I am confused. If you have been exposed to a risk for Hep C and HIV, and co-infection can affect the results of the tests, how are you supposed to know if you are infected with these diseases? Should you go ahead and have a HIV duo test at 28 days, or is it a waste of time, given that if you are co-infected the results are not reliable?
How common is co-infection, is it something commonplace amongst HIV + people or is it rare???
If the inital event was very high risk - eg unprotected receptive anal sex with ejaculation with an active partner with known HIV and Hepatitis C then clearly there is a room for error here and repeated testing is required. In the non drug injecting men who have sex with men population we think (think because the data is still emerging) that just less than 4% of HIV positive men are co-infected with Hepatitis C. (J Fox, E Nastouli, E Thomson, and others. Increasing incidence of acute hepatitis C in individuals diagnosed with primary HIV in the United Kingdom. AIDS 22(5): 666-668. March 12, 2008)
The standard tests apply and an HIV DUO can be used at this point. It is more likely to be the Hepatitis C that is the elusive diagnosis. New HIV positive patients are routinely tested for Hepatitis C and on an ongoing basis through their treatment. A new variant on this theme is the worry that some HIV positive people may have "occult" or undiagnosed Hepatitis B as well - heightening the need to be sure that as many people as possible are immunised against Hepatitis A and B. Best wishes, Sean
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So to be clear then, even if you KNOW the source was HIV+ and Hep C +, then you should go ahead and have a DUO at 28 days, ( as this is generally accurate) followed by a Hep C antibodies at 3 months, and repeat Hep C antibodies at 6 months,( just to be sure ) is that correct?
But generally speaking, a Duo at 28 days should rule out HIV, and a hep C antibodies at 3 months should rule out Hep C, is that correct? Unless you are a Male who has sex with a Male, which I'm not, cos I'm female, stupidly I shared a needle with someone, who has since gone for a HIV test and Hep C antibodies ( which was neg), but I'm not sure if they have been exposed in the last 3 months or not- what's your advice?
Dr Sean, I have gotten myself all upset and in a state worrying about all of this, I told you my risk, tell me what to do, shall I do a DUO at 28 days then Hep C at 3 months, will that be conclusive for me in my situation? I am sorry to post AGAIN on a Sunday, but I havn't slept all night, knowing what a stupid thing I have done hasn't helped at all. Show me the way forward, my GP is useless, and really admitted he doesn't know enough about it to give me the right advice. I don't want to have ruined my life by one episode of stupidity.
Hello. Thanks for the extra bit of information - the fact that you have shared a needle for injecting puts you in the highest risk category I'm afraid for Hep C. That said, whilst Hep C spreads easily within the injecting population, you are still unlikely to become infected (don't ask me for figures please).
I think you should do the following:-
Have an HIV DUO test at 28 days
Have Hep C antibodies at 28 days
Repeat both at 3 months
Repeat the Hep C test at 6 months
Yes, you were completely daft to share needles with anyone but you are where you are and so the strategy now must be to find out what if anything has been transmitted (and the overall likelihood is that nothing has been) and then to deal with it.