Despite recommendations that pregnant women have tests for certain sexually transmitted diseases, many may not be getting them, a new study suggests.

Researchers found that of nearly 1.3 million U.S. women who had blood work done during pregnancy, only 59 percent were tested for Chlamydia — a common STD that can cause pregnancy complications or be passed on to newborns.

That’s despite the fact that experts generally recommend pregnant women be screened for Chlamydia.

In addition, 57 percent of women in the study were screened for gonorrhea — a test recommended for some pregnant women.

The U.S. Centers for Disease Control and Prevention (CDC) says that all pregnant women should be tested for Chlamydia at their first prenatal visit. The American College of Obstetricians and Gynecologists (ACOG) has said the same since 2007.

As for gonorrhea, the CDC and other groups recommend screening for pregnant women who are at increased risk. that includes women younger than 25 and those living in areas of the country where gonorrhea is common.

“As our study shows, there’s a significant gap between the recommendations and actual practice,” said Dr. Jay M. Lieberman, who is medical director for infectious diseases at Quest Diagnostics inc. and worked on the study.

Quest is a diagnostic testing provider that operates labs throughout the U.S. The company offers STD testing and funded the new study.

Since not all pregnant women are advised to have gonorrhea testing, it’s difficult to tell whether the 57-percent rate in this study is appropriate or not, according to Lieberman.

However, he said, even women who should be screened, based on guidelines, are sometimes not. Of pregnant women ages 16 to 24, 69 percent were tested for gonorrhea, the researchers report in the American Journal of Obstetrics and Gynecology.

Screening plays an important role in catching Chlamydia or gonorrhea because both STDs often have no symptoms, Lieberman pointed out.

“These two infectious diseases are easy to diagnose, and easy to treat and cure,” he said.

But without screening, Lieberman added, many cases will be missed.

If left untreated, Chlamydia and gonorrhea can cause pelvic inflammatory disease, which can lead to infertility or an ectopic pregnancy — a dangerous condition in which the fertilized egg grows outside the uterus.

Both STDs can also infect the baby during childbirth. Chlamydia can cause eye infections or pneumonia in newborns, while gonorrhea can lead to joint infections or serious blood infections.

A limitation of the current study is that it’s based on pregnant women who had blood tests done between 2005 and 2008. and during those years, screening guidelines were in flux; the ACOG recommendation came out in 2007, for example.

“Clearly, this is still evolving,” Lieberman said. But, he added, “there’s also no evidence that screening rates have improved.”

A 2009 CDC study, for example, found that only a minority of U.S. women who should be screened for Chlamydia actually had been. Screening is advised not only for pregnant women, but for certain other at-risk groups — like women age 25 or younger (see Reuters story of April 16, 2009).

Exactly why some pregnant women are not tested as recommended is unclear. “Our data don’t speak to that,” Lieberman said.

For some women, access to prenatal care is a hurdle, he noted. But the data in this study all came from women already in prenatal care.

Lieberman suggested pregnant women talk to their doctors if they have not been tested for STDs or are not sure if they have had testing. other STD tests done during pregnancy include ones for syphilis and HIV.

Sometimes, Lieberman noted, women are put off by the suggestion that they have STD testing. “But doing these tests is not a judgment on them or their behavior,” he said. “We’re just trying to do what needs to be done to make sure you’re healthy and your newborn is healthy.”

According to the CDC, about 100,000 pregnant women in the U.S. are infected with Chlamydia each year. Just over 13,000 have gonorrhea.

As mothers, all we want is for our kids to be happy and healthy, right? And I think it’s safe to say that we’d do pretty much anything in the world to ensure their well being and safety, even if it means putting ourselves in harm’s way.

A woman in the U.K. named Sarah Brook was put to the ultimate test when she had to choose between possibly saving her own life or saving the life of her unborn baby. When she was six months pregnant with her daughter, she got the devastating news that she was battling bowel cancer. She’d been suffering from back aches and morning sickness, which are two symptoms that can typically be attributed to pregnancy — and she was no doubt shocked when she learned that she actually had a life threatening disease.

Sarah was faced with a gut wrenching dilemma when she had to choose whether to start chemotherapy and risk the life of her baby, or to delay treatment altogether in the hopes that her child might live.

