Hep C Discussion Forum

Tig · Admin

RE: Diagnosed with hepatitis C and health providers telling me not to recieve Hep B vaccine

Canuck · Guru

Hi beer,

You cannot contract hep b by the very act of receiving hep b immunization shots. The vaccine cannot give you the hep b virus. The vaccine itself does not contain a live hep b virus that can infect you.

"Recombinant" hep b vaccines are used to prevent infection by the hep b virus. The vaccine works by causing your body to produce its own protection (antibodies) against the disease. It is made without any human blood or blood products or any other substances of human origin. The vaccine is not capable of infecting you with the hep b virus.

A "recombinant" hep b vaccine is derived from surface antigens of the hep b virus, which are manipulated, the vaccine is made in such as way that it does not have the ability to cause you to be infected with hep b. The antigen "message" of the vaccine will only stimulate your body to produce the safe levels of antibodies one needs to be able to recognize and fight a hep b viral infection when exposed to the hep b virus in the future.

The vaccine may not protect you against a hep b infection if you are already infected with the virus at the time you receive the shot.

It is not possible to catch hep b from hep b immunization shots (not unless say the person giving you the shot contaminated your injection by putting somebody's blood/bodily fluids containing live HBV virus into your needle and injected that live virus into you, which is a ridiculous scenario I just made up!)

The theory behind why some docs (in some cases) "might" decide to give a patient a double-strength dose of hep b vaccine, may be (in part) because the patient may be deemed as having a weak immune system (from another ongoing concurrent disease process or a medication regime the patient is having) - in those cases the hep b vaccine may not work as "readily" in them, as compared to patients with no impairments. If the patients conditions warrant it, and it is important to provide this patient with immunity to b as soon as possible, the doc might opt to double-dose the b, and double-dosing does not seem to happen often. (Another good reason for having your immunity levels checked, first, to verify if any immunization was actually required in the first place, and secondly, during the immunization process to make sure that someone with a "weak immune system" is indeed responding sufficiently and gaining adequate immunity from standard b vaccination doses).

Immunity level testing simply tells you how much immunity exists in a person - whether that be before any immunization, during immunization or after. Some people who received the standard complete series of b immunizations, can (years later), if tested, be found to have lowering immunity levels over time. Most people retain immunity protection indefinitely. Even if b immunity levels fall over time, one can still retain a certain level of immunity "memory", therefore still be afforded some protection, even if testing shows it has waned to below the adequate minimum level (>10mIU/ML).

If you have some major disease going on, or a malady such as cancer, requiring potent systemic immunological treatments/chemotherapy, or, more simply, if your life circumstances just put you at more at risk to contract hep b than others, then your docs, should make these judgements, and see to it, if your immunity to b needs to be checked and ensured.

Further to this, once a person HAS been diagnosed as having hep c, then there IS a need to know if they possess immunity to other diseases (such as a, b, flu). We want to further protect that person (already busy fighting their hep c), from contracting another kind of hepatitis and/or any other infection, if possible, because they are already in a compromised state. An infection on top of another infection is not good, not wanted (not needed to say the least), to be avoided if possible. For confirmed hep c patients, it is necessary to determine if they may also have chronic hep b, before instituting treatment for hep c.

That is my understanding of it. C.

beertastic · Member

Yes i've been booked. My next hep b immunization will be on the 22nd of this month. You talked about doctor administering double doses of b to patients. Isn't there a risk of becoming infected from recieving high doses of this vaccine? If people become infected from sharing needle sticks then how much more a high dose of the vaccine which contains the infectious agent already. Just my thought anyway.

Canuck · Guru

Hi beertastic,

Hep b immunity is hard subject material to learn.

I had never receiveded immunization (for hardly anything) all my life. I contracted hep b as a teenager and was very ill with it. I got over it, it was deemed that I had naturally "spontaneously resolved" my hep b infection" - no hep b treatment was required. (I did not know then, nor for the 4+decades after, that I had also contracted hep c at the same time I had the b). So, my hep b resolved naturally back then, but unfortunately my hep c (which I was not lucky enough to also spontaneoulsy clear) was not discovered until 2015.

