A Disturbing Study regarding other routes of transmission

[DoubleDose]

I will post a link to a study that I just read which relates to one of my more hypothetical HCV transmission concerns.  I will not draw any conclusions, or follow the logic from their discussion, as I usually might.  In this case I will suggest that after browsing the article, that everyone read the discussion very closely.  I think the issues raised are potentially very contrary to common beliefs about HCV, and are in line with many of my concerns about 'other modes' of transmission.  The lymphotrophic aspects of this virus raise the possibility of infection in cells and tissues other than strictly serum related cells.  I will be curious to see the follow up studies. You can form your own questions about the potential for some sort of transmission.

Here is the link:

http://jcm.asm.org/cgi/content/full/43/9/4413

Any thoughts, or concerns from our forum members on this study???

I think the discussion is extremely noteworthy and provocative.

DoubleDose

[moahunter]

Do you think if a Hep C infected person spits on an open wound of another person, that person could get Hep C? Hmmmm - I don't know. Not sure if saliva can be such a big deal, given the spouse studies, but who knows with this disease.

[moahunter]

I sort of hope this study gets buried - not sure it will help heppers for people to know that their salivia carries virus (if that is what this is saying). This would add even more confusion I think.

[Willy50]

Interesting study.  I'm no scientist...... but it would appear that they are suggesting that HCV can be spread thru rather mundane oral transmission........in theory.

Now lets look at practice;  IF this were easily transmistted through saliva......I think that there would be many many more cases of HCV than there are.  Sexual transmission seems a rather inefficient manner of transmission (via hetersexual, non anal, and restricting during menses) one might argue that that transmission rate is often considered less than 1% to nil.  When one considers that more kissing occurs than intercourse (am I out of touch here?) you would think that there would be many more of us infected than there are.

Like sharks that reproduce without one of the opposite sex...... this theory may very well be possible but very very uncommon.

Conclusions:

Just in case...... since hetersexual sex has been proven to be safe, it may be prudent to skip kissing entirely and instead replace it with intercourse as a means of social greeting.

For those who insist on carrying on with kissing...... the well worn condum in the wallet should be replaced with carrying a fresh roll of saran wrap when contemplating serious macking.

While the study didn't address tears since they too often have HCV RNA there should also restricted as well things that may invoke tears such as unhappy thoughts,. many country songs, chick flics or cooking with onions unless proper protective gear is worn.

Yes, I'm joking a little but once when searching on the subject I read that there are no known cases of HCV ever being spread by a kiss.  One would think that given the frequency of kissing that there might be a case or two to point to.

The absence of evidence is not the evidence of the absence?

Interesting theory but I hope and think that such transmission is very uncommon.

Thanks

Willy

[Lady Lauri]

I dunno on this one, and certainly won't help our case as per the ignorance of the public, etc. Have to re-read this one in AM, when less foggy. And too many studies showing otherwise ?? (asking!) Too many of us have had spouse's, kids, etc that have been with us years, us not knowing we had it and no transmission and so few couples have been proven to have passed thru sex, and who really nows if  those weren't also doing risky behavior along with the sex, etc.
   An example...I was in the middle of dental work when got dx'd. The man I was dating had root canal @ same time, actually some work the same day! He tested when I found out, and I had him do it again. Twice negative. That and 8 yrs. dating. My VL was in millions at one point.
Hope this becomes a buried, not correct study also.

If there is any studies showing VL transmission higher with higher VL loads, etc. as per couples, I'd like to see them as I don't buy that all too much either. The couples together for years had to be having sex through out high/low VL's and so on.

LL

[Lady Lauri]

Hit my post and you beat me too it!

.....Just in case...... since hetersexual sex has been proven to be safe, it may be prudent to skip kissing entirely and instead replace it with intercourse as a means of social greeting...................

LMAO....and that's all I'm saying, LOL

LL

[cruelworld]

i think that small amounts of hcv are probably everywhere, easily transmitted
and in 30% of the population. just like herpes of the face. this is what the study would seem to indicate

and in these minute quantities of hcv, the human immune system keeps it at bay
just like herpes. this is evidenced by all the svr's, who still carry a minute amount of virus but it remains dormant or suppresed. heavy drug and alcohol users and others who have an impaired immune system are subject to this dormant hcv manifesting itself and creating a viral load in the blood and therfore an active case. as we all already know, if a person is exposed to a high viral load through IV drug use or
blood transfusion, this is an exposure that your fully operating immune system usually cant handle and that heavy exposure usually creates an active case of hcv. and a large viral load.
otherwise small amounts of hcv within the human body remain dormant and are controlled by a properly operating immune system

a high exposure to the virus and or a suppressed immune system are almost always evident in most hcv cases.

fortunately or unfortunately,  the populations of this study are small and anecdotal. if and when they do studies of wider populations it will take on more meaning.

[R Glass]

it may be prudent to skip kissing entire

This changes foreplay to 2 thumps to the head

[charm27]

Thats too funny. I sure hope you turn out to be wrong.
Two thumps just aint going to do it.
:{ :{

[Trish77]

So instead of humping, it'll be thumping?  Sigh......seems more like some Klingon ritual.

[DoubleDose]

Bingo!  I think your reply was right on the money.  I also think that the virus is probably common in the population, but as you stated, kept at bay by the immune system, and it is also probably restricted to non-blood tissues in most people, thus not even provoking an antibody response in the blood.  This is why only a small percentage of the population would test positive, as we already know, for HCV, on blood/antibody testing.

There may be huge numbers of people out there with active, low level, HCV infections in salivary glands, sexual organs and fluids, etc.  These infections have probably been kept out of the blood by cellular immune responses, and thus 'kept at bay' and virtually 'inactive' by the body's 'cellular immune system' rather than the humoral immune system.  Thus, those infected in this way would for all purposes be considered HCV negative if we looked at their blood testing results using the standard HCV antibody testing. (but what happens when you conduct cellular immune testing for HCV in the tissues, fluids, etc?)

All of this ties into my (somewhat controversial)  theories regarding why many alcoholics become HCV positive, even though they have not been IVDU's or had transfusions in the past.  There may be a 'potential' for activating a 'cellular level' HCV infection into a 'blood' infection, and I think this subject is beginning to get looked at, and even studied by some researchers, and one leading HCV-focused Hepatologist.  I think we will learn some new things about this virus in coming years, and maybe like HPV, and HSV-1, we may find that the latent virus itself is more common in the population (in fluids and some tissues, maybe) than ever believed.  That will allow us to understand what NOT to do, as far as causing or activating a 'true' blood-borne HCV infection.

This study, as other studies looking at similar phenomena with HCV, just reinforces the fact that other cells and tissues may be breeding grounds for the virus, in addition to the more understood and studied blood and liver cell infections.

Heck, I don't even think that I am being controversial with these opinions anymore, in light of what the medical researchers are investigating and hypothesizing.  I am all in favor of figuring out completely how this virus lives, works, and does harmful things to us.

Thanks for all the follow up comments!

[Willy50]

Hey, although I was having my way with the study and having a little fun along the way I wanted to drive home a few serious points.  I didn't see any conclusions except a call for more investigation.  I don't want to make light of the study since it is serious, nor do I want to make light of things since I know that you still suffer from some sort of below the radar type issues as well as your family.  In your case, I too, would keep searching for answers.

What I fear is that in a case where the researchers drew no such conclusions about behavior modifications that the people who read the study......the laymen.....will indeed start taking measures before they are proven to be needed.  Perhaps reducing it to the absurd mothers who are afraid to have close contact with their babies, husbands and wives afraid to be intimate, or whether the whole lot of us cured ot not cured need to be rounded up and isolated.  Think of it; since even SVR'ed people still maintain some HCV RNA they are a potential source of the virus, eh?