Ultimately, she decided that the life of her baby was more important than her own, so she put off chemo and wound up delivering her baby girl, Polly Jean, premature at 27 weeks. 

The baby is now 4 weeks old, and her condition is improving — and odds are good that she will go on to lead a full and happy life. but sadly, 32-year-old Sarah is nearing the end of her fight. the cancer has spread to her lungs, pancreas, neck, and intestines. And this is a battle she knows she isn’t going to win. Doesn’t that make you want to break down and cry? This is seriously one of the most heartbreaking and unfair things I’ve ever heard of a mother having to go through.

Holding her tiny baby in her arms and knowing that she won’t live to see her grow up is beyond devastating. but at the same time, I can’t help but feel inspired by her selflessness and her incredible love and devotion for her child. I mean, the thought must have crossed her mind more than once that delaying her treatment may cost her the ultimate price, but she still chose to put the health of her child above her own survival. if that doesn’t speak volumes about the level of unconditional love in her heart, then I don’t know what does.

Knowing her time with her baby girl is running out, I’m sure she’s savoring every single second she has to cuddle her, smell her tiny, perfect little head, and tell her how much she loves her. This little girl may not remember her mother growing up, but hearing the story of the incredible sacrifice she made will remind her of just how much she loved and cherished her — even before she was born.

I only hope that Sarah can find some peace in the fact that she saved her baby’s life, and that her legacy will live on in her daughter forever.

What would you do if you were faced with a decision like Sarah’s?

Image via Family O’Abé/Flickr

I remember the first time a friend told me she was using the birth control injection, Depo-Provera. she lamented that no matter what she did to lose weight, she seemed to be gaining. and it gave her mood swings. But, hey, at least she wasn’t overweight and moody from being preggers! (Though you would think with symptoms like that, you might as well be!) well, now research has gone and found another lovely side effect of the birth control shot: a 50 percent higher risk of breast cancer.

Women who used the shot of synthetic hormones for at least a year had double the risk of getting breast cancer, according to the study published in the journal Cancer Research. Family history, obesity, age, and pregnancy history didn’t seem to make a difference. Creepy, no?

There is some silver lining: Users’ risk dropped to that of non-users after several months of being injection-free. Plus, risk is low to begin with in younger women — like those in their 30s (1 in 233, according to the National Cancer Institute) — who tend to be the ones on Depo.

But here’s my Q … have they studied the long-term effects that do linger? there are plenty from certain types of birth control pills (vaginal dryness, gallstones, low libido), so I wouldn’t put the same past the shot. especially because the fake progesterone in the shot is the same used in the postmenopausal hormone therapy pill, Prempro, which was shown to boost women’s risk of breast cancer by 24 percent.

That finding plus this new one just serve as further proof that women need to be very cautious about using any drug made with fake hormones. It’s clear the body simply doesn’t know what to make of them, and they are prone to throwing our super-individual, delicate lady hormone balance off. even the maker of the drug, Pfizer, notes that women have to consider the “benefits and the risks” of their birth control. and if they’re admitting it, you know it’s true!

Does this study freak you out?

