see him now, and then every 4 months for follow up, for one year).

in other words, make sure you are in good, competent hands. Don't let doctors talk you into something you do not have, but on the other hand, don't let them discount your worries.

if you do this, you have nothing to worry about: because if something is found, it will be found very early and can be treated very effectively, and if nothing is found under tight supervision of a competentn physician, then the danger of being in "false security" are nearly zero.

[[ Why do i write this so extensively? Because i wish somebody would have told me that. (but that's a story for a totally different thread) ]]