Once my hep c was diagnosed, the very first thing any of the docs I saw (from first family docs, to an internist and the specialist) wanted to ascertain, was what my current levels of immunity to A and B were (if any). They did this because they knew I needed to be treated for c and because my c treatment was imminent.

I told them and they were aware that I had never received any hep A/B immunization shots.

When my immunity tests for A/B were done the results showed "not immune to A", and "not immune to B" - at <5.6 mIU/ML. (I had some retained immunity "memory", some natural immunity, gained by virtue of actually having a case of hep B in the past which I successfully naturally resolved, but my immunity was too low, I would be/could still be susceptable to catching hep b again.

In theory, the immunity test result which would deem me "immune to B" would have to say say "immune to B" - at >10mIU/ML .

I then started the 6 month series of A/B of immunization innoculations to gain suffiecient levels of immunty to A/B.

But, while I was being given the immunizations, they re-tested my immunity levels, to see if I was indeed gaining immunity. My immunity levels were sluggish to respond, accordingly (by my docs knowing what my levels were before and during immunization), they opted to give me some "double" doses of B (which some docs "might" do). They were satisfied when my immunity test results returned saying "immune to A" (at the end of the 6 months), and "immune to B" - at >10mIU/ML (which started to increase by the 2nd hep b shot of the series of 3).

It should be noted that whilst your immunizations are underway, even if your immunity levels to b have not reached a titre of 10, you are still being afforded some protection to b.

If you pursue "immunity testing", that is what you should be looking for - test results which say ... "immune to A", and "immune to B" >10mIU/ML.

Are you booked to have 3 innoculations of b over a 6 month period? C.

beertastic · Member

I quickly googled "Hepatitis immunity testing in nigeria".

Background: Chronic hepatitis B infection is a global problem; however, Asia and sub-Saharan Africa are most affected by it. Hepatitis B status of pregnant women is essential for the effective management of the disease and prevention of mother to child transmission.
Materials and Methods: The study was conducted at the antenatal care unit of four hospitals within Kaduna Metropolis, Nigeria, between August and December 2011. After obtaining ethical clearance, blood samples were collected from 800 consenting pregnant women, the plasma were screened for hepatitis B surface antigen (HBsAg) using first response HBsAg card and the reactive sera were confirmed with enzyme-linked immunosorbent assay. Other serological markers of hepatitis B virus (HBV) were detected using the one-step HBV multi-5 test kit.
Results: Of the 800 pregnant women screened, 31 (3.9%) tested positive for HBsAg. Only one of the 31 HBsAg positive women had developed the hepatitis B surface antibody, 16 (51.6%) had the envelop antibody, 18 (58.1%) had the hepatitis B core antibody (anti-HBc), and two (6.5%) had hepatitis B envelop antigen (HBeAg). The highest prevalence of HBsAg was recorded among women in age group 2125 years old (P = 0.968). Similarly, married women (P = 0.772), women in their second trimester of pregnancy (P = 0.938), women with tertiary education (P = 0.972), women from the South-East geopolitical zone (P = 0.250) and those whose husbands were in polygamous relationships (P = 0.944) had the highest seroprevalence of HBsAg.
Conclusion: HBV was detected with a prevalence of 3.9% among pregnant women in Kaduna Metropolis, Nigeria. About 96.8% (29) of the reactive women had HBeAg negative chronic hepatitis while 6.5% (2) had HBeAg positive chronic hepatitis B infection. About 58.1% of the women had anti-HBc, hence, did not have immunity and probably had chronic infection with reduced risk of vertical transmission. Pregnant women should be screened for HBsAg at the first antenatal clinic visit for appropriate clinical management and effective prevention of vertical transmission.
Hepatitis B surface antigen (HBsAg), the hallmark of HBV infection, is the first detectable serological marker to appear in acute HBV infection. It is most frequently used to screen for the presence of HBV infection and its persistence for more than 6 months suggests chronic infection.[1],[7] However, early in an infection, this antigen may not be present, and it may be undetectable later in the infection as it is being cleared by the host. The infectious virion contains an inner core particle enclosing viral genome also known as hepatitis B core antigen, or HBcAg. During this window in which the host remains infected but is successfully clearing the virus, IgM antibodies to the hepatitis B core antigen (anti-HBc IgM) may be the only serological evidence of disease.[5],[8] Shortly after the appearance of the HBsAg, another antigen named as the hepatitis B envelop antigen (HBeAg) will appear. The presence of HBeAg in a host's serum is associated with much higher rates of viral replication and enhanced infectivity; however, variants of the HBV do not produce the e antigen, therefore, this rule does not always hold true. During the natural course of an infection, the HBeAg may be cleared, and antibodies to the hepatitis B envelop antigen (anti-HBe) will arise immediately afterward. This conversion is usually associated with a dramatic decline in viral replication.[5],[8] If the host is able to clear the infection, eventually the HBsAg will become undetectable and will be followed by IgG antibodies to the hepatitis B surface antigen and core antigen (anti-HBs and anti-HBc IgG). A person negative for HBsAg but positive for anti-HBs have either cleared an infection or has been vaccinated previously.