Maine is aging faster than any other state, with 16 percent of our population 65 years and older. we also hold the title for the highest number of residents seeking treatment for opiate addiction. when you picture someone addicted to prescription pills, typically a senior citizen doesn’t come to mind. but there are an alarming number of older people in Maine who are battling this very addiction. Experts say it’s not so much about abuse, but more about the misuse of the drugs. Joy Hollowell has a special report on why a combination of the two is cause for concern. ==== “On average over the course of a year, someone 65 years of age or older takes 20 or more different prescription drugs,” says Len Kaye, Director of the UMaine Center on Aging. Mixing them with alcohol or homeopathic remedies, the wrong combination of pills, or even taking them at the wrong time, can lead a senior to become addicted to drugs. “Unfortunately, older adults probably are at greatest risk of not using drugs as directed because they don’t ask all the questions that they need to ask when they see their doctor,” says Kaye. Certain prescriptions, according to Kaye, like sleeping pills or anti-anxiety medications, wave a red flag. “This class of Benzodiazepines is really a group of drugs that we should be very, very worried about because older adults are prescribed them left and right and you really shouldn’t be on them for long periods of time, longer than 8 weeks,” he says. “And folks are on them for years at a time.” “We’re estimating between 10% and 20% of seniors over the age of 65 are addicted to either drugs, or alcohol or both,” says Lee White with the Eastern Area Agency on Aging. White says pain is a very real symptom for older Mainers. “There can be losses, there can be challenges, there can be loneliness,” says White. “And sometimes, there’s pain. and so the basis often times when dealing with addiction is, what do you do with your pain?” according to the State Office of Substance Abuse, those 55 and older make up 9% of Mainers who misuse prescription drugs. “This is really about an access issue,” says Guy Cousins, Director of the State Office of Substance Abuse. “So any age group is vulnerable to that.” Experts say it’s easy to miss the signs of senior addiction. It’s not uncommon for older people to see several doctors at the same time, and symptoms of addiction can be misconstrued as early signs of dementia. “Older adults who misuse or who are dependent on drugs, are far less visible than individuals who abuse alcohol or drugs,” says Kaye. “They are less likely to be involved in legal complications resulting from taking these drugs.” even family members can be in the dark. “It’s an epidemic now,” warns Kaye, “and it probably will be more so in the years ahead, because guess what, we have 76 million or so baby boomers now entering into retirement and those are folks who have consumed more alcohol on average, and in particular, taken more prescription drugs than any other previous generation of older adults.” ==== There is help available for seniors, care givers or family members who are concerned about addiction. Office of Substance Abuse Information and Resource Center 1-800-499-0027 maineosa.org Emergency Hotline 1-888-568-1112 Eastern Area Agency on Aging 1-800-432-7812

The Bay Area is the epicenter of a liver cancer epidemic. there are more cases of liver cancer in Santa Clara and San Francisco counties than anywhere in the United States.

Largely caused by hepatitis B viral infection (HBV), liver cancer is lethal. According to the World Health Organization, it kills nearly 750,000 people each year. The five-year survival rate after diagnosis is just 15 percent.

The good news is that most cases of liver cancer can be prevented. there is an effective and safe vaccine for HBV that the Centers for Disease Control and Prevention and WHO call the first “anti-cancer” vaccine. HBV is also easily diagnosed with a simple blood test. The challenge is to educate, test and vaccinate as many people as possible, especially those at greatest risk.

HBV, which can appear in either chronic or acute form, is responsible for 80 percent of liver cancers. HBV is called a “silent killer” because most people with chronic infection often have no symptoms. By the time they realize they have the disease, it is too late for effective treatment. sometimes people only find out about the disease when they are diagnosed with liver cancer. Untreated, HBV can also lead to cirrhosis and liver failure.

HBV is transmitted much the same way as HIV/AIDS. it is only transmitted through blood or semen, but it is 100 times more infectious than HIV. it cannot be transmitted through casual contact.

No one is immune, but liver cancer is especially prevalent in people from Asia and the Pacific Islands. The statistics are staggering. Asians and Pacific Islanders make up 4.5 percent of the U.S. population but account for more than 50 percent of chronic hepatitis B cases. recent immigrants are at greater risk. Two-thirds of those infected are unaware that they have HBV. Many acquired the virus at birth from mothers who were unaware they were carriers.

In Santa Clara County, where an estimated one-third of the population is of Asian descent, approximately 35,000 live with chronic HBV. A quarter of those with chronic HBV will die from liver cancer.

The Stanford Asian Liver Center and Stanford Health Library have scheduled “Understanding Hepatitis B and Liver Cancer,” a program featuring Stanford physician Stephanie Chao, M.D., 10 a.m. Nov. 5 at the Clark Center auditorium on the Stanford Medical School campus. Admission is free and open to the public. to register, call 498-7826.

Interested in learning more? Visit Stanford Health Library for books and additional resources, in both English and Chinese.

A good place to begin is “The Liver Disorders and Hepatitis Sourcebook” (McGraw Hill, 2006). Author Howard J. Worman, M.D., professor at Columbia University, covers the broad topic of liver disorders, so there is much more in the book than the focused discussion of HBV and liver cancer.

The value of this book is in Worman’s clear, reader-friendly explanation of liver function and things that can go wrong with the liver. An excellent chapter on viral hepatitis begins with an explanation of viruses in general before he delves into the specific types of hepatitis, including hepatitis B. A similar book is the “Cleveland Clinic Guide to Liver Disorders” (Cleveland Clinic, 2009).

