POZ Community Forums
Main Forums => Living With HIV => Topic started by: Ann on April 05, 2012, 08:30:23 am
-
HCV Testing, Diagnosis Being Overlooked in People With HIV (http://www.hepmag.com/articles/hiv_hepatitis_diagnosis_2501_22128.shtml)
Although hepatitis C virus (HCV) is a common and serious coinfection among people living with HIV, it often goes undiagnosed, even in a major U.S. city with multiple HIV care providers and a clinic dedicated to caring for people with both infections. This is the finding of a Miami cohort study reported Tuesday, March 6, at the 19th Conference on Retroviruses and Opportunistic Infections in Seattle.
Conducted by Khaled Deeb, MD, of the University of Miami’s Miller School of Medicine and his colleagues, the analysis presented in Seattle involved a medical chart review of 14,900 people living with HIV, who were in care for more than a year during the period between 2000 and 2011.
Though HCV antibody testing is widely recommended for all people living with HIV, only 49 percent of the Miami cohort had been tested. Of this group, 19 percent were HCV-antibody positive, indicating past—but not necessarily current—HCV infection.
Forty percent of those found to be HCV-antibody positive did not have confirmatory testing, notably an HCV viral load test to look for active infection. Of the 1,074 HCV antibody-positive individuals who did receive confirmatory testing, HCV viral loads were detectable in 705 (70 percent).
Only 68 percent of those found to have active infection underwent HCV genotype testing—an important pre-treatment determination. Of those who were tested, 84 percent were living with genotype 1a HCV infection; only 11 percent carried non-1 HCV genotypes.
A majority of those living with HIV and hepatitis C were male (69 percent) and were over 50 years of age. With respect to race/ethnicity, 60 percent of people living with HIV and HCV were non-Hispanic blacks; 29 percent were Hispanic and 11 percent were white.
The authors recognized that recent improvements in HCV treatment have sparked a higher level of interest among providers and their patients. Nonetheless, Deeb noted, “only about half of the total HIV population was tested for HCV.” What’s more, he reported, “Only half of those coinfected were referred to the hepatitis C coinfection clinic.”
Deeb concluded: “There is a great need to educate providers on HCV treatment and improve care to this most vulnerable inner city population. Referring the patients to a dedicated HCV/HIV coinfection clinic may lead to better patient care and treatment outcomes.”
Everyone living with hiv should be periodically screened for hep C - even if you believe you have not been at risk. Next time you have an appointment with your hiv doctor, be sure to ask whether or not you've been screened. If you haven't ever or haven't been screened in the past few years, be sure to request that a hep C antibody test is run along with your other labs.
-
The doctors are supposed to screen everyone here.
It is still best for each of us to advocate for ourselves and make sure.
HUGS,
Mark
-
The doctors are supposed to screen everyone here.
It is still best for each of us to advocate for ourselves and make sure.
HUGS,
Mark
I'm screened once a yr. for HEP B & C ( I've already had HEP B back in 1979) I'm also screened for any STD's STI's annually, and if I'm not mistaken it's required by the State DOH here in New Mexico for any access ASO programs provided by them, whether your on Medicaid or not :)
-
World Hepatitis Day is Saturday, July 28, 2012.
The CDC has declared May 19, 2012 as the first ever Hepatitis Testing Day
Mark your calendars and talk to your ASOs about doing something to promote HEP-awareness on those days. ;)
-
Thanks for the reminder Ann . I suffered with chronic Hep B for years and recently had a liver scan and some blood work done to keep tabs on it . Thankfully I'm in full remission from years of being on truvada treatment .
I did have a scare when I went in for the liver scan and read that I was referred for the test because of Hep C ... my heart sank and I was very upset until I found out that Hep C had been checked instead of Hep B on the test order . It useally takes days for a nurse to call back if you are not having an emergency at my clinic but she called me within the hour apologising for the scary mistake .
-
Yes, I have been checked.
-
Been screened at least once a year. They do the syphilis test far more often. My friend had Hep B at some point and cleared it, but the VA never told him he tested positive for it. So, I always look at my own lab reports to double check.
-
With my very boring life, I doubt I'll ever be at risk of hep C , or even B, but I'm still screened by doc's orders, so I had a recent scan of hep B and C (negative both of course).
-
Yep I was tested in 2006.
-
I had hep b and cleared it. Wicked high liver enezymes made the dr realize I had a liver problem. My question is does hep c cause high liver enzymes too? So if one had normal liver tests he would be good to go?
-
My doctor screens for this (along with a host of other panels) once a year.
-
Surf, sometimes hep C causes elevated liver enzymes and sometimes it doesn't.
I was initially tested because of an isolated lab result showing elevated enzymes, but that was the only time they were high. From that point and all through the next three years before I did the treatment, my enzyme levels were always within normal ranges - or only very slightly above.
However, even though I had normal enzyme levels, a biopsy showed that I had a fair amount of liver damage. I think it was stage three - out of four. (It's been nearly ten years since I had to worry about my liver - the treatment was successful for me - and so I'm a little hazy on some of the numerical details.)
Also, before treatment, my hep C viral load was in the region of 300 MILLION. (very high hcv VLs are common) I went undetectable within about ten weeks of starting treatment and I'm undetectable to this day - which means I had a "sustained response" or "cure" in layman's language. My doctor runs a hep C VL test on me at least once a year - occasionally more often if my liver enzymes are slightly elevated due to a heavy weekend in the pub. (I know, terrible, right?) ;D
So no, having normal liver enzymes will not tell you whether or not you have hep C. Only antibody testing - and follow-up viral load testing if the antibody is positive - will tell you where you stand in relation to hep C. Get tested, even if you think you have not been at risk.