I know it is not your intention to spread fear and I know that many of us may be able to "interpolate" : ) the study and take it with a grain of salt......(or a tear that contains HCV RNA) but frankly the world community doesn't or won't.  They will "error on the side of safety" and in my opinion the cure will be infinately worse that the potential of the disease.  

Take a read; this is the world that we also live in.  Last year a child with HIV was prevented from entering a swimming pool.  Here's another interesting read;

http://www.cbc.ca/health/story/2008/01/31/judge-hiv.html?ref=rss

"Judge probed for insisting HIV-positive witness wear a mask"

To recap; I see you as a scholar that is on the track of something real....but I want people to understand that if it were common that we would be seeing far more proof of the effects.  Human nature being what it is..... I fear the ignorant or OVER reaction to news, not the news or truth itself.  What I so often see is that when people don't understand something they end up creating a simplistic version of the story, or study or principle so they can wrap their head around it.

best,
Willy

[DoubleDose]

I understand where you are coming from, and agree.  What I am saying is that maybe with some study, they will find that many if not most people may have been exposed to the virus, as in Herpes, and HPV, and carry a 'dormant' version of the virus somewhere in tissues, or wherever it resides.  This would not single out or frighten people because large chunks of the population would all be in the same boat, and like Herpes, HPV, etc. the focus would be on developing vaccines and anti-virals, etc. rather than isolating or ostracizing people who might 'carry' the virus.  

Too many people out there have likely been exposed, if this theory holds true, and may either have ongoing cellular immune responses to the virus (which may even be absent, OR present in small quantities), and so, like HSV and HPV it will become a matter of fact, and people will focus on how to prevent anything more drastic from taking place .  I don't think we are talking about spreading alarm, or fear, because as you note, this latent virus, IF it Iturns out to be common in the population, is not seeming to cause any other problems, or blood/liver, chronic HCV infections, etc.....except, MAYBE....in some alcoholics...if this mode of infection is borne out to be real and common.  And again, if this ends up being as common as I suspect, there won't be anyone to hide from, or to isolate...most, or many at least, will have the same issues.

Thanks for your comments, and I appreciate your understanding where I am coming from on all of this.  I do have personal concerns as you have noted, and family related observations, that MAY eventually be explained by some of the new research and investigation.  I am still waiting for more answers, as we all are.

DoubleDose

[geterdone]

Well then while were at it here is a little something else to SWEAT about. Kinda relates back to the cat claw thing.

jasper

Hepatitis C virus replicates in sweat glands and is released into sweat in patients with chronic hepatitis C.
Ortiz-Movilla N, Lázaro P, Rodríguez-Iñigo E, Bartolomé J, Longo I, Lecona M, Pardo M, Carreño V.
Institute of Hepatology, Hospital Pardo de Aravaca and Fundación para el Estudio de las Hepatitis Virales, Madrid, Spain.
Hepatitis C virus (HCV) replicates in salivary glands of chronic hepatitis C patients and is released into the saliva, suggesting that HCV may replicate in other exocrine glands. The presence of positive and negative HCV RNA strands was demonstrated by in situ hybridization, and of HCV core protein by immunohistochemistry, in sweat glands and keratinocytes in healthy skin biopsies from 15 patients with chronic hepatitis C and 10 anti-HCV negative patients with chronic liver disease. Positive and negative HCV RNA strands were detected in 9.6 +/- 5.2% and 4.2 +/- 3.8%, respectively, of the epithelial cells of eccrine sweat glands. Core protein was detected in 6.0 +/- 3.93% of these cells. HCV RNA resistant to RNase digestion (encapsidated HCV RNA) was detected in 10/10 sweat samples from HCV-infected patients. Positive and negative HCV RNA strands were detected in 6.7 +/- 2.97% and 3.0 +/- 3.08% of the keratinocytes, respectively. HCV core protein was found in 4.5 +/- 2.76% of these cells. No HCV RNA or HCV core protein was detected in the skin biopsies from the 10 anti-HCV negative patients. In conclusion, HCV replicates in eccrine sweat glands cells and keratinocytes in healthy skin and is released into the sweat. Copyright 2002 Wiley-Liss, Inc.
PMID: 12376961 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/12376961?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

[geterdone]

Could it go full blown? probably not but it is not outside of the realm of things as with the above articale.
jasper

[geterdone]

Then again it may explain or extend the theorization as to why we get sores in or around the mouth and the riba rash when we first start treatment or there after and are the meds also going after the extra cellular body fluids and tissue that hold these +/- rna strands and when found the inflammation caused by the decaying of those virions sets off a chain reaction by our now pumped up immune system to rid itself of this decay caused by the inflammation which in turn surfaces on our bodies. Hum, who knows but are points to ponder.

Sorry, just a tangent here and having some fun between the two reference points.

Jasper

Although I can say one thing the time laps in the INF and just straight riba has brought out some nasty rashes here in the last couple of weeks.

[jmjm530]

Based on the above, and in spite of my SVR, I've decided to voluntarily quarantine myself from all human contact.

I have been known to kiss on impulse which I now know may have deadly consequences. But even if I could control that pesky kissing impulse, it now appears that skipping the kissing part also has a risk profile as I have also been known to sweat during sex, at least when performed under the summer sun.  Not to mention that my sweat has on occasion touched objects that others might touch and has no doubt even become airborne at times, such as on windy day which conceivably could land on someone''s open wound.or other novel HCV entry point.

BTW this is not a new study and I assume if something clinically relevant was in that study, we would have heard about it.

[sfbaygirl]

Jim,  I think you may need to wrap yourself in saran wrap, of course sweat could pour out the bottom....hmmm lol.  I also doubt you are going to find any woman that won't want to kiss first before doing the deed. Especially when it's the first time!  

RG;  Are you talking about thumping on the head with a club, like a caveman?  Wouldn't that be romantic!  Maybe after many years of marriage, a few thumps may do it, but no kissing?  LOL

I have kissed, hugged and had sex with hubby for 13 years. He doesn't have it. That is my study along with so many others here that have been married for up to 30 years and the spouse doesn't have it.  

[R Glass]

I was thinking about actual thumps but the clubbing may give it a more romantic touch. Especially if a few candles are lit to set the mood.

[DoubleDose]

By the way, we are NOT talking about having HCV, or GETTING HCV, as in typical blood borne/ HCV+ detectable chronic infection, from this oral, tissue, or fluid related route.  
What we are discussing, from the information in the article, is the potential for "harboring" the virus, or passing the virus on as a 'contained' cellular, or tissue based infection, which is kept out of the blood by the cellular level immune system.  Thus a spouse could have the salivary version of the infection, or sexual fluid/tissue infection, as transmitted by the partner's fluids, and the low level cellular level infection in these tissues would become isolated, latent, and totally under immune system control....because of its initial nature of transmission, and its non-blood entry route. Nonetheless, it would be a FORM of the infection, although of questionable danger.

Thus, the local, cellular immune system would prevent the infection from overcoming the blood, or humoral immune barriers, and would keep it from triggering a typical HCV infection.  Here's a bet for you:  I will bet that if all of the HCV+ or formerly HCV+ Forum members were to have their long term partners tested for evidence of ongoing HCV infection in salivary tissues, or sexual tissues...using the newer cellular immune testing methods (not a blood HCV antibody test)....I am betting you would see a good percentage of HCV positive test results!  In fact these sorts of spousal tests have been done on a small scale in the past, and have mostly proven to be positive, in result.  One well known Hepatologist is organizing a study to look on a larger scale at this issue, in family members and sexual partners.  I am again betting that they find lots of HCV+ tissues and fluids in these partners, and without ANY evidence of a blood borne HCV infection, or also without any HCV positive antibody tests from blood samples.