A new book, “Hepatitis Essentials” (Jones & Bartlett, 2011), provides a concise overview of viral hepatitis. it is written for clinicians but is of interest to many consumers. with contributions from some of the world’s leading hepatitis experts, this book covers all aspects of prevention and management of the disease.

An action plan that both describes the problem and prescribes a solution, the National Academy of Sciences Institute of Medicine published a report in 2010, “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C” (Institute of Medicine for the National Academies of Science). The report makes a strong case for stepped-up vaccination efforts, a public education campaign and increased resources for prevention and treatment, as HBV infection is increasing nationwide. it explains that few among the populations most at risk seek testing or information on how to protect themselves from infection. it is valuable reading for those who want to understand the issues better.

Stanford Health Library has a large collection of books on HBV and liver cancer written in simplified Chinese. The library also carries DVDs.

Stanford Health Library is free and open to the public in five locations: Stanford Shopping Center, Stanford Hospital, Stanford’s Cancer Center, the Taube Koret Center for Jewish Life and the Ravenswood Family Health Center. For more information, call 725-8400, email This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or visit healthlibrary.stanford.edu.

Nancy Dickenson is head librarian at Stanford Health Library.

 1 Comment 1Commentat Thursday, 20 October 2011 09:12by JP where did you get the statistics for the liver cancer? How do you know it is caused by the virus? What about the radiation coming from Fukushima? Please substantiate. Post Comment

August 03, 2011 12:15 PM Eastern Daylight Time 

DUBLIN–(BUSINESS WIRE)–Research and Markets (researchandmarkets.com/research/68be38/2011_annual_report) has announced the addition of the “2011 Annual Report on Prostate Diseases” report to their offering.

Prostate disorders usually develop after age 50, but some men experience them at a younger age. the three most common conditions are prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Although they share some of the same symptoms, they are very different. Treatments vary, too. For example, two men with prostate cancer might opt for treatments as divergent as radical surgery and doing nothing at all. Even getting screened for prostate cancer, which seems like it would be a no-brainer, requires thoughtful consideration. That’s because most men usually feel compelled to undergo treatment if cancer is diagnosed often without knowing for certain whether the cancer would ever cause problems during their lifetime. By doing so, they risk complications like impotence and incontinence that can dramatically undermine quality of life.

whether you are considering medication for BPH or erectile dysfunction, or debating between radiation therapy and surgery for prostate cancer, you need to review your options carefully. this report, which provides an objective assessment of the risks and benefits of various procedures, can help. more than a primer on the most common prostate conditions, this unique publication includes summaries of that latest research, roundtable discussions with experts at the forefront of prostate cancer research; assessments of different therapies from Harvard Medical School doctors; interviews with patients about their treatment decisions; and physicians’ answers to questions posed by patients. it also includes helpful tips on managing and treating erectile dysfunction and impotence caused by prostate disease therapies.

Prepared by the editors of Harvard Health Publications in consultation with Marc B. Garnick, M.D., Clinical Professor of Medicine, Harvard Medical School, and Hematology/Oncology Division, Beth Israel Deaconess Medical Center.

Key Topics Covered:

• a year of advances and breakthroughs in prostate disease
• Monitoring prostate health
• Prostate enlargement (benign prostatic hyperplasia)
• Inflammation of the prostate (prostatitis)
• Prostate cancer: What you need to know at every stage of the disease
• Erectile dysfunction and urinary incontinence
• Take charge of your condition

For more information visit researchandmarkets.com/research/68be38/2011_annual_report

I know that the air pipe is filled with mucus(right?!) but what does tuberculosis trigger? No symptoms please!!!!

well you get this little calcifide granulomas nodules deposite particles deposited in the low part of the lungs and that starts to affect the way you breath and you start to get sick.But remember know a days there are a lot of medicine that helps to fight illness like isoniazid.always remember if your in a closed enviroment and someone is sick cover your self to protect you from contamination.just with a little droplets in the air and your at risk of infection.

When I was pregnant with Abby, I did a bunch more screening that I either opted out of or didn’t have available when I was pregnant with Penny. I remember being amazed: new tests from amniocentesis or CVS are becoming available and affordable so rapidly that a gap of just 22 months can mean significantly different tests. Medical researchers are creating and refining these tests, but other researchers are looking at another angle: what ethical questions do these tests lead us to? will parents treat a kid differently if we have fuller knowledge of our kids’ risk for genetic abnormalities or diseases? A recent study says that more information, earlier, is a good thing so far, but many patients still resist the tests — and though that’s not how I roll, I understand why.