Am beginning to understand why immunity testing is important. My guess is that every one who has been innoculated and responded to the vaccine will always test positive for anti-HBs. If this is true then it will no longer be possible to tell whether a person had an infection cleared off by themselves. The next time I go for testing I will opt to be tested for anti-HBc (IgM antibodies). That will be before I receive my next hep b shot.

-- Edited by beertastic on Wednesday 31st of May 2017 04:15:53 AM

Canuck · Guru

Yes, understanding what testing is done to simply determine your levels of "immunity" to B, and, in addition, understanding the testing parameters the docs look at that help determine whether you do (or do not) currently have an actual case of "chronic or acute B" (or perhaps a case of "resolved B" in the past), is hard material to digest.

It IS "complicated" (as you say Tig)!

Here is yet another pictoral example of a result that shows how many "varying" factors have to be taken into consideration to determine whether one is negative for a B infection, or might be positive for an acute or chronic B infection (or if one might have had a resolved B infection in the past).

As long as the patient is aware of the importance of ascertaining his "immunity levels" via immunity testing, and the importance of knowing whether he has been "tested for active B" before he is treated for C, then that is all a patient is required to do, to bring these subjects up with his doc, ahead of time, ask if these things have been determined by the doc, and go from there.

HBsAg, Anti-HBc, and Anti-HBs, even when tested for and known, can sometimes be "inconclusive" - that is why our docs need to make these judgements.

HBsAg	Negative	Interpretation unclear 4 possibilities:
Anti-HBc	Positive	1. Resolved infection (most common)
Anti-HBs	Negative	2. False positive
		3. "Low level" chronic infection
		4. Resolving acute infection

Tig · Admin

The purpose of innoculation against HBV is to impart immunity to the virus. If the vaccination protocol was effective and immunity is sound (proven), then it's unlikely to test positive for the surface antigen. HBV immunity can weaken over time (years) and a booster is sometimes required. If the immunity has weakened, then certainly, you can be infected and will test positive for the surface antigen. Immunity testing will provide the knowledge of current defense levels. It can be confusing.... smile

Hep B Antigens/Antibodies

HBV Surface Antigen

beertastic · Member

The first thing the doctor questioned about the report was whether they was such a thing as hepc genotype E. After discussing the hep c genytype E issue with the other doctors they contacted the lab only to find out that the patients identification number written on the report did not exist in the labs database. I repeated the HBsAg test and result was negative so I decided to go for vaccination that same day. I forgot to ask them about immunity testing but I'll do that for sure. My question now is that can a person become HBsAg positive after innoculation?

Canuck · Guru

Hi beertastic,

So, good!

You are being told to come back to have bloods "re-done" next week, to "verify" things - so, does that mean you are going to have a "PCR", (be "genotyped"/VL determined all over again)? I hope so.

Did your doc say anything about that curious "Hep E" result thing?

So, the lab the doc is sending you to, to have your blood tests re-done, would they not have known how to test you for your current levels of immunity to hep A and B there? I find that odd. Kind of a mute point now, being that you have already received the hepb shot - it is always good to know aforehand what types and levels of immunity you are actually lacking.