The reason would be just as described above.  This is a different 'mode' of infection, and would be contained, and isolated, at a cellular level, by a different immune system than the blood's immune system.  The ability to crossover this barrier would probably be very low, just like in SVR's, and spontaneous clearers.  Could it ever happen?  Theoretically you would have to think YES, under very specific circumstances.

You guys can make (nervous) jokes about the above issue, but the realities will come out whatever they are...and I do not think they are as dramatic, or hysterical as several of you make it out to be.  Just another piece of the viral behavior puzzle.  Let's wait and see what the follow up research bears out.

DoubleDose

[cruelworld]

if yall realized how many bugs and viruses you body harbors and is exposed to everyday
you would all go kill yourselves. try to resist the urge.

[geterdone]

I was making light of the two studies but also reflected back to a recent thread which hr clarified some points of interest to me at the time.

jasper

The 30% chance was only referring to the 1ml of serum investigated in the test. You could still have 3000 viruses in the non tested other part of the blood and also there will some be located  in the interstitial fluid - outside of blood vessels but also out side of the bodys tissues. that is at least 10 more liters of fluid where a virus can be, although the concentrations in this interstitial space should be less than in the circulation, since the virus is at least partly confined/blocked off  by the endothelium lining of blood vesels.
Note however that in the liver this otherwise fairly tight endothelial lining has numerous large holes (fenestrations)  - to allow better access of plasma components to the liver cells, that actually for this reason  come in direct contact with the plasma alongside the sinusoids, this way there is no barrier for viruses  in the liver capillaries at all.

HR - Surprisingly, the circulating or otherwise existing in the extracellular fluid virions are only of relevance insofar as they can reinfect new, uninfected hepatocytes , from the blood passing though the liver.

[DoubleDose]

By 'clinically relevant' I assume you mean those doctors that made the assumptions a few years back that HCV had no symptoms?  Or did you mean 'nothing clinically relevant', as determined by the doctors that felt that HCV in most cases was not 'clinically relevant' because 80% of the HCV infected population would suffer no problems in their entire lives from the virus?  Oh, I guess it could be either groups of doctors....I am now VERY reassured that it must not be 'clinically relevant', since the above doctors have not yet ruled on this entity.  Boy, and was I worried,...all for nothing!  Phew!!!!!  Guess that's that!

Thanks Jim for the always authoritative 'wrap up'.  I needed some clarity on this one.....

DoubleDose

[Myown]

I will bet that if all of the HCV+ or formerly HCV+ Forum members were to have their long term partners tested for evidence of ongoing HCV infection in salivary tissues, or sexual tissues...using the newer cellular immune testing methods (not a blood HCV antibody test)....I am betting you would see a good percentage of HCV positive test results
----------------------------------------------------------------------------------------
I agree with you 100% - on ALL of this.

[kcrandy]

here we go again.  i guess i will calll my local bio-hazard company and order my bio suit so i don't have to be responsible for my spit flying around.  we have gone from dogs, cats,birds.lizards,swimming pools to god knows what next.  i guess some one is already starting to invent the spit condom,  i would'nt want my spit being the culprit.  i wonder if i can still be a unick  ( bad spelling )...  the issue should remain on a cure and a test that does not take 20 + years to show up and cause the damge it has in the liver b4 said test reveals hcv positively!

thump, thump, thump    

[sfbaygirl]

I have read numerous posts of yours that proclaim celluar and occult HCV in family members. I tend to agree, this is possible. I too worry about all of this stuff.  Occult hcv is worrisome and I tend to worry about it as well.  But what studies or other info do you have to suggest that we can get HCV from saliva or cells.  Granted, I would be totally interested in knowing about this stuff. I have watched your posts for years now and you interest me, but I have to say that although I believe in those aliens and all that, how do we know this occult info is real?  I would love to know. I would love to believe you that this is all true, but we need some studies or info to back this up. I know you are adament that this is true in family members etc.  I would love to know if this were true of not....YOu convince me at times, others not....You are a smart cookie and I would love to beleve you on all of this.. If you can show us some empirical evidence, or even just some anecdotal evidence, perhaps I could believe you more....As I said, you are one smart guy and I would love to believe what you say is true.   Just prove it to us in a better way.

Linda

[DoubleDose]

I am really not saying that I think you can get chronic HCV blood/liver infection, per se, from saliva, sexual fluids, etc.  Just that there seems to be a real possibility, from the research evidence, that people MAY be able to transfer, transmit, or whatever, some sort of "cellular" viral infection, or tissue based HCV infection, or maybe ' viral inhabitation' through these methods.  I think this transmission does not cause a blood borne infection, but MIGHT 'set up shop' so to speak, in local tissues, glands, or fluids.  It seems very logical, especially if they continue to find reproducing virus in saliva, gastric fluids (the Gastro. specialists have published on this phenomenon), and lymphatic glands and cells.  If it reproduces in a fluid format (non- blood), and is transferred to another persons oral cavity, sexual organs, etc., then I do not see how or why it would NOT continue to reproduce, in that persons fluids, tissues, etc.  

I am not extremely concerned if this is happening, because the local cellular immune system probably prevents it from ever going into the blood, or into a systemic typical HCV infection....BUT...I would like to see further studies, to determine if there are or could be long term problems from a localized low level HCV virus.... problems like:  lymphoma, autoimmune issues from the constant immune cell reactions...inflammation...tissue degradation... migration into other tissues, etc.  

I still believe that I can observe many so called 'extrahepatic' symptoms in my close contacts...and it always seemed to begin happening sometime after being with or around an intimate partner for awhile.  There may possibly be organ irritation, allergic type responses, autoimmune reactions taking place.  I am not 'hysterical' or extremely anxious about this observation, but am very curious to see what shakes out regarding this subject in coming years.  If I were a betting man.......  well we will have to see what the realities are as time goes on.

I still see no real reason to think this line of reasoning is 'way out there' as some members seem to 'freak out' about.  The researchers would not be running these studies if there were not good scientific reason to ask these same questions, and to look for answers.  I am somewhat put off by people who are so frightened of asking unusual, or atypical questions about the virus, that they automatically go into hyper-obnoxious, defensive mode.  For goodness sake, if the research is not valid, great! But, let's find out first!   But people who ridicule and mock an explanation or line of reasoning, seem to me to be very threatened at the prospect of uncovering something new...or discovering the truth.  I say, just deal with it.  

I appreciate your openness and candor about your reactions to my theories and explanations.  And I understand where you are coming from completely.  I don't ask anyone to take my questions as truths...but just to keep an open mind to the possibilities. More people should be asking these questions!  There are often more complexities to viral behaviors than most of us realize.  Science is still in the infancy of its understanding of viral and immune system behaviors.

DoubleDose

[sfbaygirl]

says, "I am not 'hysterical' or extremely anxious about this observation, but am very curious to see what shakes out regarding this subject in coming years.  If I were a betting man.......  well we will have to see what the realities are as time goes on."  I agree, I am curious as well.  As someone that has had extra hepatic problems, I to wonder about this stuff. I always was curious about your assumptions about the occult in family and cellular features of this disease.  I hope you keep on checking this out and letting us know what you find. I for one apprieciate your take on your findings, whether anecdotal or not.  Thanks for posting,  I look forward to any findings you have regarding this phenomea.  I to wonder about this....

Best to you,
Linda

[Mr Liver]

The presence of hcv RNA does not mean that infective virions exist in the body. This is another matter entirely. RNA is just one of many parts of the whole that is needed for HCV to complete its life cycle.

regards,
Mr Liver

[willing]

I'm fairly certain, but too lazy  to go on pubmed and confirm this,  that detection in saliva is not new. As I recall,  cells/tissues/fluids in which  hcv  has been detected include (at least) lymphoid cells, central nervous system, saliva, tears, vaginal fluid and sperm. Of course,  given the low titer, how realistic this is as a form of trasmission remains very speculative (but it's probably worth reading that Lancet '91 study to see how much saliva it took to infect the chimps - chimps are sloppy kissers on the best of days anyway).  