The study in question, published in Pediatrics this month, studied some 2,000 moms at hospitals in North Carolina and looked at their reasons for deciding whether to have their newborns screened for Fragile X, a genetic disease that can cause mild to severe mental retardation. relatively few moms opt for this screening, which can be done pre-conception (to find if the mom is a carrier), in utero (via two different methods), at the baby’s birth, or later in the child’s life, say at age 3 or 4, when symptoms begin to appear. when it was offered as part of a newborn screening array, about 63 percent of moms agreed to find out if their babies could be affected by Fragile X, with a higher percentage of African-American moms opting out. The upshot of the survey was that while most parents do want to know if their kid might later turn out to have an issue such as Fragile X, many are happy to choose not to know, and their reasons range from a mistrust in the medical establishment to worries that they’d treat their children differently. That’s pretty interesting. but what’s more interesting is who did the study and why. Dr. Debra Skinner, Ph.D., who is one of the study’s authors, works for the Center for Genomics and Society and the Fragile X Research Center at the University of North Carolina (Chapel Hill). She’s part of a growing field of scientists interested in ELSI research — the ethical, legal, and social implications of these kinds of genetic tests. As they get more detailed, cheaper, and less invasive, what do these tests mean for moms, and who gets the final say on what the test results mean? “before long,” she says, “you’ll be able to get your whole genome scanned for pretty cheap, and it could be that we won’t even need the newborn screenings — we’ll be able to identify everything. and that opens a huge can of worms. do you want to know if your baby has an elevated risk for Alzheimer’s 40 or 50 years down the road?” but the tough questions aren’t reserved for the future — they’re popping up now, too. now that it’s easier to find out if a child is a carrier for Fragile X or will be affected by the syndrome, moms need to figure out how much they want to know. Skinner has worked with families that have four Fragile X kids before they realize they have a genetic predisposition for the syndrome. That can lead to a huge load on a family’s resources — both financial and emotional. “We work with many Fragile X families for years, and by far, the overwhelming answer when we ask is ‘we wish we had known before we had children,’” she says. “The trouble is, they love the children they have, but they might not have had those children if they had known. So you see where the problems arise.” A lot of parents who opt not to have their newborns tested say they’re worried that they’ll treat the baby differently, but according to Skinner, that’s not a concern. “at first, it’s a surprise, but people take in the information and use it to adapt to the situation and then quickly get measures in place to help their child,” she says. That might include advocating for their kids who need specialized services, making choices about whether to have more kids, or just avoiding endless rounds of doctor visits to find out why their kid is having health problems.

For the record, I did almost no genetic testing on Penelope, because I was just that desperate to spawn. when Abigail rolled around, I did all the tests I could — though I worried about the risk of miscarriage — because I had a family who would be impacted by a special-needs baby in a different way. I’m grateful that I didn’t have to make any kind of tough choice, and the experience has almost eliminated the judgment I might make on anyone else who had to do so — no matter what her choice was. would you test for an incurable condition? when would you want to know if your kid had something like Fragile X? ?

Image via Image Editor/Flickr

By Joseph Brownstein, MyHealthNewsDaily Contributor

A new study of influenza and air travel shows that passengers seated in the two rows either in front of or behind someone with the flu are at greatly increased risk of getting the flu themselves ? almost half as likely to become infected as the people who are seated next to the sick passenger.

Australian researchers found a “splash zone” of sorts ? within two seats, in any direction, of an infected passenger ? while studying flu infections that spread aboard two large airliners that entered the country during the swine flu pandemic in May 2009.

There was an increased risk of 3.6 percent for passengers sitting within two rows of someone with flu-like symptoms, the researchers said. that jumped to 7.7 percent for those within two seats on either side of the infected passenger.

“The closer you are to an infectious person, the higher your chances of becoming infected yourself,” said study researcher Paul Kelly, an epidemiologist at Australian National University in Canberra. “This is especially the case on long-haul flights,” those lasting more than four hours.

Researchers hope the results will help officials make better decisions when it comes to screening travelers to avoid the spread of not only influenza but other infectious diseases.

