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Acute Hepatitis C in the HIV infected patient

The patient. 46 yo maleHIV diagnosed 1992HIV Rx Combivir (Lamivudine/Zidovudine) and Nevirapine previously had d4T, saquinavir and DDI, with hypersensitivity to Abacavir) CD4 586, HIV Viral load < 50 copies/mlHep B Surface Ab and Core Ab detected, Hep B Surface Ag negative. Social. Lives with

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Acute Hepatitis C in the HIV infected patient

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    1. Acute Hepatitis C in the HIV infected patient MIDG Talk September 23rd 2008 Tom Schulz

    2. The patient 46 yo male HIV diagnosed 1992 HIV Rx Combivir (Lamivudine/Zidovudine) and Nevirapine previously had d4T, saquinavir and DDI, with hypersensitivity to Abacavir) CD4 586, HIV Viral load < 50 copies/ml Hep B Surface Ab and Core Ab detected, Hep B Surface Ag negative

    3. Social Lives with HIV positive and Hep C positive housemate, Minimal alcohol use Full time employed Depression, has seen a Psychiatrist and is taking sertraline

    4. Course of events : Oct 2005 Found to have ALT 411 No acute hepatitis symptoms reported Hep C Ab positive – other causes of LFT increases excluded Had negative Hep C serology in March ’05 Diagnosis of Acute Hep C Viral load 8.64 million copies/ml (log 6.94) Genotype 2a

    5. Hep C Risk factors Never Intravenous drug use Tattoo 6/12 ago reputable tattoo parlour No blood transfusions Occasional sharing of toothbrush with house mate Currently MSM Including rough sex/fisting Did he contract Hep C from sexual contact?

    6. Hep C Transmission Largely parenteral, IVDU, tattoos, transfusions Rarely sexual, perinatally Generally speaking – HCV is not transmitted at all well by sexual contact – except in the setting of HIV

    7. Hepatitis C sexual transmission – Is it possible? Detection of HCV in semen:

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