Personally, I think that Egyptian/NY study you posted a while back is much more disturbing...

BTW anyone interested in occult/residual virus should take a look at a recent paper from the Michalak lab on medscape:

The Michalak lab, which Pham works in,  has probably  been the leading lab in occult hcv research. For medscape, which is primarily a  continuing-medical-education site, to include their work on detection methods suggests that occult hcv  has now been accepted by the mainstream med community.

mrliver: this is true but, short of electron miscroscopy, there's just no way to count whole virions. PCR amplification of the 5'UTR of the HCV RNA (and of the - strand intermediate produced during replication) is the standard proxy for viral count, else why would people bother with vl tests?  (and they point out that "We found that results obtained from our in-house real-time RT-PCR method were well correlated with those from the COBAS AMPLICOR HCV MONITOR Test, version 2.0 (Roche Diagnostics, Tokyo, Japan)"

[willing]

I left urine and sweat off that list, eg

http://www.ncbi.nlm.nih.gov/pubmed/1329499

also I was curious about the chimp smooching and looked up  reference 1 from that paper. It's actually a letter to Lancet commenting on an earlier study that had found hcv rna in saliva. The authors point out they reported this back in '87.  As for quantity

" We analyzed the saliva from four chronic carrier chimpanzees. RNA was was extracted from 3mL saliva, reverse transcribed into cDNA..."  

3mL  is pretty intense drooling... Also

"HCV RNA was also detected in sera from a recipient chimpanzee inoculated with HCV RNA-positive saliva. Although our data are few, these results strongly suggest that  the saliva of patients with HCV infection is infective".

so they injected the saliva,  which seems like cheating (though it may be relevant to the sexual-practices threads)

[Trish77]

I'm glad that you note for yourself that your concerns are largely hypothetical.  I think that's pretty accurate.  The study you cite here says that there is only one other study that found positive evidence of HCV RNA in saliva and there were quite a few.  The interesting thing is that all the other studies found NO evidence of this and they did quite a variety of studies, including "throat washings" of children with HCV infection.  And yet.. they turn up nothing.  The one study that DOES turn up something is the one that studied gingival crevicular fluid.  And even in the study you are citing here, that is where, if it is found at all, it is most likely to be.

I read synopses of a quite a few other studies on this.  The one study noted that, because the other studies didn't put any emphasis on excluding the possibility of blood in the saliva, they went to extra methods to exclude the possibility of blood in the saliva they tested.  Their study found that there is no evidence to suggest that HCV RNA resides in saliva without the accompanying presence of blood in the saliva.

To say that saliva, in and of itself, contains HCV RNA is irresponsible.

The possibility of me exchanging my gingival crevicular fluid with someone else seems incredibly remote.  

It's certainly not out of the question....but incredibly remote.  Even more remote than me passing on HCV through monogamous sexual intercourse.

The medical community does not suggest that monogamous couples wear protection because of the huge body of evidence that demonstrates the low rate of co-infection between these couples...who also kiss more than they have sex.    

I think that a recommendation of condoms for our teeth is even more remote as a result.

Recently there was a study done here in Canada on the presence of HCV in saliva on crack pipes.  It was found to be positive in a certain number of cases.  The study was then summarized and presented in major publications that ONLY said that HCV was found in saliva of crack pipes.  The comments of people who were able to respond to the online article started asking if they could get HCV from sharing beverages or kissing, etc.  I was absolutely alarmed and particularly so when I went back to read the ACTUAL study and found that the reason the saliva on SOME.. not ALL...crack pipes contained HCV was because people who smoke crack get mouth sores and bleed. This fact was left OUT of all the articles which seemed to be copied from one news publication to another, leaving the impression that saliva, in and of itself, is a means of transmission.

Further study is warranted, yes.  But please be responsible with how you present your hypothetical theories, in what context and to whom.  The last thing the HCV community needs is an already paranoid public taking a remote possibility that hasn't been studied sufficiently and turning it into a probability.  


  

[susan400]

It seems to me that HCV may be even more like an immune system situation (similar to HIV), than what they even know about.  If, in fact, that theory mentioned about some people possibly caring it around dormantly in their bodies???  I just don't know....    Maybe the virus is an immune system disorder that concentrates on the liver?    Obviously, I don't know what I'm talking about and I should probably leave this to the experts.

Susan

[DoubleDose]

Again, you are confusing what I am saying, and are assuming that I am saying that the saliva (or other fluids) can transmit and cause HCV infection.  This is NOT what I hypothesized, or stated.  What we are talking about is an isolated, cellular, tissue based infection that never gets into the blood and never triggers a full blown HCV infection.  Please actually READ what I said, above.  Also, your statement that this is the ONLY study finding HCV in saliva and other fluids is not at all correct, and as several have listed and referred to above, there are numerous studies that have found evidence of HCV in a variety of bodily fluids, and tissues.  The Gastro.medical publication last year published a study demonstrating the finding of HCV actively replicating in gastric fluids, with no evidence of blood contamination.  Other studies have found HCV in saliva.  You missed my point though.  I said that this fluid contamination does NOT provoke an HCV infection, nor does it cause antibodies to HCV in the blood.  What it DOES do is to provoke a localized, cellular immune response that remains ongoing, and resides in the local tissues and fluids.  There have been a number of small studies regarding this 'cellular immune response to HCV' in close contacts, and the issue will undergo a full research study in the near future by a leading hepatologist.  The point is that nobody knows what the implications of this sort of 'infection' of tissues or fluids might be.
That is why we are discussing it.

I don't think we are going to spark any widespread riots or protests around the country by discussing this research issue.  Nor do I think people will begin shunning you because there is a discussion of fluid based HCV activity and the potential for cellular infectivity.  I sure made it out of the house intact today...no stone throwers out there.

DoubleDose

[DoubleDose]

Also, in reference to the sexual HCV issue, we know that it is rarely transmitted by sexual activity.  The studies are numerous.  They have frequently found, however, HCV in varying levels, in sexual fluids.  When this takes place, there may indeed also be an exchange of these fluids, which could also, as in the salivary situation, have the potential to 'set up' a localized, cellular/ fluid based HCV 'inhabitation', or ongoing 'infection' contained within the tissues and fluids only.  This would also probably never convert into any sort of true HCV blood borne infection, but could conceivably cause localized tissue, or organ issues or dysfunction.  This is where there needs to be additional ongoing study, and there needs to be more qualification of what this 'cellular immune response to HCV' that has been observed in close contacts means.  It is a less pressing issue than the life-threatening HCV blood/liver infection, but it warrants study nonetheless.  That is my belief at least.  I am not afraid to see them look at these issues.  I would rather know what the mechanisms of the virus really are, than try to gloss over threatening or atypical issues.

DD

[Trish77]

I will go back and read your comments more intensively.  A cursory read seemed to say to me that if there was HCV RNA in saliva it was then transmissible and infectious.  

You misunderstand me also.  I read numerous studies last evening that found HCV RNA in saliva.  They didn't clarify if that was due to the absence or presence of blood except for the one that expressly took effort to ensure that there was no blood present because they found that the other studies didn't do that.  

I was referring to YOUR study which cited other studies within IT...I clicked on the link for each of those studies where it said no evidence of HCV RNA was found and then clicked on the link for the one study where it WAS found..and I was only referring to the one study you posted and the references within it.

I'm not afraid to look at these issues either.   I make myself do difficult things all the time.  I've never been one to bury my head in the sand.  Indeed, I forced myself to read your article even though your topic makes me nervous.