Governments should “screen and stop symptomatic patients from flying,” Kelly said.

For travelers who are worried about an infected seat neighbor, Kelly had the following advice: “Change seats!”

He added: “If you have a mask, wear it or suggest your neighbor wears it. Wash your hands, and avoid touching your own face to minimize the chances of spread via that route.”

The two flights studied had a total of 738 passengers, and 319 of them responded to the surveys. the researchers also used databases with reports of the H1N1 flu virus to find additional cases. However, they acknowledged there may have been more flu cases they did not obtain information on.

At least eight passengers on one flight, which left from Los Angeles, had flu-like symptoms at takeoff. Shortly after landing in Sydney, 2 percent of tested passengers on the plane had confirmed cases of H1N1, and there may have been more unreported cases.

The other flight, which arrived in Sydney from Singapore, was not suspected of posing a problem because Singapore had not yet reported any cases of H1N1. One passenger had flu-like symptoms before takeoff, and two others developed them in-flight. Only one of those three passengers was tested later, and that person did not have H1N1. Shortly after the plane landed, however, a child on the flight was found to have contracted H1N1.

The researchers said a major obstacle to warding off epidemics comes with delays in flu symptoms. Five of the nine infected passengers did not show signs of flu when boarding the plane.

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“It’s these people who are asymptomatic who may be the most troublesome, because they’re harder to find,” said Brian Coburn, a research scientist who does mathematical modeling at UCLA. “They’re going through life without awareness that they’re infected yet.”

Coburn, who was not involved in the study, and the Australian investigators emphasized the importance of screening, particularly of passengers seated around a person known to be infected. that might include the need to contact them after the flight once an infection is discovered.

“It’s that one person that actually gets away that could actually cause a major outbreak in an area,” Coburn said.

Coburn said the results of the study are in line with previous projections of how influenza spreads on an airplane. (Coburn and colleagues made one such projection during the swine flu pandemic.) so there now seems to be a way to try to determine the spread of other infectious diseases, such as avian flu and tuberculosis, if they emerge.

“If you have the data on a virus … for airborne diseases, I think this is an excellent framework for people to follow with other diseases,” he said.

More from MyHealthNewsDaily:

• 10 Medical Myths that just Won’t go Away
• 7 Foods you Can Overdose On
• Myth or Truth: 7 Wonders of Cultural Health

I had sex with a guy for like three minutes (what a joke) and I'm not sure if he came on me, or if it matters. he has hep C and i'd like to know some symptoms.
there was no protection and I understand the fail there.

hepatitis c is usually transmitted by blood not sex.BUT sometimes it might happen when your genital organ is bleeding.
the major symptoms :jaundice, hepatalgia .
the most important thing is that hepatitis c is the most harmful kind in the hepatitises . In the meanwhile , it can cause the liver cancer .
So you have to check your blood in the hospital.

Hepatitis C is not usually transmitted via sex. the exceptions occur where there is contact with blood during sex.
In male to male sex, this is most likely to happen during prolonged or rough anal sex or fisting, where tiny tears in the anus or rectum might occur. Men who are HIV positive are at increased risk of contracting hepatitis C through sexual contact with other men.
It really doesn't sound like you two did enough, for long enough, for you to be at any risk at all. him coming on your skin, or inside you, is not in itself a risk for hep C transmission.
It is very common for people to have hepatitis C for 15 or 20 years without any symptoms, so there is no point in you even thinking you can tell whether you were infected by how you feel now.
Even when people do have hep C symptoms, they are so common and potentially caused by so many other conditions, that it is impossible even for a doctor to diagnose on symptoms alone. They have to do a blood test. Symptoms include tiredness, flu like symptoms, nausea, muscle pains and indigestion. Everybody in the world has some of these, some of the time.
However, since you had unprotected sex, there may be a risk for HIV or other sexually transmitted diseases. it would probably be a good idea to get tested, and while you're there, then they can do a hep C test as well.

Hep C is NOT transmitted through sex. Unless the girl is on her period and bleeds on the guy then theres a small chance. it has to be blood to blood contact. I have Hep C it has no symptoms…sometimes my liver hurts a bit but thats it. it takes 4 months from the date of infection for it to show. You have absolutly no reason to worry but if you are then wait 4 months and get a test.