Scared nurse

[Peachynurse]

I am a healthcare provider who had a needlestick in march of this year. Pt was HCV +. I had a hcv antibody come back reactive yesterday and my world has been upside down since. It was 15 weeks since the needlestick.  My s/c ratio is 1.29. I am going back to employer today to have PCR drawn. any advice?? Encouragement?? Feeling very overwhelmed and consumed by this.

[Anne1717]

ALTHOUGH  - there is thought that the acute stage can last over a year or so.  They just know so little about the acutes.  My GI still considered me acute when I started treating 8 months post probable exposure.  

And yes Peachy, it does seem to be largely hypothetical when it comes to Acute HCV. Because so few of us are caught so early, there isn't a whole lot of data.  What is clear is that the cure rate is significantly higher if the treatments are started early - usually about 4 months after exposure.  I didn't because of a doctor change, but still had great results....so far.

[willbb]

You would be getting close to the chronic stage now..I believe infection any longer than 6 months is considered chronic. So ...obvoiusly there is nothing to be done until such time you get your PCR results other than staying healthy and complete abstinence from alcohol and if you haven"t spontaneously cleared by indication from the PCR a conversation with a Hepa or a knowledgeable G.I.  about when to tx. would seem warranted.

Good luck...let us know on the PCR.

Will

[Peachynurse]

Gosh, thanks a lot for all of the great info! The day of the needle stick I tested non reactive so I know this is related to the the needle stick so that would make this acute I guess.  It's been 16 weeks today. And as far as the needle stick, I was told I had a 3% chance of seroconversion which I guess I did since I developed antibodies. The needle was a pediatric butterfly approx 24/25 guage.

Again, thanks for the encouragement and important info. I am grateful that if I do have it,  I know when the exposure occured and can get treatment sooner than later if needed.

What makes someone out of the "acute" phase? I of course would like to get treatment within the time frame/window of the 90% success rate if possible. I know I have a lot of info to receive yet as far as being able to make decisions and this is somewhat hypothetical in some aspects.

[Anne1717]

The thought is to treat aggressively during the acute stage so your success rate is in the 90 percentile and you treat for a shorter period of time. This is what my GI who is a Tufts GI recommended. I was undetectable at 2 weeks and then again at 8 and 16 and without the addition of the new 3rd drug.  I am also  geno 1b.  
If you do  find you are newly infected, it would be good to have the conversation with your doctor about:
a) waiting a little to see if you clear on your own - but have a cut off date so you don't wait too long
b) starting on the just Peginterferon straight away to try to give your immune system a boost and perhaps avoiding future duel treatment with the Ribavirin
c) Treating aggressively if you do find you have to treat

Really, before you find out your final results, it would be a good idea to stay as healthy as possible and do everything possible to give your body a chance to rid itself of the virus.  I am an older chick so my chances were not great from the outset but I was able to start treating from a very healthy position.

Above all, relax and do your homework.  It is not a death sentence.

[willbb]

Hi there...sometimes a weakly reactive positive on an antibodies test can be a false positive,however because you had a known exposure to HCV ,that is unlikely.Thats not to say tho,that you have antibodies and could  not have cleared the virus by your own immune system. This happens in about 15 -25% of cases.If that is the case the PRC will come back negative.If the PCR comes back positive then you have active HCV infection.

As far as treatment goes..if you treat during the acute stage the success rate is approx. 90 %,so good news there.

Depending on were you live your PCR results could take a number of days ..,if in the U.S someone else may have a better handle on that as I am in Canada..it takes about 10 days here.

Try not to panic..as you may or may not know,being in health care..HCV  is a very slow mover  that most often takes many years and most often decades to do any liver damage...and treatments are becoming more and more efficient all the time.

Good luck  on the PCR and welcome..

Will

[Peachynurse]

I just went and had my PCR drawn and of course I am praying for negative but remaining realistic as well. I am not even sure if I could get a negative. Do you remember what your antibody s/c ratio was when you came back reactive?

Thank you sooo much for the post. I have read your reply about 3 times already and I feel like a sponge trying to soak up any info that I can.

How bad are the treatments?? Also, since this was done on the job I am having to go thru the proper channels and follow protocols so based on the PCR results I assume I will be referred to another MD.

I did get to talk to an infectious disease MD on the phone today and he was EXTREMELY positive and said that treatments out today can eradicate the virus. I do know that the source I contracted it from was genotype 1b which I have heard less than favorable things about this type but also have heard that with treatment the chances of life ending liver failure and liver cancer are drastically reduced. Please feel free to correct me! Again, I am desperately seeking info and finding it in abundance on the web while trying to gather info from reputable sources.

Do you  remember how long it took or know how long it takes to get the PCR back? And does the reactive antibody mean that I definitely have hcv? I hear that it does then I hear that it shows exposure?? Also, in your case with your treatment, are you free of the virus?? Will your viral load levels be in the undetectable range or will they be zero. Just a lot of questions? I know that the patient I contracted it from ha a viral load (quant) of 79k. She didn't know she had it and was 84, retired nurse.

Thanks again. Yesterday and today have been a rollercoaster and getting your post made it a lot better.