I confess I don't completely understand all your terminology.  Perhaps that would be the case for other laymen reading it and they'd come away with the same impression, an erroneous impression.  Something to consider?

As for your comment about no stone throwers out there......I encounter people all the time who are nervous about how HCV is transmitted.  One of my male friends won't kiss me on the lips, for example.  I let him have his fears because he understands they are just that...HIS fears.  He's not stup  I also referenced that article in the newspaper for a reason.   Perhaps I was a bit heavy handed and I apologize.  However, I run into these kinds of things regularly and my concern was that persons would take a little bit of information and jump to the wrong conclusion.  Somewhat what you've suggested I've done with what you've presented.  

I will re-read your information.  Thanks for clarifying.

Trish

[jmjm530]

DD: By 'clinically relevant' I assume you mean those doctors that made the assumptions a few years back that HCV had no symptoms?  Or did you mean 'nothing clinically relevant', as determined by the doctors that felt that HCV in most cases was not 'clinically relevant' because 80% of the HCV infected population would suffer no problems in their entire lives from the virus?  
-----------------------
Actually, I meant "clinically relevant" per what was stated in  actual study you just posted:

"Further large-scale epidemiological studies employing real-time RT-PCR assays are required to clarify the clinical significance of HCV in the saliva and GCF, including the potential for viral transmission through exposure to these fluids."

Also, not sure what doctors you're talking about -- but the doctors I saw "a few years back" held neither of your stated beliefs and these same doctors had no such transmission concerns per the study posted, either back then or now.

Also, I'm curious, since you posted this article, why you seem to distance yourself from some of what the study suggests when you say to "Trish", above.

"Again, you are confusing what I am saying, and are assuming that I am saying that the saliva (or other fluids) can transmit and cause HCV infection.  This is NOT what I hypothesized, or stated.  What we are talking about is an isolated, cellular, tissue based infection that never gets into the blood and never triggers a full blown HCV infection."
-----------------
I say this because the study posted both (above) and in the abstract clearly talk about the possiblity of "transmission" which I read to be transmission of the virus and not your hypothesis, quoted above.

DD:
Thanks Jim for the always authoritative 'wrap up'.  I needed some clarity on this one.....
-------------
And thank you for your sarcasm, as I'm sure you appreciated mine as well.

BTW I have always appreciated your posts in this and related areas, but when someone posts a study like this, you should expect to see differing views. Probably sarcasm was not the best response my initial post, but re-reading it again -- it really does communicate best how I feel about this particular issue. Hopefully, you understand the sarcasm was not directed at you but at the subject material. I think we have gotten along reasonably well in the past in spite of differences of opinion on certain issue.

-- Jim

[sfbaygirl]

said"I will bet that if all of the HCV+ or formerly HCV+ Forum members were to have their long term partners tested for evidence of ongoing HCV infection in salivary tissues, or sexual tissues...using the newer cellular immune testing methods (not a blood HCV antibody test)....I am betting you would see a good percentage of HCV positive test results! "

That's a scary thought!  But it sounds like family members would have a different type of HCV....one that isn't that dangerous.  Hope so!

Sorry for the jokes, you know we like to have fun. It wasn't at your expense....just sort of was a topic to have fun with.  I know it's a serious issue and hope you didn't take my comments as making fun of you. You have some valid concerns about this.  

Linda

[TnHepGuy_]

Is this the Pham occult paper at Medscape you are referring to?

"Molecular Diagnosis of Occult HCV and HBV Infections"

Had you seen this mentioned on pg. 8 (General Characteristics of Occult HCV Persistence) ? ........... "Furthermore, the most recent investigation of six individuals with occult HCV infection documented HCV replication in isolated, mitogen-stimulated CD4+ and CD8+ T cells and/or in untreated B cells or monocytes from all individuals [Pham et al., Unpublished Data]. Interestingly, CD4+ T cells most frequently expressed HCV-RNA-negative strand."


And also this, on pg. 10 (Future Perspective)? ............. "The persistence of low levels of replicating HCV and HBV in cells of the immune system suggest that not only hepatic, but also lymphoproliferative disorders, could be the consequence of unapparent infections with hepatitis viruses. In this regard, upcoming research will establish the validity of the etiopathogenic links, while new antiviral treatments should aim to control, if not to eradicate, replication of the viruses in both the liver and the lymphatic system."


I also find this from pg. 11 (Conclusion) a rather interesting future prospect for SVR's and post-clearance individuals ............ "This approach should be combined with periodic (yearly) evaluations of liver-function tests, markers of HCC development and screening for extrahepatic, particularly lymphoproliferative disorders, in individuals with occult HCV and HBV infections. It is expected that with the introduction of more effective antiviral therapies, the burden of chronic hepatitis C and B will diminish and consequently occult infections could become the main epidemiological and clinical concern for which development of new preventive and therapeutic strategies might be necessary."



TnHepGuy

[willing]

tn:  yes, that's the article. Either the mh software stripped the url or, more likely, I failed to include it. Here it is again:

http://www.medscape.com/viewarticle/563337_1

It's interesting reading; these guys have been studying viral persistence for quite a while. In particular, this publication, including methods, should challenge some of the drs inclined to dismiss occult as sloppy-pcr/contamination to demonstrate that equivalent methods (eg PBMC stimulation "it has become evident that ex vivo stimulation of PBMCs with mitogens activating different lymphocyte subsets and monocytes significantly enhances detection of HCV and hepadnaviruses by augmenting their replication." ) *failed* to detect  HCV RNA.

Unfortunately, they don't yet seem to have adapted this research to the problem of viral resistance to tx: ie what do virions surviving at eot look like and where do they hang out.
There's an easl conference on this topic next week that may turn up some new results:

http://www.easl.ch/hepatitis-conference/

Also, a nice summary here:

http://www.vhpb.org/files/html/Meetings_and_publications/VHPB_Meetings/geneva2002/S2AP2%20Leroux.ppt

PS - in the midst of all this discussion about how widespread viral infection is, it's nice to see there are at least a few places that are *not* hcv-infected:

http://www.ncbi.nlm.nih.gov/pubmed/17935188

[DoubleDose]

The Medscape article and discussion is definitely cutting edge stuff, and describes a pretty atypical range of viral behaviors, and a frequent absence of HCV test detection of the virus.  The possibility of lymphatic infections, in the absence of blood liver infection is intriguing, and one of the possible profiles described.  Additionally, the evidence for ongoing HCV RNA replication in SVR's, in all locations, blood, liver cells, lymphoid cells, etc. is also pretty compelling and conclusive.  Having digested most of this article again, today, with a more clear mind than in the past, it seems to me that occult HCV may be a bigger problem, and present with a greater variety of profiles, than I ever imagined.  I do not think we should so quickly dismiss research like the 'Saliva" related study, in light of the Occult findings.  There may be more relationship among all these separate research undertakings than we currently realize, and the fact that someone can test negative on HCV antibody assays, or even normal PCR testing, apparently does not always mean HCV free, according to the Medscape article.  That dovetails with my take on potential salivary, or fluid based infections.  They may not provoke a positive on standard testing, but as in the occult cases studies, may involve a 'different' form of HCV infection, or just a case of isolated location, with a very mild, immune controlled version of HCV replication....which may be a better description than saying isolated HCV infection.

Lots of puzzling lines of question generated by the Medscape article, and  all warrant long term study and understanding.  I like the proposal that they made of using future antiviral therapies to control or maybe even eradicate some of these occult infections.  Maybe the SVR's demonstrating viral persistance (as they claim 100% actually do upon more sensitive testing) would eventually benefit from a more targeted, effective antiviral therapy when they are able to combine a handful of them, and really eradicate the remaining persistent virus.

