Got my blood work back today. Negative Hep B titer

[seizurecrow]

I'm looking forward to getting another 7 month hep b series

I wonder what impact this'll have on my immunization deadline.

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[gyngyn]

I'm looking forward to getting another 7 month hep b series

I wonder what impact this'll have on my immunization deadline.

As long as you keep trying, it will be extended. I'm sure student health will be able to advise you.

 

[Law2Doc]

It's a pain, but still better than getting hepatitis.

 

[ramifications]

There will always be a fraction of class batch that will have to do this. You're not alone. I wonder that since it is much easier to get HepC, maybe we should be administering hepc vaccine since that is now available. What are the thoughts on that?

 

[Gastrapathy]

An HCV vaccine would be very big news. Unfortunately it doesn't exist.

 

[NeuResurgens]

There will always be a fraction of class batch that will have to do this. You're not alone. I wonder that since it is much easier to get HepC, maybe we should be administering hepc vaccine since that is now available. What are the thoughts on that?

I think I was required to get Hep C for all my medical jobs.

 

[ramifications]

An HCV vaccine would be very big news. Unfortunately it doesn't exist.

recent work is under way and I believe that this year especially there was a good talk about its creation and successful clinical trials: http://www.ox.ac.uk/news/2014-11-05-new-vaccine-generates-strong-immune-response-against-hepatitis-c

It's super cool, wishing that it comes out and becomes available. Would be a huge safety for healthcare workers.

 

[Gastrapathy]

What successful clinical trial? 15 volunteers with t-cell response, no proof of actual immunity, no assessment of genotype-specific response, no large-scale safety data . This is miles behind the HIV vaccine literature. You wrote that this was "available"which is only true if you stole it from their lab or were enrolled in the upcoming phase 2 trials (and are an IV drug abuser since they are the ones getting HCV now).

Plus, the funding will disappear now that there is an effective cure.

 

[ramifications]

What successful clinical trial? 15 volunteers with t-cell response, no proof of actual immunity, no assessment of genotype-specific response, no large-scale safety data . This is miles behind the HIV vaccine literature. You wrote that this was "available"which is only true if you stole it from their lab or were enrolled in the upcoming phase 2 trials (and are an IV drug abuser since they are the ones getting HCV now).

Plus, the funding will disappear now that there is an effective cure.

The 15 healthy patients were able to clear HCV virus out of body in correlation with individuals that were infected and subsequently cleared naturally. I think that whether T or B cell are involved, it is really promising because if it works, we can have actually have use of early screening for the disease and in eventuality a cure. I don't think that this is a small feat since HCV and HIV are similar in the fact that they are so many serotypes of each.

 

[ramifications]

When I got my needle stick my intern year, I said a silent prayer of thanks that my titer had been checked.

Is this a rookie mistake that happens rarely or something that most interns experience once in their lifetime? Just curious to know.

 

[Law2Doc]

Is this a rookie mistake that happens rarely or something that most interns experience once in their lifetime? Just curious to know.

It's not a rookie mistake so much as bad luck. When you have tired people working with needles some minority percentage are going to stick themselves. I wouldn't call it rare, but it not something that happens to everyone either.

 

[Law2Doc]

I think I was required to get Hep C for all my medical jobs.

That's dedication, unless you mean the vaccine. 🙂

 

[ramifications]

It's not a rookie mistake so much as bad luck. When you have tired people working with needles some minority percentage are going to stick themselves. I wouldn't call it rare, but it not something that happens to everyone either.

wow thanks. I understand and on top of that difficult patients can really make carelessness occur out of no fault of the handling physician or nurse.

 

[Gastrapathy]

15 healthy volunteers. You aren't listening. Do you wash dishes in this lab or something?

You can quote this post in 5 years when the first trials come out showing a marginal benefit and some demyelinating events.

 

[ramifications]

15 healthy volunteers. You aren't listening. Do you wash dishes in this lab or something?