I also find it odd, that if you, or your doc, and no-one, knows (for certain) what immunity you may (or may not) have possessed (only revealed by having your A/B immunity levels checked) that he said to just go ahead and have only the B innoculations, without the A, the two usually accompany one another in the "A/B series" of immunizations. Regardless, be sure to complete the B series, now that you have started.

I guess, in the end, the reasoning holds, that it would not matter much if a person was needlessly "over-immunized" for B, and/or for A. (They "say" that any over-immunization can do no harm?). Paramount would be, that a person should be protected from any other infection, period, whether that be a another hep virus, or flu or otherwise, if they are currently disadvantaged with battling a hep c infection. If I could not have access to the benefit of "immunity testing", then I would opt to the safety of caution and err on the side of being over-immunized.

If you do end up requiring treatment for hepc, then (at least) you will know, for certain, that you have received some immunization for B, but it is always ideal to first know, what your actual A/B immunity levels were, prior to any immunization innoculations (to know if any are actually required), and then after innoculations, to know if you have actually succeeded in bringing up any inadequate levels to a protective level.

(At minimum) when a person is about to receive hepc treatment, docs have to test for B surface antigen, that is a must, so if and when your hepc treatment is imminent, then make sure that one is done.

I am glad you are pursuing the further testing your doc ordered and will gain more clarity for your situ. C.

beertastic · Member

The docs could not verify the authenticity of the viral load report with the lab where my blood samples were supposedly taken to so I was told to come back next week and repeat the test. My hep doctor told me to go ahead with vaccination so I received my first shot of hep b vaccine two days ago. Am yet to find a lab where hep a test can be done. Thanks for you concern once more.

Tig · Admin

Give it up, nothing gets by Canuck... Memory like super computer!

Canuck · Guru

Hi beertastic,

Prior, you thought you would be seeing your doc on the 18th? to see if you could get anymore clarity on your diagnosis (s)?

Did you indeed go and see him on the 18th? Did you get any explanation about your HCV status, or, find out what your GT is, or, figure out what the ref to hepE is? What did he say?

Did you go for immunization to hepA/B (on your own), or did you ask this doc to test your A/B immunity levels?

Just curious. I hope you saw him and got some answers. smile C.

Canuck · Guru

Hi beertastic,

Thanks for sharing your history.

My, you have been through a lot. You did well getting your schooling done, despite all. Very good you are proactive and pursued your health issues and got tested for HCV.

We are all seeing some questions here, and we will have to continuing pursuing all the bits of info, until you have a more definitive picture and direction. I am glad you are finally going to be able to see this hep doc fairly soon - that should help to firm up many things and start providing better answers.

One more thing (in your last post) stands out to me, that makes me wonder whether your cousin IS or IS NOT a carrier of B - your cousins B status remains unknown, she may not be a carrier of B, and no risk to you, not anymore so than anyone else is a risk to you - the "3 injections in her arm" could simply be her receiving a standard series of A/B immunizations. It is possible that she once had, in the past, a case of hep B - but that does not seem to be known for sure (and even if she did, it is possible she could have cured it all on her own, with no treatment - a "spontaneously naturally resolved" case of B, and she could have gained immunity to B that way, just by enduring that infection and it successfully resolving itself to give her natural immunty). "Natural" immunity gleaned from having a "spontaneously naturally resolved" B infection, OR, B immunity gained by "vaccination" to A/B, can wane over time. Being tested for current immnuity levels to A/B, that in itself can show the current need for a series (of 3) innoculations for A/B immunization (or re-immunzation, as the case may be). Her 3 injections may have just been them bringing her immunity levels up to a protective level. Just the same dilemma you are now facing, trying to ensure you obtain immunity to A/B.