Thanks for the links, and the good commentary.  I wish things were more simple, and clear cut, but apparently there are many little understood things still remaining with HCV, and I would like to see where it all leads.  Maybe it will prove to be a good thing...as far as more effective treatment, and even 'total cures'.  

DoubleDose

[R Glass]

very important Link

http://www.youtube.com/watch?v=CaLRcvzUyUY

[DoubleDose]

Where can I order one?

DD

[kcrandy]

if you say you are trying to create discussion and are just basing this discussion on a hypothesis, then ask others to research your hypothesis i am confused.  do you not believe that just the mention of hcv transmission routes could be caused by spit.saliva, whatever, would not make it to the public information highway, therefore leading those not infected to believe that hcv infected people are dangerous and society must know who all those hcv infected people are.  and have us ostersised as the hiv infected people were and still are. you might think i am just being a scinic, but the way things are going in society today i must be.  please explain to me in laymans terms how your hypothesis is going to help me.  

i apologizeif i appear to take this all personally but i do.  what would thrill me would be studies that show vaccines that kill hcv without almost killing the person taking them.  stem cell research that can reproduce a liver that someone might need.  a vaccine that can be given so the worries of getting hcv are non exsistant ( polio,small pox, etc. )..

am i asking for to much???

i know this group is for studies and research, but for hypothesis?

please help me to understand, am i wrong just a poor misguided soul who is lost and does not know the whys and whatefores.  i will stop if i am out of line here.


enough rambling i will check back later and see if anyone has an answer for me.

thanks..

[beamishboy]

research has proven conclusively that we are ALL gonna die-sooner or later.until that final day try and enjoy what ya got...

[jmjm530]

beamish: research has proven conclusively that we are ALL gonna die-sooner or later...
---------------------
Haven't seen any double-blind studies to this point, please post if you have.

[sfbaygirl]

I spoke with HR about your study and he agrees with you. Actually he told me that if all our spouses were tested for HCV in the lympathic system they most likely will have it!  He says the T cells somehow protect them.  I am not great with the medical language, but having it in the blood is different that the lymph system. So the spouses etc, don't have to worry about coming down with it. He also thought that the household transmission rate such as the cat claws, razors etc is more disturbing and a hazard to transmission.

[Mary4now]

Thank you sfbaygirl.  If possible could people identify their genome type and VL? Thank you, M4now

[sfbaygirl]

Not sure about genome, but genotype and VL can be tested with a PCR.  If you have this you want to know your genotype and VL, especially before treating.  

[Nomadpixie]

I have never heard of HCV being transmitted thru Saliva....We really don`t need scaremongering  storys like this....

http://hepcforum.co.uk/phpBB3/index.php

[Mary4now]

Ha right genotype.. I am 1 w/ 10mil viral load,  All blood tests and ultrasounds are normal, next is biopsy...

[DoubleDose]

If you go back and re-read the article, and the subsequent posts, you will find that nobody is saying that HCV infection is caused by saliva, but only that a different form of transmission may take place, and cause an isolated viral HCV " inhabitation" of some sort, in localized cells.

Read the post a few posts above yours, from sfbaygirl, referring to what HR said about this viral phenomenon.  Don't go off half-cocked, and over-reacting to what you read.  There is no reason to fear that the world will collapse if we discuss some of the newer and more unique findings regarding HCV viral behavior.  Are the researchers who have isolated and identified replicating HCV in various locations of the body long AFTER SVR "scaremongers"???  If they are, in your estimation, then you probably shouldn't be reading much on the Forum, because most of us are searching for the truth about HCV, not trying to 'smooth things over' or stick our heads in the sand.  These issues will become very clear over time through research anyway, so why worry.  There is no reason to fear finding out the realities of this virus.  That's my position anyway.

DoubleDose

[kcrandy]

first, why no response to my question???

what bothers me the most about this study is it has no purpose other than to say hcv might travel thru saliva,but it does not have the same effects as blood to blood transmission.  how on earth is this going to help to find a definite cure for this virus.  the only question it raises is why does the virus not have the same effects as a blood born virus.  to the layman who passes thru the various groups and or the media who could be doing a research program for a later story, or a student who is doing a thesis in the  "HYPOTHETICAL" as you keep reminding everyone could take this hypothetical issue and turn it into a mass uninformed society that takes everything literally and and starts the ostersizing of hcv sufferes.  

you said earlier to another not to put there head in the sand.  how dare you,  said person such as myself does not hide from truths and we do our homework and we fight to make it thru the tx so we can beat this virus and as you know it is an odds game that all of us know might or might not work therefore having to go thru another tx...   i call that courageous not hiding in the sand,  and to talk down or just not reply to some to me is hiding in the sand.  you asked for replies and it appears the only ones replied to are chosen to confirm your hypothesis..  i am all for an open forum discussion, but a one sided discussion that does not allow for all ideas or fears to be shared without rebuke and distane is wrong.

please feel to respond.

[sfbaygirl]

said, "here we go again.  i guess i will calll my local bio-hazard company and order my bio suit so i don't have to be responsible for my spit flying around.  we have gone from dogs, cats,birds.lizards,swimming pools to god knows what next.  i guess some one is already starting to invent the spit condom,  i would'nt want my spit being the culprit.  i wonder if i can still be a unick  ( bad spelling )...  the issue should remain on a cure and a test that does not take 20 + years to show up and cause the damge it has in the liver b4 said test reveals hcv positively!"  

Okay, I am not DD, but am responding anyway. We joked about the saran wrap and condoms for the mouth, but truly we do need to understand what transmission is....cats clawing could be an issue, not sure about lizards and birds, but if they have claws and can transfer blood to someone that has a cut or sore, I would consider it worthy of speaking about transmission.  

I won't respond to DD saying anything about putting their head in the sand, but possibly I was pretty amused by the situation described.  Once I realized this could really be something to consider, while I still was laughing, I wanted to understand. I think DD is only expressing the possibilty of transmission that we arent' aware of and really not concerned with. Lymphatic transmission is something we really don't have to worry about, nor our mates. Why you are so angry about DD's posing of this theory is kind of strange to me. I laughed and made fun and then did a bit of research myself and found that what he is saying could be true. I didn't hear him put anyone down....yeah I even appologized for making fun.  It is no laughing matter, I now believe what he says is true.  Perhaps you took him too literally and we all were not taking him serious enough. I really doubt he meant to dis you as you allege. I don't think the studies he cites are hypothetical. What if they are true? If you do your homework maybe you could consider these statements, consider them, not put down the messanger.  Not trying to start anything, certainly not!  I just don't think DD is trying to start a fight either...

Linda

[kcrandy]

well stated, and point taken.  i guess i took some remarks a little to personal.  when anyone implies i or anyone in the group is hiding thier heads in the sand rather than want to face a fact not a hypothetical it tends to tick me off.  i was taking my issue to the impth degree to make a point that the issues such as DD brought to the group,
( and for me i stated it is a good idea to know how this virus can be transmitted ),   could be take completely out of context, therefore reflecting negatively on hcv sufferers.  as you stated and referenced HR blood to blood transmission should be the focus, but HR also stated that bl to bl trans percentages are extremely low.  my bio-hazard suit was brought up in another thread a while back and my point then as it is now was not to take the saliva issue to seriously or out of context and cause mass hysteria a.k.a.
"refer madness", goerge bush, hilary, barroka, mccain, global warming etc... : O )

i guess i could blame all this on post tx brain fog.  :O)

[sfbaygirl]

LOL  Yep, I can blame all my ranting on bush, hillary and the bunch. especially global warming!  I think my husbands ex blames me for all of the above and the war and Hamas!   It is hard not to take remarks personally at times...god know I do.  I am sure your bio hazard suit is a great thing to have. Wish I had one! LOL  You are okay, I am okay we all are okay, on or off tx that post tx fog is alive and well!  Just a shame we have to deal with any of this.  I agree, blood to blood should be the focus...I would hate to think my hubby has virons running around b/c  of me. I haven't told him this yet and maybe I won't as the transmission in the lympathic sytem won't effect him.  I sure don't want to freak him out!  Especially when it isn't going to cause him harm.  

