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Article on Occult/Persistence and Other Posts
Here's a good, comprehensive article by one of the leads (Pham) on research into occult Hep C:
<a href="http://www.findarticles.com/p/articles/mi_m3230/is_2_38/ai_n16084704">Occult hepatits C virus persistence: identification and characteristics</a>
(from the article):
"<i>Although HCV is considered to be primarily hepatotropic, accumulated evidence clearly indicates that the virus also invades and replicates in the immune system. In fact, the presence of both HCV RNA positive and negative strands has been demonstrated in lymphoid cells in both in vivo and in vitro settings. For example, T cells, B cells, monocytes, and dendritic cells from patients with chronic hepatitis C have all been shown to carry HCV genomes. (2), (10-12) Most recently, by applying assays of superior sensitivity mentioned above, replication of HCV has been seen to persist in lymphoid cells for years after spontaneous recovery or a sustained virological response to IFN-alpha/Ribavirin therapy. (1-3) In addition, low levels of HCV RNA in lymphoid cells have been detected in a significant proportion of patients with persistently elevated liver enzyme levels of unknown etiology. (13), (14) Along the same line, susceptibility of T and B cell lines as well as primary human T cells and macrophages to HCV infection have also been documented. (15-18)</i>"
<a href="http://www.findarticles.com/p/articles/mi_m3230/is_2_38/ai_n16084704">Occult hepatits C virus persistence: identification and characteristics</a>
(from the article):
"<i>Although HCV is considered to be primarily hepatotropic, accumulated evidence clearly indicates that the virus also invades and replicates in the immune system. In fact, the presence of both HCV RNA positive and negative strands has been demonstrated in lymphoid cells in both in vivo and in vitro settings. For example, T cells, B cells, monocytes, and dendritic cells from patients with chronic hepatitis C have all been shown to carry HCV genomes. (2), (10-12) Most recently, by applying assays of superior sensitivity mentioned above, replication of HCV has been seen to persist in lymphoid cells for years after spontaneous recovery or a sustained virological response to IFN-alpha/Ribavirin therapy. (1-3) In addition, low levels of HCV RNA in lymphoid cells have been detected in a significant proportion of patients with persistently elevated liver enzyme levels of unknown etiology. (13), (14) Along the same line, susceptibility of T and B cell lines as well as primary human T cells and macrophages to HCV infection have also been documented. (15-18)</i>"
Infections from unsterile resued instruments was in the news a few months ago. I think there's a scandal there waiting for somebody to blow the lid off.
The way I get it, instruments designed for a single use are being "reprocessed" and reused. The hospital buys them from a reprocesser and uses them, taking on faith that they're clean. Some of the reprocessors have dubious qualifications. Since each instrument is different, there aren't standards for how to do it. Some of them are destroyed by heat. Since they were designed for a single use, sterilization wasn't a factor in their design.
To top it off, hospitals have a single price for an instrument. They don't distinguish between new ones and reprocessed ones. So some suspect they charge new prices for tools that cost them a fraction of the new price.
The next time somebody wants to stick a tool in me I'm going to insist that it's new. Does anybody know if the health insurance industry has weighed in on this? Will they pay for a new tool if a used one is available for less?
The way I get it, instruments designed for a single use are being "reprocessed" and reused. The hospital buys them from a reprocesser and uses them, taking on faith that they're clean. Some of the reprocessors have dubious qualifications. Since each instrument is different, there aren't standards for how to do it. Some of them are destroyed by heat. Since they were designed for a single use, sterilization wasn't a factor in their design.
To top it off, hospitals have a single price for an instrument. They don't distinguish between new ones and reprocessed ones. So some suspect they charge new prices for tools that cost them a fraction of the new price.
The next time somebody wants to stick a tool in me I'm going to insist that it's new. Does anybody know if the health insurance industry has weighed in on this? Will they pay for a new tool if a used one is available for less?
HEre are my little numbers if they will help you i'll put it down
Month 1 Lethargic / RibaRash / Losing Weight
Month 2 Anemic / Totally DEVASTATED / RibaRash / Losing Weight - Hair
Month 3 Recovering from anemia... extremely lethargic /RibaRash / Losing Weight and Hair
Month 4 Lethargic / Found Gold Bond Rash going away / Losing LOTS of hair
Month 5 Lethargic Losing LOTS of hair
Month 6 Lethargic / Thyroid Diagnosis / Hair and Weight Leveling
Month 7 Getting a bit more energy (maybe the thyroid med?) Weight level, hair not falling out as bad
Month 8 Here Now doing OK no major problems
Month 9
Month 10
Month 11
Month 12
I definitely had many more problems in the first few months. Hopefully this will continue on like it is or even better - I never want to go to anemia land again.
It seems like for ME month 7 was the real turning point. I don't know why but...
I hope that helps!