In North America, generally patients have the right to access (or get access) their own medical records, by one way or another. Not always easy, but one's records (test results, lab results,etc.) really, for all extents and purposes, belong to you (in theory), thus they should ultimately be available to you, by law, if you request them. We have various methods to do this here, that have to be followed, forms to fill out or such, but other than that, getting copies of info is possible. I don't know what it is like in your country. Where I am (and it seems similar near around) I can simply walk into my family doctors office and request a paper copy of any tests I have had done with him (that he has the results of, in my file). Alternately, any distant hospital or testing facility I have to go to, to get some imaging done for instance, I can also make a written request for that info right at that facilities medical records dept. and they will mail me whatever I have requested, either just a written paper copy of the interpretive "report" of the imaging I have had done, or an actual CD of the images, and the report. Others in N. America know how to receive their own records that they want, on-line, a service they can just sign up for. I'm not good at on-line stuff, but just some food for thought for you, going forward.

You will have a lot to discuss with your doc, just to get the basics covered, and your condition further (better) defined. Confirm your diagnosis(s), find out your genotype and sub-type, ask what drug choices may be considered for you, and how long it may take to get treatment, ask if you can have your immunity levels for A/B checked to know what immunizations you require. Inquire if you need a flu shot as well. Good you had the U/S, ask if you can have a fibroscan.

Hope you are not feeling too bad at the moment. Hang in there, keep working at it - you will know more soon. smile C.

beertastic · Member

Thanks Canuck. As far back as I can recall I started having severe brain fog in 2011 but I suspect this was linked to the many hours I spent on my PC writing computer codes and also fiddling with gadgets. I was getting very little sleep at that time. During that period I didn't have sufficient sleep for over a month or so. There were days I spent approx 20 hrs on my pc then took about an hour nap at abt 4-5 am then continued from where I stopped as soon as I woke up. A friend came to visit me one day and we decide to go over to his house. When I left my PC that day I felt severe pressure in my head as I walked on my feet. At times it felt like everything went blank in my head. This problem however, resolved itself in the matter of days. Year 2011 the brain fog relapsed and was far more severe this time around and accompanied by series of migraine, impaired vision especially at sunset, hearing impairment, lower back ache, vertigo, the problems where many I cannot recall every one of them. At some point I even had to carry an umbrella around because I could barely withstand the sun rays reaching my head. I started visiting a psychiatrist were I was place on carbamazepine. The situation did not get better. I gained admission into college in 2012 but again went down with chronic depression so I decided to visit the school's teaching hospital where I was referred to a psychiatrist. The psychiatrist placed me on carbamazepine and sertraline which had side defects but those health symptoms I have mentioned disappeared one after the other. Prior to being admitted into the school. Medical checks were carried out by the school and blood tests were done. I can't recall whether hepatitis screening was on that list too. During the course of our degree program we lost three of our mates. One of the cases was hepatitis. The fellow told us he had been diagnosed with hepatitis. He stopped attending school months later then a news came circulating the he passed away. Another one was a case of swollen abdomen which I also suspect to be hepatitis. After these two case the thought of getting tested and receiving hepatitis vaccine kept lingering in my mind. Few months after I completed my degree program I started having fever, chills and abdominal pain. My health began to deteriorate badly so I decided to move over and stay with my parents. I also I started having severe diarrhea, chronic fatigue syndrome, and even passed blood along with stool. Series of test I did at the hospital showed that nothing was wrong with me. The thought of getting vaccinated against hepatitis occurred to me gain so I decided to go for testing. When the results came out I discovered I was hepatitis c positive.
Talking about the liver function test. The result have been stored in the hospital's database for doctors use but no copy was given to me. Currently I do not know how long it takes for people to get treatment here. Its been four months since I was diagnosed. The last time I went to see the doctor, the HCV RNA quantitive pcr result wasn't ready so the doctor told me to come back after 30 days. I told her the result would be ready in less than a week but she still insisted on the 30 days appointment. So far she has only told me about how much it costs to get treatment for 12 weeks. As for my cousins hep B issue I recall she mentioned receiving three shots in the arm or so. She came to know about her hep b case when she started having severe chest pain and headache.

Canuck · Guru

Hi again beerstatic,

Thanks for the additonal info, I know it is not always easy to clarify things, when all of us do not necessarily know if we have ALL the data we need to think things through.