[DoubleDose]

Let's get this straight as far as trying to criticize or make light of other people's opinions, etc.  First, I did not make any comments to you in my last post, but responded to Nomad's rant.  I have basically tried to follow a line of reasoning, based on recent research and questions raised by the doctors doing the research.  I don't apologize for wondering what is going on, or what some of these more 'strange' findings might mean.  I mean, do any of you lambast the researchers who publish studies documenting 'occult' HCV and how it behaves in very odd and not understood ways?  Often infecting only one system, or compartment, and without any confirmation by standard HCV testing.  

Other researchers have published many, many studies now, in various countries, documenting ongoing viral replication long after SVR is achieved, and also in spontaneous clearers.  Does anyone accuse them of spreading fear?  Or 'ostracising groups of people.  Look, I understand that the fluid, and salivary issues are very unclear, and have few serious researchers looking at what might happen in these apparent 'exchanges of fluids" with close contacts, that MIGHT bear replicating HCV.   I think the study first posted in this thread asks some provocative questions, and allows for the fact that the medical community does not fully understand what any of this might mean, as far as some sort of 'infectivity', or localized, compartmentalized ongoing replication, or transmissability...etc.  

I merely have tried to extrapolate what the researchers are discovering, and ask questions that will need to be answered.  We have just seen a relayed comment from HR  (thanks sfbaygirl), indicating that this may well be happening just as hypothesized by me, and as alluded to by the research article.  From his comments, this 'spousal infection' within the lymphatic system is likely not a problem, and remains contained, without triggering a blood borne infection.

The only question that I will leave all of you with is this:

If there indeed is some sort of 'lymphatic infection' with HCV being passed sometimes, to close contacts, or any other sort of benign, or unspecified infection being transmitted through saliva, sexual fluids, etc....whether assumed harmless or not........
Would you want to know about this?   Would you want to see the viral behavior studied, and ultimately fully understood?  Or would you rather that researchers ignore these 'odd' findings, and just assume that they either are not important, or that they should not create additional concerns about HCV???

As far as the comments about brave people treating, and dealing with the horrible consequences of therapy....believe me I understand that one personally.  I think I have earned my 'bravery' stripes with the nearly three years of high dose tx that I endured.  I don't usually refer to it in these terms, nor consider it to be a big deal...just a necessary ordeal to be able to avoid a more horrible alternative.  I hope that I also qualify to express my opinions, ask questions, and follow lines of reason...so that we all can eventually figure out what the complete range of the disease involves.  

I truly don't think anyone is going to single out our questions and theories and use them to incite hysteria or discrimination out there.  I honestly do not.  I think that the medical research has a far bigger chance of being looked at by the public and taken as serious commentary.  And some of the recent research (not just my comments) has been downright disturbing.  I may not always like to hear all of what is being discovered, but I do want to know it anyway.  It is whatever it is.  And if some of my more disturbing hypotheses, or just plain scary questions can be proven false...I will be the first one to say Hurray! Wonderful!! I certainly do not WISH these things to be true.  The research, though, drives my questions. (and often my personal observations, as well)

I am honestly sorry if any of my comments have insulted anyone, or appeared to be demeaning to anyone....but if some of you are totally frank about some of your responses...I could as easily be offended!  But I am not.  I usually just tend to shoot back with a similar veined response.  Absolutely nothing personal in my comments...other than just tossing the 'compliment' right back.

And, I absolutely respect and encourage the opinions and theories of everyone on this Forum.  Sfbaygirl, I really do admire your humor and candor.  I like your style.  Thanks for your comments and criticism.  You say what you think, and you are not concerned about looking at both sides of a coin.  Sometimes we can feel two contrary ways about the same issue, and simultaneously hold oppositional points of view (within ourselves), and I think that is good.  It is the root of seeking truth.

DoubleDose

[kcrandy]

wow!  thank you for your response. i too as you do want to find the answers to and eventual cure of hcv.  if you think my comments directed to you were personal they were not they were meant to be hypothetical and to prove a point that things and or comments and or opinions can be taken out of context.  just look at the hiv sufferers in thier early dealings of that virus and the publics reaction to it.  i was not trying to question your knowledge or your question about transmission of this virus.  personally i would be curious to know if the virus has other ways of transmission, could this be a different type of virus in the line of hcv or can said virus mutate and become something entirely different yet appearing as the hcv virus still causing the same damage.  your question is a good one as i stated on my first response.  i too come to this group to get knowledge and try to help the newcomers,the ones in tx and those who are post tx.


i will admit i say things that appear to be cofronting or demeaning and if i have done so to the point that some or anyone of you thinks i am out of line i pray said persons will let me know, i respect confrontong issues heads up.


please forgive my abrasive attitude DD.


look forward to hearing from you in the future.  :O)

[Mary4now]

For now I will adhere to the recommendations by my hepatologist who seems to be on the ball.  I think looking at the information is important but being able to decipher the studies is beyond me at this point.   M

[BThompson4]

Regarding occult hep c research, I doubt if researchers who find traces of hcv in someone's body when it is undetectable in the blood also write about family members of hep c carriers having "inexplicable" hep c symptoms.  Given your posts on hep c symptoms in people you live with-- people that have been tested for hep c but always turn out negative-- begs the reader to come to the conclusion that you are saying that the presence of hep c in places other than a person's blood is potentially dangerous, whether you state that it is dangerous or not.

[sfbaygirl]

Thanks for the compliment. You deserve one as well.  I was hasty in my first response and upon reflection tried to see your POV. Especially after speaking with HR I saw the wisdom in your words. I sure hope, as do you, that our families aren't effected by lymphatic HCV. Sounds as though they are...who knows what this will cause in the future for them. Hopefully nothing.  Actually I think I said that I haven't mentioned this to my husband, because I don't want him to worry. Maybe I should, but what will this accomplish?  So far, he knows he doesn't have HCV, what good will come from telling him he has it in his lymphatic system?  Not much, unless someday we discover that it really matters and our spouses have this virus as we do.  So far, I doubt that telling him that he has it is going to help him much....it's not like he will go on tx or need to. He certainly doesn't know as much as I do about HCV and I don't want to scare him unnecessarily.  Geez, I sure don't want to keep a secret...I suppose if there were something I could do to contain this in him, I would. But what do we tell our families about their exposure?  A bit late to warn them and what do we warn them about?  

I remember some posts about your family having symptoms...do you think this lymphatic exposure is causing them to have symptoms?  Scary stuff DD.  LOL  I really don't want to even think about it, although as I said today after my scan...I am glad I got the look at the left side of my liver, although bad...at least I know. Now do I tell John or what?  

[kcrandy]

i see a whole lot of thumping coming on lol.


p.s.  "news bulltin "kissing bandit" found to have hcv and the "news media" is asking all those kissed by her to report to your local CDC center for evaluation"    : O )

[sfbaygirl]

Okay, are we talking about the RGlass thumping ie; caveman thumping, or what? lol  Yep, it can be pretty funny, but after talking with HR, I am totally convinced this is the real deal.  

[kcrandy]

sorry could'nt pass up the kissing bandit snide.  and yes the caveman looks like the best method for kissing fiends lol.

[sfbaygirl]

Hey did you hear that the best way to greet friend is to kiss cheeks, not shake hands?  Less exposure to virus and bacteria.....Sounds good to me!  To bad in the US handshakes are the standard, not the kissing cheeks as in Europe and other countries.....It is safer to do so.

