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Does Increase In SGOT,SGPT And Bilrubin Levels Indicate HIV Infection?
Question: I am a 30 year old male.I had protected sex with a sex worker on 15th of August.
As far as I could see, there was no visible breakage in condoms (I used 2) . I removed the condom with my right hand.Some vaginal fluid or lubrication (I don't know exactly) stuck to my fingers. I cleaned my penis with the same hand. I am circumcised. All this happened barely seconds after pulling out from the female's vagina.
Then I took some water in my hand and repeatedly gargled.
Do these activities put me at a risk of HIV? is it possible that HIV entered my blood stream through micro cuts in my penis, mouth, throat or GI? I do. not have any visible ulcers on my penis or mouth
1. I tested for HIV with a Retroquick test at 57 days after exposure. It was negative
2. I took my cd4 counts 25 and 57 days after exposure. On the 25th day it was 847 (43.2%). On the 55th day it was 454 (42.7%)
3.I tested for Hepatitis c at 45 days after exposure. It was positive. RNA PCR count put it viral load at 4.19 millions. Genotype 3. Subsequent ultrasound showed normal liver
4. I had a blood transfusion done when I was an infant. If I acquired HCV because of transfusion then by now my liver should have been in very bad shape, right? And that would have showed in the ultrasound, correct?
5. My Liver Function Tests were normal on 25th day after exposure but SGOT,SGOT and Bilrubin were elevated at 55th day after exposure.
6. After being diagnosed with HCV, I was eating not more than 1 meal for a period of 8-10 days. I also did not sleep for more than 2-3 hours on an average after diagnosis. I had taken the second cd4 count 8-10 days after being diagnosed with HCV.
8. As far as I could see the condoms (I had used 2) were not torn
I have researched extensively about c4 counts, HIV and HCV. Based on the sharp drop in cd4 counts and the sharp rise in SGOT,SGPT and Bilrubin, I have convinced myself that probably I have also contracted HIV. I know that an HIV acclerates HCV.
I am extremely worried doctor. I know you would advise me to take an ELISA test.
Doctor, I do not want a sugar-coated answer. Please let me know if I was at a risk.
Brief Answer:
Get tested
Detailed Answer:
Hi XXXXXXX
Thanks for writing in.
Ive gone through details uploaded by you.
Now there are 2 issues in your case .First is HCV positivity in your case which is proved by blood test.Second issue is probable HIV infection suggested by fall in CD4 count.
Your HCV positivity can be due to blood transfusion given to you as an infant.HCV spreads mainly by blood products.As at that time blood products were not screened for HCV there is a chance that HCV was transmitted to you in early stage.Also in large number of patients a so called "Carrier state" develops .In carrier state only blood markers suggest HCV positivity and no symptoms occur.
That may be the reason for no changes on ultrasound of abdomen.
Secondly according to the sexual encounter described by you there is no or very
little chance of HIV transmission .Condom is protective against HIV transmission.Even without condom the risk of infection is only 2-3 per 1000 sexual acts.Understanding this there is very little or no chance of HIV transmission in episode described by you.Is there any other type of exposure you had? like needle prick or needle sharing or unprotected sexual exposure.If yes then it can be source of HIV transmission.
The decreased appetite ,decreased sleep can be due to psychological trauma or due HCV infection. The drop in CD4 count is significant .
Normal CD4 count can range from 500 to 1000 cells/mm3.
CD4 count can vary from day to day. It can also vary depending on the time of day your blood is drawn and on whether you have other infections or illnesses, like the flu or STDs like HCV.
As the CD4 count can vary from time to time and can be decreased due to HCV infection,it is not diagnostic of HIV.
As you already know you need to undergo ELISA or RNA PCR testing for HIV.It is the only diagnostic of HIV.
There is a small but definite risk of HIV in your case.
You need to get tested for HIV.
Effective drugs are now available for HIV which can prolong lifespan and person can live many years in relatively healthy state.
Hope this helps.
I will be available for further clarification.
Regards
DrSudarshan
MD HIV and STD specialist.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor,
I am feeling suidcidal. I going to get tested tomorrow. I will kill myself if I test positive. I had a cbc and LFT done yesterday. WBC was at 12500 - higher than normal and platelets were lower than normal . I know that wbc is high when body is fighting a viral infection.
Bilrubin too was elevated
I have never done drug use, never shared injection, never had unprotected sex. If this is what God is giving me inspite of me being a good human then I do not think I should live anymore.
I am depressed and I feel that suicide is the only option if I test positive. I cannot live with this stigma.
Thank you.
Brief Answer:
No need to panic.Wait for report.
Detailed Answer:
Hi XXXXXXX
As already told the blood changes can be due to HCV infection.
If you havent had unprotected sex/needle sharing/drug use then you cannot have HIV.Also even if the report comes positive ,new effective medications are available which can prolong life by upto 15 -20 years.
Feeling depressed is natural but thinking of suicide is really wrong.Suicide is not the solution to any of the problems.You need to be stable and strong and move ahead in life.
Hope this helps.
I will be available for follow up.
Regards.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi Doctor,
But the blood changes can be from HCV only f HCV is acute, right?
If HCV was contracted 30 years ago then, I do not understand how it will cause blood changes all of a sudden.
I am incredibly depressed doctor.
15-20 years XXXXXXX I will die by the age of 45-50, correct?
Brief Answer:
Dont be depressed .Share the results of blood test
Detailed Answer:
HI Again,
Blood changes can be produced by HCV in acute stage but even an acute phase can come in chronic infection where viral load increases to produce sudden changes.Even a chronic infection can produce sudden blood changes.
You need not be depressed as your report has not came positive for HIV.
As already told,HIV does not necessarily mean death.Many patients live for near natural life span with the help of the latest anti retroviral drugs.
I would request you to have your blood tested for HIV and share its results.
With advanced drugs and good personal care patients can significantly increase the lifespan.
Hope this helps.
I will be available for followup.
Regards.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi Doctor XXXXXXX
I tested for HIV with an antibody test on the 100th day after exposure. It was negative.
Do I need to test again?
I am asking this question because I have read that simultaneous exposure to both viruses can delay sero-conversion.
Is it possible that I contracted HCV from the exposure described earlier?
Brief Answer:
Test very much reliable at 100 days of exposure
Detailed Answer:
Hi XXXXXXX
Its good to know that your test for HIV has came back negative.
At 100 days after exposure(>3months) antibody based test are very much reliable.
It is not possible that you have acquired HCV from above described exposure.
However as you know about seroconversion it may be delayed in co-infection .
You should test at 3 months from now again to be 100% sure of your negative status.It is very unlikely that your result will change but for sake of confirmation you may check it at interval of 3 months from now.
Hope this helps.
Regards
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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