Like Tig, I am wondering a bit about this hep E situ too. I can only assume you have tested postive for chronic hep C (by your postive PCR result of "2664 copies/ml", AND, that addtionally, there is some result that actually says you are also positve for hep E?

I do not clearly understand your pcr result, it seems low ... you wrote ... "HCV RNA quantitaive by real time pcr shows 2664 copies/mL, 720 Units/mL, Log 00, 18 LOD (IU/ML), HCV Viral Genotype E."

Here is a sample of conversions from "copies/mL to Log" - so, why does your result say "Log 00", when (about) 2512 copies/mL = 3.4 log?

Log10	copies/mL
3.1	1,259
3.2	1,585
3.3	1,995
3.4	2,512
3.5	3,162

That is a curiosity, as well as the E issue, unless there is such an animal as a "sub-type" E.

As you said you have only been immunized for pneumococcal so far, you should also think about getting influenza immunization.

You say the only hep B test you had, was to check for the Hbsag, which was negative - so you have no "hep B surface antigen", which may only tell you you that may not right now have an active case of hep B, but that test does not tell you whether you possess any existing immunity to hep B, that would be a different test (to check for any current levels of A and B immunity). The only ways you can possibly gain any immunity to B is by either having hep B at one time and successfully spontaneously (naturally) resolving it yourself, or, by way of being immunized for hep B. Being that you say you have never been immunized for B, and if you have never actually had a case of hep B in the past, then quite probably (if your blood was tested for A and B immunity levels) you may indeed find you have no immunity to A and B.

I have read suggestions that "it will do no harm" to be immunized (or re-immunized) to A and B (even when it is not really needed) - people get re-immunized sometimes (in error) not recalling they had been immunized before (and because their existing levels of immunity were not tested) beforehand, and "they say" being "over-immunized" does no harm, but as the whole series of A/B immunizations usually come in a series of 3 shots along a very specific 6 month timeline, it is an investment in time and effort - it's best (under ideal circumstances) to know whether you really need it aforehand based on immunity level tests, and, it's also good to be re-tested along the way (during the 6 months) to know how much measurable immunity you have gained against hep A/ B as a result of the shots. If one does not actually have their A/B immunity tested, and then (in error) they are "over-immunizing" a person, then (in my book) this would be preferable to not having immunity to A/B and just not knowing it.

I never received any immunization for A/B prior ever. When I was diagnosed with hep C, my immunity levels for A/B were tested, pre-treatment, when it was determined that I had no immunity to A and my immunity to B was too low, my 6 month A/B immunization series was started just before hep C treatment commenced, and it progressed through the treatment for my hep C. My A/B immunization was not entirely completed prior to my hep C treatment - but right from the first A/B shot, it affords some protection.

Just on principal, if you have a liver infection such as hep C, you should try to be protected from any other infection, whether that be hep A/B, pneumoccocal infections or influenza, or even the common cold for that matter!, so, it is good you are alert to this - it's your call, if you are only days away from seeing your hep doc and asking for your hep A/B immunity levels to actually be tested, you could ask him for this and know if you need the shots. If you get immunized for A/B (on your own) starting tomorrow, then it may have no harmful effect, if you are "over" immunized, but it could be waste of time and effort too, over the next 6 months.

Do you have any idea how long it takes for people to actually get hep C treatment in your country?

You should ask your cousin if she had to be treated with anti-viral drugs to be cured of her hep B, and, ask her if she knows whether she is a "carrier" of hep B, or not, as I am gleaning you are worried about being exposed to her.

Do you happen to know any other blood test results, "liver function tests" (LFT's), sometimes called a "liver panel", will usually show ALT/AST/bilirubin, etc.?

Do you have any idea how long ago you might have contracted hep C?, sometimes people never know or get it figured out

C.

beertastic · Member

Its midnight here already. I will go for vaccination tomorrow morning. Thanks for all that information. 18th of this month I hope to know what hep C genotype it is.

JimmyK · Guru

Again, Greetings.