[kcrandy]

im a hugger.  as for my gal pal im currently searching as to were i can get the caveman movie for some good pointers. : O )


p.s.i got a million of em  :O)

[sfbaygirl]

You have a million caveman movies?  Perhaps I am dense, but I don't think there are that many. I taught ancient history and had some good ones, but none had those guys thumping heads of the women! LOL  Now, take the ones of fiction, perhaps there is one or two....Or are you referring to yourself having a million pointers on how cavemen can thump?  

PS...Still getting over that electro shock therapy...thanks for pointing out the language used in MO for this... Whewwwwww

[kcrandy]

no, i was reffering to rodney dangerfield always saying i've got a millino of em whenever anyone left their self open for a sny or funny come back line.

[sfbaygirl]

I am still breathing hard and not because I am turned on!!! LOL

[DoubleDose]

Thanks for your follow up.  In answer to your question, this lymphatic thing is something I had not entirely considered in my past concerns about family member related symptoms.  In thinking more about what HR said, and the research article, etc. I will continue to keep an eye on any further discussions or research on this sort of lymphatic manifestation.  I would think that if any of these chronic symptoms that I have observed are indeed not just coincidental, and are indeed caused by a virus, then this could be a subject worth studying.  I have long feared that some form of the HCV could be the culprit.

  I am hoping that the 'cellular immune response' study within close contacts and family members, that a prominent Hepatologist is planning to conduct will have some conclusions related to these unusual, and questionable non-blood transmission issues.  I am curious as to whether the virus could just set off an immune response that remains chronic, but the virus is repelled...or that the immune response in the cellular tissues keeps triggering from a small amount of latent, controlled virus, that remains but never goes anywhere else in the body....or other related explanations.  I am now more curious than ever, and see some reason to really wonder where these chronic family member symptoms have been coming from.  I guess it will take time, but I am going to be looking at all the research, more than in the recent past.

Have a nice weekend!

DoubleDose

[sfbaygirl]

Interesting stuff. I have not noticed anything in family members, but who knows?  Now I am curious about it as well. From what I understand at the moment the T cells continue to protect the family. I heard a story about some prostitutes that had the virus and were protected by those t cells as long as they kept doing their jobs. As soon as they stopped, they came down with the virus, because they were no longer protected by those T cells...kinda interesting story, huh?  So does this mean we can never divorce or our spouses will come down with HCV?  Ugggh....Okay a story, but something to think about!  

Have a good weekend too!

Linda

[DoubleDose]

I am counting on the T-cell protective concept. The only problem that I have with that theory is that it indeed implies that there is some sort of 'contained' or controlled virus present there in the tissues or cells, and that these T-cell responses must continue on a permanent basis to keep this 'contained' virus in check.  If this is what really happens, might that not be an avenue for the development of autoimmune problems, and related symptoms to eventually emerge?  Maybe that is what the symptoms would be caused by, as the body struggles to keep this isolated invader under control, and to prevent it from moving into adjacent systems or organs.

In other words, if the spouses, and intimate contacts are indeed 'locally infected' on some small scale, or have a 'lymphatic viral carrier state', then would we expect to see the emergence of symptoms that would not occur if the virus were not present at all?  I think the first step has to be the isolation and quantification of this cellular viral phenomenon within non-HCV positive family members, by the researchers looking at this issue.  It needs to be determined, in an absolute sense, whether this is an ongoing, isolated viral infection, or just a lingering t-cell reaction from prior exposure to the virus in fluids, or tissues.  We need to be certain that there is indeed actual replicating virus present in the lymphatic system.  A good starting point would be to look at spouses (HCV negative of course) who have not been exposed to an HCV+ intimate partner for some time, like two to five years.  Then take samples from various tissues, and lymphatic structures to determine if there is cellular reactivity to HCV (ongoing immune responses specific to this virus), and next to do very sensitive PCR testing with amplification, to see if indeed actual replicating HCV can be verified.  
Once this issue is made clear, one way or the other, we will then have a good starting point to look at what the implications might be over the long term.  

DoubleDose

[sfbaygirl]

Not sure if I posted the story about the prostitutes who kept their T cells fighting the virus, but once they quit they came down with the virus... So we need to have a great sex life with our spouses so their T cells can continue to fight off the virus!  Of course this is a story without data I have, but I find it interesting.  

[beamishboy]

"prostitutes" and.." great sex lives"....damn girl,you can always get my attention...
i am posting this advice to whom it may concern,immediately...thank you

[Lady Lauri]

So we need to have a great sex life with our spouses..............
Uhhhh, need the spouse first :}   Good news tho! Soon as OFF , I'll get to work on that one again,lol!


beamish....your so crazy :}

[DoubleDose]

As far as discussing this issue with our spouses, I think so little is really fully determined at this point, and the HCV infection in the Lymphatic system has not yet beenvery much studied or broadly acknowledged by the greater HCV medical community, that I think we need not feel compelled to discuss it.  I have personally gently discussed the issue with my spouse recently, only because we have been both discussing these possibilities more in the last year or so.

I have occassionally tried to introduce some of my concerns, but do not want to create any undue fear or stress.  I also do not like being absolutely withholding on things that could be an issue either, so I have slowly begun the dialogue.  My spouse takes an approach of 'whatever it is, is what it is' and we will deal with any problems if and when they arise.  As to the present, don't lose any sleep over it, is her attitude, and I have to say that makes me, in turn, feel more comfortable and less guilty.

I have, of course, been thinking a lot lately, about how this possible 'lymphatic infection' that may reside in our spouses systems (and ours as well) might be responsible for the range of odd symptoms I have seen in my intimate relations over the years.  Its pretty easy to connect the dots, and I also think that a lymphatic or immune system infection could easily provoke some 'symptomatic' reactions.  I guess at this point I will just wait for further research, and as long as no other problems crop up in the family, will not worry too much about what the future consequences might be.

Just to interject a thought....if there turns out to be a 'silent' lymphatic infection, which is transmissable to intimate contacts through means other than blood to blood, hen I would expect that a far greater proportion of the general population would harbor this version of the infection, and would probably show no typical signs on testing for the virus, or also no liver symptoms, since the virus would not affect those organs.  It could be in some ways similar to HPV, or HSV, in that it might be fairly commonplace, but for the most part, somewhat benign.  Thats precisely what we will need to understand in the future....just how benign is it?

I do have a concern that much of the HCV medical community is focused on other issues, and our understanding of peripheral issues like HCV persistence, lymphatic infection, remission vs. eradication, extrahepatic symptoms, etc. may be a long time coming.  There does not seem to be nearly enough research dollars, government interest (as compared to HIV, etc.), or bucks to be made by Pharma to really conduct the due diligence on this virus, that other diseases routinely receive.

Best wishes to you and have a nice (worry free) week.

DoubleDose

[DoubleDose]

I would be curious, as in the past, to see if anyone else has had any similar thoughts or concerns about a less obvious, non-blood form of HCV infection possibly causing problems or transmitting to intimate partners.  I would think there would have to be odd or unexplained symptoms developing in these partners, that seemed more chronic, or unusual, to have triggered any concerns.

The potential for 'lymphatic infection' with HCV
might indeed be capable of causing some sort of noticable symptoms, but if they were apparent, and chronic, I would think other board members would also have noticed.  
Now that the concept of an isolated 'lymphatic infection' seems a bit more credible (see HR's comments related above), I don't feel as far 'out there' asking some of these questions, nor do I think some of my family member observations should be as easily dismissed either.

DoubleDose

[kcrandy]

this just ina double-blind done by two blind guys has proven equivically that we are all going to die whether we see or not ( no pun intended ).. so enjoy life while you still can  :O)


OO
  0           see ya!!!
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