You can quote this post in 5 years when the first trials come out showing a marginal benefit and some demyelinating events.

dude they are doing clinical trials in the US that are said to be conclusive on whether or not the treatment can go into effect. The britain test trial was just the beginning...no need to be rude as a troll. And what would a dish washer have any info or stake into backing this lab's finding? They wouldn't be marginally equipped to start a baby experiment...let alone do electrophoresis on their own. Jeesh.

 

[ramifications]

I would like to say that I was exhausted, or it was the middle of the night, or something similar. It was not. I was changing out a line on a very sick gentleman, it was the middle of the day, and I had not been on call the night before. I had all the proper equipment. I just struggled getting the Keith needle through the skin, and ended up plunging it into the pad of my thumb all the way to bone. Yes, it was a solid needle, but again (without going into too many details) this guy was very sick.

It was the only time I ever went through the occupational health clinic. I elected not to do any HIV prophylaxis, and the patient did come back negative. Nonetheless, I had a wife and kid, and it was still very stressful.

In answer to the original question, I have lost track of the number of times I have been poked, cut, scraped, etc. We work with heavy duty hardware, and broken bones are as sharp as knives. It is rare that anything breaks the skin, but it does happen once in a blue moon, even with doubled gloves. I don't worry about it. I am fully immunized, in a monogamous relationship, and I get an HIV test annually.

What line of field are you working in? Ortho? Just curious. Glad you came out of it alive.

 

[ramifications]

Ortho.

Hollow needles. I'm scared of hollow needles. I'm extra careful with any injection or aspiration.

off topic: I've worked with a horse needle before (not really meant for a horse but for something completely different). I was laughing at the gauge and how painful it must be to stick that bad boy. Fancy a horse would want that?...not really.

 

[Gastrapathy]

dude they are doing clinical trials in the US that are said to be conclusive on whether or not the treatment can go into effect. The britain test trial was just the beginning...no need to be rude as a troll. And what would a dish washer have any info or stake into backing this lab's finding? They wouldn't be marginally equipped to start a baby experiment...let alone do electrophoresis on their own. Jeesh.

Why am I arguing with a premed?

Dance recitals are boring and I'm on call so the wife isn't too irritated by my phone use.

You're new to medicine, so these preclinical advances seem exciting. You will see over time that the vast majority don't pan out. It's ok. The overwhelming enthusiasm is endearing.

Look at the percentage of phase 1 drugs that make it to market.

HCV is cured. gilead and abbvie have won (for now).

 

[Khaan]

It's happens. Hep B vaccinations often go through phases of increased/decreased serum antibodies, and some just fail (like mine). Really, you should only need to get a single booster, unless a booster didn't take, before doing a whole new series. Did your provider think a whole new series is really indicated?

 

[ramifications]

Why am I arguing with a premed?

Dance recitals are boring and I'm on call so the wife isn't too irritated by my phone use.

You're new to medicine, so these preclinical advances seem exciting. You will see over time that the vast majority don't pan out. It's ok. The overwhelming enthusiasm is endearing.

Look at the percentage of phase 1 drugs that make it to market.

HCV is cured. gilead and abbvie have won (for now).

If there weren't premeds such as me, we wouldn't be so inclined in research. This is a research very close to what I have been doing so I think I speak for myself and not some premed kid. A professor of mine said the same thing as you are saying, it's a high flying idea. I think that clinical results are looking promising and if this works, it should be made a requirement in the work place. Of course this can take over 10 years to actually become available.

 

[Gastrapathy]

So now you want to restrict my liberty and require me to be vaccinated for a low risk curable infection. HCV treatment is short, effective and well tolerated. It will be better and cheaper in 10 years. Why would we vaccinate at all?

 

[Inventor of Post-Its]

...Well this thread has gotten off track, but I had a negative hep B titer as well and have to start the series over again. I never heard why the doctor advised the entire series instead of just a booster, but maybe it had to do with the fact that my levels were so low as to be basically nonexistent. Student Health was actually surprisingly relaxed about it - I think it's more common than you would expect.