My Doctor is rather well thought of in the field. He as well as my Insurance insisted on A and B vaccines prior to treatment. I did it and am still here. So far so good and all that. LOL

JimmyK

beertastic · Member

Thanks for the info JimmyK. I've continued to educate myself about hepatitis in general ever since I got my hep C positive result. I'll leave the genotype issue to the doctor. My major concern at the moment is to be sure that receiving Hep B vaccine while am still positive for Hep C will not cause me any harm as the health care providers have been insinuating then I will talk to the specialist about the matter. If they still deny me the vaccine then I will find other means of getting it.

-- Edited by beertastic on Tuesday 9th of May 2017 05:21:11 PM

-- Edited by beertastic on Tuesday 9th of May 2017 05:24:05 PM

JimmyK · Guru

Greetings.

Here is some information for you.

"A pilot survey of hepatitis C virus (HCV) infection in Nigeria was carried out on healthy adult blood donors and children of preschool age. Sixteen of 200 (8%) donors were positive for antibodies using a second generation enzyme-linked immunosorbent assay (ELISA) but all of the children were negative. Supplementary testing of the ELISA-positives using a recombinant immunoblot assay (RIBA-2) confirmed the presence of antibody in four and two others were indeterminate. Four of the anti-HCV-positive sera and one found positive by ELISA but which was negative by RIBA-2 were found to be positive for HCV RNA using reverse transcriptase-polymerase chain reaction (RT-PCR) and primers specific for the 5' untranslated region (5'UTR) of the HCV genome. The NS5 and core regions also were amplified and the PCR products from all three regions were sequenced. Sequences from the 5'UTR could be divided into two groups: one group comprised three isolates with greater than 95% sequence identity with published sequences of genotype 1 and the other comprised two isolates with greater than 93% sequence identity with genotype 4. Analysis of three sequences amplified from the NS5 region confirmed this assignment to genotypes 1 and 4. Pairwise comparisons of the NS5 region sequences with representatives of 1a, 1b, 1c (for the first group) and 4a-4h (for the second group) show the first group to include subtypes classifiable as 1a and a novel sequence and the second group to include a novel sequence within genotype 4. Sequence analysis of the core region was consistent with this interpretation. These data confirm the presence of at least two major HCV genotypes in Nigeria (genotypes 1 and 4) and we report two novel sequences which have been designated provisionally as genotypes 1d and 4i.

Genotypes of hepatitis C virus in Nigeria. Available from: https://www.researchgate.net/publication/14386295_Genotypes_of_hepatitis_C_virus_in_Nigeria [accessed May 9, 2017].

JimmyK

beertastic · Member

I also questioned that when I saw the result but I was told to take the result to the doctor and hear from the doctor. When I go to see the doctor on the 18th of this month the I will understand what they meant better. If it was a mistake the doctor will still tell me. The hep C test was done at a different hospital so the Hep C positive report couldn't have been wrong. I was referred from that hospital to a different one where am currently seeing a specialist.

Tig · Admin

Could you explain what you mean by Genotype E? There is no genotype E, but there is another family of hepatitis known as Hepatitis E virus. If you have your paperwork, look at those results again and confirm what it says. I have never known anyone here that had HEV. It normally resolves on its own. Here's a link to that info: Hepatitis E

beertastic · Member

I've never been immunized for A or B. My arrangement was to get tested then recieve shots of vaccines. I ended up receiving meningococcal vaccine only. They refused to give me hep B vaccine for fear that it may cause other unpredictable problems. The tests conducted were Hbsag and Hcv. Hbsag was negative while Hcv was positive. HCV RNA quantitaive by real time pcr shows 2664 copies/mL, 720 Units/mL, Log 00, 18 LOD (IU/ML), HCV Viral Genotype E. Abdominal USS result: The hepatobilary system, pancrease, and spleen appear within normal limits. Both kidneys are normal (not too sure what was written there) in size, outline, shape and position with good corticomedullary differentiation.They measure 9.5cm x3.5cm and 10.2cmx4.8cm on right and left respectively. There is increased intraluminal gas, with more seen at the epigastric region. The other person I talked about is a cousine who is currently staying here in my parent's house until she completes an exercise which has been mandated by the govt. for all college graduates. The exercise normally lasts for a period of six months and is aimed at exposing college graduates to work environments so as to equip them with skill neccessary for finding a job after school.

