HIV/HEP B Questions

[CaptCarl]

I have had both HIV and HEP B for 19 years now. When I was diagnosed with the Hep, my diagnosing Dr. told me that it was years away before I had to start worrying about the Hepatitis. Well it's now years later and I'm worried a bit. There is very little info out there about the coinfection, and most of it seems to concern the Hep C, rather than B. The biggest question that I have at this point is this, How infectious am I right now in regards to the Hep B? I understand that following safer sex guidelines is important, but lately it seems that I'm hearing that With the Hep, even kissing could lead to infection for someone else. I was under the impression that unless you are actually sick with it, you are not infectious, but this seems to be wrong. I was talking with someone the other evening, and she also said something about antigen and e-antigens. That one was worse than the other, and far more infectious. I really have no idea what is going on anymore, and would really like it if someone could give me a little illumination on the subject. I've recently gotten involved with someone after 10 years, and do not wish to cause him any health problems. We are both more concerned about the Hep than the HIV. Any info will be greatly appreciated. Thanks.
                                                                                                                        Capt. Carl

[newt]

Hello Carl,

Hep B can be measured by two antigens.  People showing the antigen HBsAg (hepatits B surface antigen) are usually not at high risk of transmitting the virus unless they also carry the antigen HBeAg (hepatits B envelope antigen). Since you have a chronic HBV infection you will almost certainly show up as having HBsAg. Your doc can tell you if you are showing a significant level of HBeAg.  However, reading Hep B test info is a bit of an art, and it does not always show the true picture.  So...prevention...

(1) Normal safe sex practices, plus not sharing razors etc, putting plasters on cuts etc.  Hep B is a blood-borne virus. Re: kissing, well some say yes n some say no.  In the UK we discount kissing as a substantive risk or say "rarely".

(2) Vaccination. There is a simple, effective vaccine that confers long-term (but not permanent) immunity for most people.

How can hepatitis B be prevented? on AIDSMEDS
Determining your Hep B status etc on AIDSMEDS

- matt

[Boo Radley]

Carl,

matt answered your HBV questions far better than I could and up until this year I had chronic hep B and HIV.  I have a question for you -- are you on HAART for HIV?

I ask because after contracting hep B in 2001 I was advised to begin HAART (when I elected to begin it) using an HIV med that was also effective against HBV.  In October of 2004 I started HAART in a clinical trial of Trizivir, a twice a day dose containing AZT, abacavir, and 3TC.  3TC is also effective against HBV and it apparently changed my status from antigen positive to antigen negative and antibody positive (i.e., cleared the HBV infection) sometime late last year or early this year.  (Note -- Trizivir is composed of 3 NRTIs and is not recommended as the solitary med for most people infected with HIV since the standard practice is to use a combination of 2 NRTIs and 1 NNRTI or 1 PI, or some combination thereof, and not put all your eggs in one basket  -- at the time I went on meds I had no health insurance coverage so elected to try it and luckily for me it's worked)

So, if you are on HAART are you on an HBV med as well?  Excuse me if I'm nosy.

Boo

[Eldon]

Hello Carl, it is Eldon. Newt hit the nail on the head with this one. Also, please do click-n-read the links that he provided to you.

Have the Best Day.