Month 1 Lethargic / RibaRash / Losing Weight
Month 2 Anemic / Totally DEVASTATED / RibaRash / Losing Weight - Hair
Month 3 Recovering from anemia... extremely lethargic /RibaRash / Losing Weight and Hair
Month 4 Lethargic / Found Gold Bond Rash going away / Losing LOTS of hair
Month 5 Lethargic Losing LOTS of hair
Month 6 Lethargic / Thyroid Diagnosis / Hair and Weight Leveling
Month 7 Getting a bit more energy (maybe the thyroid med?) Weight level, hair not falling out as bad
Month 8 Here Now doing OK no major problems
Month 9
Month 10
Month 11
Month 12
I definitely had many more problems in the first few months. Hopefully this will continue on like it is or even better - I never want to go to anemia land again.
It seems like for ME month 7 was the real turning point. I don't know why but...
I hope that helps!
I have to agree with Jim on the "sx experiences". Yesterday was by far one of my worst days for riba rage. I just wanted to beat the **** out of everyone, my husband, my best friend, my step daughter, my mother in law and anyone else I came in contact with. Fortunately, I'm really not that kind of person and even if I were, I would not be strong enough! LOL. So, I walked around the house cussing everyone out under my breath. I'm thinkin' they all knew well enough to stay away and give me my space.
Shot 44 tomorrow.
Shot 44 tomorrow.
This article - along with the <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16537674&query_hl=1&itool=pubmed_DocSum">Comar et al</a> study and the <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16628675&query_hl=1&itool=pubmed_docsum">Giannini te al</a> study posted by 'willing' - are a set of research beginning to show that occult can/does have it's own set of potential implications:
- Giannini shows a direct cause/effect relationship between occult and cryo.
- Comar points to a relationship between occult and HCC.
- the Pham paper above mentions that the Radkowski et al and Carreno et al papers point to a relationship between occult and continued histology post SVR: "<i>Although these patients generally exhibit histologically apparent improvement after IFN-alpha/Ribavirin therapy, including partial regression of fibrosis, liver biopsies from many of them show evidence of persistent minimal inflammation or even of active chronic hepatitis.</i>"
The practical message to HCV patients is: just because you've cleared the virus (SVR or spontaneous) doesn't necessarily mean that your viral story may be over. It would be prudent for patients and their caregivers to keep a close eye on things via appropriate periodic testing (eg. - CBC, Liver Panel, AFP, Ultrasound, possibly bx for those with more advanced histology prior to viral clearance, CAT scan, cryo, etc). And to find a doc/group who keeps current with ongoing developments in HCV research and developments - not to mention keeping current yourself. Any doctor who thinks "SVR=cure" and "out-the-door-you-go" is now in the stone age.
TnHepGuy
- Giannini shows a direct cause/effect relationship between occult and cryo.
- Comar points to a relationship between occult and HCC.
- the Pham paper above mentions that the Radkowski et al and Carreno et al papers point to a relationship between occult and continued histology post SVR: "<i>Although these patients generally exhibit histologically apparent improvement after IFN-alpha/Ribavirin therapy, including partial regression of fibrosis, liver biopsies from many of them show evidence of persistent minimal inflammation or even of active chronic hepatitis.</i>"
The practical message to HCV patients is: just because you've cleared the virus (SVR or spontaneous) doesn't necessarily mean that your viral story may be over. It would be prudent for patients and their caregivers to keep a close eye on things via appropriate periodic testing (eg. - CBC, Liver Panel, AFP, Ultrasound, possibly bx for those with more advanced histology prior to viral clearance, CAT scan, cryo, etc). And to find a doc/group who keeps current with ongoing developments in HCV research and developments - not to mention keeping current yourself. Any doctor who thinks "SVR=cure" and "out-the-door-you-go" is now in the stone age.
TnHepGuy
I would imagine your odds of contracting something from a colonscophy are FAR outweighed by your increased chance of colon cancer if you don't have the procedure.
I've had two of them in the last ten years and with modern technique and medications they are entirely painless, with zero discomfort.
The sedation used works fast and wears off mostly within a half hour post procedure. You're in the office and out the door within a couple of hours.
As many will testify, the worst part of the colonoscophy is the prep 24 hours before where you have to drink some solutions to clean out your bowels. But even that has changed radically in the last ten years and now it's really no big deal.
Neither of the two procedures you mention will be able to snip a polpy out on the spot and then biopsy it. I've had a few removed during the procedure and later biopsied. Fortuntly they were benign.
Now cystoscophy is another animal and is a truly barbaric procedure at least for men.
I've had two of them in the last ten years and with modern technique and medications they are entirely painless, with zero discomfort.
The sedation used works fast and wears off mostly within a half hour post procedure. You're in the office and out the door within a couple of hours.
As many will testify, the worst part of the colonoscophy is the prep 24 hours before where you have to drink some solutions to clean out your bowels. But even that has changed radically in the last ten years and now it's really no big deal.
Neither of the two procedures you mention will be able to snip a polpy out on the spot and then biopsy it. I've had a few removed during the procedure and later biopsied. Fortuntly they were benign.
Now cystoscophy is another animal and is a truly barbaric procedure at least for men.
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