-- Edited by beertastic on Monday 8th of May 2017 11:05:53 PM

-- Edited by beertastic on Monday 8th of May 2017 11:20:13 PM

Canuck · Guru

Hi there beertastic,

Sorry to hear you found out you have hepc.

We can try to help with questions.

Are you sure you have definitely received confirmation that you do indeed have chronic hep C?. Do you already know what your genotype is (GT1,2,3,4,5,6)? And do you already know what your viral load count is?? What other lab work have you had done - do you know the results of any of your labs or what the ultrasound report said?

Maybe you have not had all the testing done yet.

Have you ever been immunized for hep A or B?

Often (part of a hep C pre-treatment work-up and lab testing) involves testing your blood for any existing levels of immunity for hep A and hep B, to see if any past immunization (you may have had) to hep A and B, are still high enough. You might have already had your blood tested to see if you currently hold enough immunity against both hep A and B, but, maybe you have not been tested for any existing immunity, it hard for us to know what lab testing you might have had done already.

Sometimes people can gain immunity protection against B, not by being routinely immunized when they are in a normal healthy state, but instead may have gained some immunity to B by way of actually having been sick with B at one time. Some people who have actually gone through an acute case of hep B, can naturally resolve the infection all by themselves (without treatment), they recover from the B infection "naturally", do not become "chronic" carriers of B, they do no require tretament and cannot infect anyone, and soley because of their prior successfuly "resolved natural" infection they have gained immunity to B. They already hold B immunity (antibodies) because their bodies (luckily) naturally and spontaneously resolved their B infection on it's own.

The trick though is, knowing "how much" immunity you hold, to know whether you are protected from contracting an A or B infection, regardless of whether you may have gained that B immunity as a result of immunization or via previously having a case of hep B. This is why this standard A/B immunity level test should be done (during work-up/before HCV treatment) to measure "how much" immunity you hold.

If a recent test did show you are already sufficient immunity to B, then you might not need to be immunized (or re-immunized) for B at all. Even if the test showed you were immune to B, you still have to know you are immune to A as well.

But you should have this hep A/B discussion with your doc again (and review any past immunizations you may have received) with him. ASK if your hep A/B imunity levels have already been tested. You should also review with him any other immunzations he might consider you could need, such as influenza or possibly pneumoccocal.

Hep A/B, influenza or a pneumoccocal infection is unwanted when one already has an hep C liver infection going on. We do not know if your partner has had a successfully resolved case of B (is not a carrier), nor do we know if your partner has chronic B, and could possibly expose you. You and your partner should both present yourselves to the doc, and discuss all your infection status's with him. (That's what my partner and I did) - we were both brought "up to date" on any immunizations we needed, and became aware of who could possibly be of risk to the other another. Just like your partner with a history of hep B, would not wish to get hep C, you need to be protected from B as you already have C. And neither you (nor anyone!) needs flu or pneumonia on top of anything else.

I (personally) would argue (strongly) for immunzation (especially B) prior to or at least at the start of your hep C treatment, IF YOU INDEED KNOW (by immunity testing) that you do not have sufficient immunity to B.

Do you think it will be a short time or a long time before you will be able to get hep C treatment?

I hope this info is of some help. C.

beertastic · Member

Started feeling very sick towards the end of my program in school. I decided to get tested for Hep B/Hep C and the Hep C test turned out to be positive. Right now am really bothered about health care the providers i've been sicking advice from telling me to wait until am treated before recieving Hepatitis B vaccine. Currently am living with a person who has a history of hep b infection an this is really getting me worried. The specialist doctor told me medication for hep c will cost me the equivalent of $1700 in our local currency for a 12 weeks treatment course which is huge amount of money in my country. A person earning $158/month in my country would be considered to be earning a reasonable pay. It's already four month since I was diagnosed. I don't know how long it will take before I get treatment but they keep telling me not to take the vaccine until I recieved treatment. 18th of this month I'll be going to see my doctor with my VL and USS test results. Any advice please?

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