Ahem. Let me repeat that - Get tested, even if you think you have not been at risk.
It's great to hear that so many here are being regularly screened. I'm going to harp on about this anyway - because I'm willing to bet that some members have never been screened and need to speak to their doctor about it.
Anyone who wants to know more about any of the heps should go read the Lessons (http://www.hepmag.com/articles/2509_18769.shtml) over at our sister site Hepmag.com (http://www.hepmag.com/index.shtml). They also have Forums (http://forums.hepmag.com/) you can join if you want to talk to others who are dealing with hepatitis of one sort or another.
At the risk of being repetitive and boring the crap out of everyone - I'm going to say it yet again:
Get tested, even if you think you have not been at risk.
-
World Hepatitis Day is Saturday, July 28, 2012.
The CDC has declared May 19, 2012 as the first ever Hepatitis Testing Day
Mark your calendars and talk to your ASOs about doing something to promote HEP-awareness on those days. ;)
Thanks for that, Mike.
Thanks for the reminder Ann . I suffered with chronic Hep B for years and recently had a liver scan and some blood work done to keep tabs on it . Thankfully I'm in full remission from years of being on truvada treatment .
I did have a scare when I went in for the liver scan and read that I was referred for the test because of Hep C ... my heart sank and I was very upset until I found out that Hep C had been checked instead of Hep B on the test order . It useally takes days for a nurse to call back if you are not having an emergency at my clinic but she called me within the hour apologising for the scary mistake .
Wow, yeah, scary. Have you been tested for hep C? Make sure you have.
Yep I was tested in 2006.
That was six years ago Rod. You'd be wise to have an antibody test run again - better safe than sorry.
I just can't help it - I'm gonna say it again!
Get tested, even if you think you have not been at risk.
-
Wow, yeah, scary. Have you been tested for hep C? Make sure you have.
Get tested, even if you think you have not been at risk.
Yes ... they test me for it every year .
-
Am I the only one who noticed that Mark didn't actually say if he'd been tested? :D
-
Am I the only one who noticed that Mark didn't actually say if he'd been tested? :D
Why, yes, you are the only one who noticed that.
HUGS,
Mark
;)
-
Why, yes, you are the only one who noticed that.
HUGS,
Mark
;)
btw, the test doesn't come buried in a gluten-free cupcake.
-
aidsmap: Hepatitis C infections now twice as likely in HIV+ gay men as in injecting drug users, Swiss study finds (http://www.aidsmap.com/Hepatitis-C-infections-now-twice-as-likely-in-HIV-gay-men-as-in-injecting-drug-users-Swiss-study-finds/page/2304127/)
-
I ve been tested too...
My dad has Hep C, he got it from a blood transfusion in 79, he received two treatments for two years, these are very strong and discapacitive (much more than the desease itself) but it has never been eradicated, thanks goodness, evolution is very slow.
I have the impression that medecines against HIV give aa better life quality than those against hep C...
-
I've been tested at least twice annually, since 2003, and prior to that at least once per year.
I also had the HEP B vaccinations done around 1997.
Ray
-
Got tested last week, negative :). Dr diagnosed fibromyalgia, though. :(
-
aidsmap: Hepatitis C infections now twice as likely in HIV+ gay men as in injecting drug users, Swiss study finds (http://www.aidsmap.com/Hepatitis-C-infections-now-twice-as-likely-in-HIV-gay-men-as-in-injecting-drug-users-Swiss-study-finds/page/2304127/)
I meant to thank you for that link when you first posted it. It gave me a lot to think about - including wondering how much needle exchange programs (very much the norm in Western Europe) have played into those stats.
The IVDU hiv and hep C transmission rates in areas where needle exchange programs are in place are extremely low. Needle exchange programs have been proven to work and it's a crime they're not in place everywhere.
-
I was tested for Hep B and C when I was diagnosed a little over a year ago.
-
btw, the test doesn't come buried in a gluten-free cupcake.
I wish it did!
I believe I was tested about a decade ago. Or, at least, I think I was.
I will double check with the doctor to be aure.
I know Hep B is a done deal, though.
HUGS,
Mark
-
My Dr. does a Hep B and C screening once a year , every 6 months if I date someone with Hep.
Michelle 8)
-
I believe I was tested about a decade ago. Or, at least, I think I was.
I will double check with the doctor to be aure.
Mark, even if you were tested ten years ago, it's time you were tested again.
Ahem... Get tested, even if you think you have not been at risk.
Don't make me come all the way out to the wilds of Arizona just to give you a spanking, young man! ;)
-
Don't make me come all the way out to the wilds of Arizona just to give you a spanking, young man! ;)
You shouldn't be threatening Mark with a good time. ;D
-
A little more on Hep C, and a clip from the article:
http://www.medicalnewstoday.com/releases/243766.php
"An effective HCV vaccine is desperately needed. The World Health Organization (WHO) estimates that the virus has established mostly silent infections in 130 to 170 million people worldwide - nearly 3 percent of the human population - and spreads to 3 to 4 million new people annually. HCV principally infects liver cells, and is thought to cause chronic, often-unnoticed liver inflammation, which eventually can lead to serious liver ailments. The virus already is responsible for about a quarter of annual US cases of liver cirrhosis and primary liver cancer, and it is the leading cause of liver transplants. In some developing countries, HCV prevalence is extremely high; studies suggest that in Egypt, as many as 22 percent of the population is infected - apparently due to poor screening of blood products and past re-use of syringes. Even in developed countries, HCV infections represent a looming public health crisis. In the United States and Europe, up to 14 million people are now HCV-positive, and each year an estimated 150,000 people are newly infected..."
Ray