 

[ramifications]

So now you want to restrict my liberty and require me to be vaccinated for a low risk curable infection. HCV treatment is short, effective and well tolerated. It will be better and cheaper in 10 years. Why would we vaccinate at all?

lol your dance recital event must really be stretching you, but then I really like to type instead of yap with ppl in real life. The fact is that at most hospitals it is a requirement to get HBV vaccinations too. That is fairly short too and it is less complicated than the HCV vaccine. If you don't have a problem with that, why should you have a problem with the HCV one? after all, it's there for your protection. I agree with prevention rather than cure. That approach can save certain symptoms from acting up. Say that you are a physician who doesn't realize after a blood spurt that they have hcv and you find out after some side effects take place. Would you rather be the one with the vaccine already or taking tons of pill regiments to keep yourself at bay? I don't know why you wouldn't want to be safe. If you like to go for the regiments, I'd rather not want to be trained by someone who considers hcv to be so miniscule of a disease that it isn't considered a big health hazard.

 

[Gastrapathy]

I'm not dancing. My kid finished 88 minutes ago but we can't leave.

HBV treatment is rarely curative (<5% SAg conversion over long followup). Treated patients on antivirals require lifelong therapy and monitoring, all pts have increased risk of hepatoma, and interferon doesn't really work except on test questions. It's a totally different risk benefit calculation.

to address the other question, boosters are out of vogue because you have to recheck titers. If they redo the entire series, no recheck for immunity. Don't ask me to explain it.

 

[Gastrapathy]

You know what's funny? I didn't find out about the cure until I saw a commercial on TV.

Now just HIV and herpes and we can go back to the free love era. Too bad I'll be old, fat and married.

 

[ramifications]

I'm not dancing. My kid finished 88 minutes ago but we can't leave.

HBV treatment is rarely curative (<5% SAg conversion over long followup). Treated patients on antivirals require lifelong therapy and monitoring, all pts have increased risk of hepatoma, and interferon doesn't really work except on test questions. It's a totally different risk benefit calculation.

to address the other question, boosters are out of vogue because you have to recheck titers. If they redo the entire series, no recheck for immunity. Don't ask me to explain it.

I believe the reason why boosters are not used is that by protocol they don't trust you got vaccinated if you don't have immunity. Because of a high health risk in hospitals, most employees that have low immunity go through the shots again. Again, I agree with that and think it is for your own protection.

hmm interesting about the HBV logistics. Does the treatment for hepC also require lifelong therapy and monitoring?

 

[ramifications]

Oh c'mon, don't sell yourself short. Statistically-speaking, you should get a new wife at some point in the future.

haha...is that really the life we want to lead? Again my sympathies for them keeping you well over an hour for dance recitals. Good thing you didn't invest your kid on golf, that would have been a pain to go through tourney

 

[Gastrapathy]

Only HCV patients who require followup after cure are the ones who are already cirrhotic or transplanted.

Low risk to get. Easy to treat. Not going to be much interest in a vaccine.

Glory be, we are leaving.

 

[NeuResurgens]

That's dedication, unless you mean the vaccine. 🙂

You know what I meant 😛

 

[allantois]

lol your dance recital event must really be stretching you, but then I really like to type instead of yap with ppl in real life. The fact is that at most hospitals it is a requirement to get HBV vaccinations too. That is fairly short too and it is less complicated than the HCV vaccine. If you don't have a problem with that, why should you have a problem with the HCV one? after all, it's there for your protection. I agree with prevention rather than cure. That approach can save certain symptoms from acting up. Say that you are a physician who doesn't realize after a blood spurt that they have hcv and you find out after some side effects take place. Would you rather be the one with the vaccine already or taking tons of pill regiments to keep yourself at bay? I don't know why you wouldn't want to be safe. If you like to go for the regiments, I'd rather not want to be trained by someone who considers hcv to be so miniscule of a disease that it isn't considered a big health hazard.

Why are you arguing with a GI on Hep C?

 

[ramifications]

Why are you arguing with a GI on Hep C?

I had nothing better to do, what do you expect? Plus I got a lot out of this conversation; probably the best resource to pick a brain of.

He probsbly thinks he's winning, too

lol don't these conversations all come out to be a competition? I still don't believe we shouldn't be vaccinated for hcv given once it is available. I mean people have treatments for the flue like taking cold medications and what-have-you but why should we get vaccinated for it each year?