HIV and Hep C coinfection window period
HIV Hep C Window Period
This is another question I see asked very often. Many people are afraid of being co-infected with HCV and HIV. After reading reports that HVC affects the HIV window period, they begin to suspect the validity of their HIV test results. Let’s find out the truth.
All this hullabaloo stems from a MMWR published by the CDC on 29th June 2001 titled Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis.
In this report, it is stated that ‘Extended HIV follow-up (e.g., for 12 months) is recommended for HCP who become infected with HCV following exposure to a source coinfected with HIV and HCV.’ In other words, ONLY in people acutely infected with HCV will the window period for HIV testing change.
So the real question to ask, if you really think this applies to you, is this: How can you tell if a person is infected with HCV?
Are there any symptoms of acute HCV infection? Most people actually suffer NO symptoms. Even if they have symptoms, it is usually mild and vague e.g. fatigue, loss of appetite, abdominal pain and rarely jaundice. So the absence or presence of symptoms is no help at all.Click here for more Info on Hepatitis C
You can test for HCV. The common cheaper test to do is the EIA antibody test. This is frequently accurate 4 weeks post exposure but might take up to 15 weeks. And there is the more expensive HCV RNA PCR test that can be done 2 to 3 weeks post exposure. (Updated 15th September 2014)
So if all these test come back clear for HCV, we can then conclude a person does NOT have HCV infection and therefore the window period for HIV testing will NOT be affected. If any of these tests come back positive, then a person is diagnosed with acute HCV infection and the HIV window period will be prolonged.
That said, is there a real need to be worried about HCV infection in the first place? HCV is mostly transmitted through needle sticks i.e. sharing of needles in drug users, needle stick injuries, contaminated tattoo needles, sharing razors, acupuncture etc. Less than 5% of HCV infections are due to high risk sexual exposure.
So if you really feel that you are at risk of both HCV and HIV, talk to Our Doctors about getting tested for HCV. If you are clear for HCV, then you do not need to worry about the window period for HIV being prolonged. If you test positive for HCV then you will need to see a Liver Specialist for further treatment. Also your HIV testing window period should be extended to 12 months.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.