Complete elimination of the HCV RNA Virus

Can the virus HCV RNA known to cause Hepatitis C be completely eliminated from the body? if Yes, how? is there anybody who has undergone a successful second renal transplant after having undergone treatment for hepatitis C and the virus did not come back after starting the immunesuppressor drugs? Please let me know.........

[mikesimon]

Yes the virus can be eradicated with interferon and ribavirin therapy though you will still test positive for the antibody. I do not know of anyone in the situation that you present but my lay opinion is that if the virus were eradicated it would not recur with the introduction of immunosuppressive drugs. If the virus is eliminated I would not think it would recur. Perhaps there are different opinions or studies on this but that is my opinion. On the other hand, if the virus was still present, the anti rejection drugs may encourage replication beyond that which would occur in the absence of this type of drug. It could and likely would progress more rapidly. Just an opinion. Mike

[ral]

Speaking of eradicating the disease, I think you guys were 1b's, did you have liver damage and did you guys after clearing do another or will you have another  biopsy?

After clearing will your liver repair itself to some degree if you have cirrosis (cirrhosis)? I have mild scarring 3-4 closer to 4 some cerrotic changes.

[mikesimon]

I'm 1b. I am not an SVR. Cleared in May and doing tx till June. There is evidence that tx can reverse fibrosis and even cirrhosis. The cirrhosis thing is still somewhat controversial and there is disagreement on this issue. Mike

[GI.PA]

mikesimon has this well under control..I agree.

GI.PA

[mikesimon]

I didn't respond to your question about liver damage. I am a transplant recipient. I've been on tx more or less since transplantation in June 2000. And I have no liver damage. I have had several biopsies and will no doubt have another if not more. But my situation is unusual and I wouldn't think that SVRs would have a biopsy post tx unless there was significant liver damage prior to tx or some other condition present. Despite the ease  most of us have had with biopsy there is a risk involved with the procedure and this must be weighed against the value. Mike

[willing]

improvement in liver histology post-SVR is slow but well documented,:
"Follow-up liver biopsy results from patients with SVR have been reported in 3 studies. Investigators from France6  reported on the results of liver biopsies taken from 48 patients 1 to 6 years after treatment, which showed a decrease in mean histology activity index from 8.2 to 3.6. Investigators from the National Institutes of Health7  described liver biopsy findings in 5 patients taken 10 to 11 years after alpha interferon treatment, finding that the mean histology activity index score decreased from 10.0 to 1.8, and that fibrosis resolved in all patients. Finally, in a recent report from Japan,8  liver biopsies were taken from 183 patients with SVR from 3 to 10 years after starting interferon therapy. Biopsy readings using the Metavir scoring system showed a decrease in mean inflammatory score by 1.73 units and a decrease in fibrosis score by 0.88 units. An example of the changes seen in serial biopsies with SVR is shown in Figs. 2 and 3."
<a href="http://hepatology2.aasldjournals.org/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=ajhep036s114&nav=abs">paper</a>

I like these <a href="http://hepatology2.aasldjournals.org/scripts/om.dll/serve?action=image&location=/extractor/images/jhep/36/5b/f036s114003.jpg">before  and after</a> pictures so much (11-years apart) I've been wanting to post them on my fridge.

[willing]

a little more fine-print on "complete eradication". Measurement of HCV RNA from blood serum is a "surrogate marker". It tells us how much free virus is floating around in our blood stream. The virus replicates by infecting liver cells (by preference) as well as other cell types including B-cells and central-nervous system cells. Unfortunately blood-based HCV tests tell us nothing about those tissues so our understanding of overall infection is necessarily limited. In fact, rare cases of late relapse have been detected in patients that have been followed for 2-4 years. The odds are so small (<<1%) that only chronic pessimists like me are likely to care.

[cmurphy]

Hi.  I read about a test to detect Viral RNA in nerve tissues called a "nested reverse transcription-polymerase chain reaction (RT-PRC)."  http://www.voy.com/17059/339.html.  I was wondering if you know anything about this test or others for the hcv virus in parts of the body other than blood.  Just curious.  Thanks.

[willing]

Hi - the trouble is that to measure HCV RNA levels in tissue, as opposed to blood serum, you have to do a biopsy - in this case, the paper says they did "sural nerve biopsies". This has limited clinical use, in part because people are understandably reluctant to lose chunks of their internal organs here and there. In the papers that detected hcv in brain tissue for example, they actually had to rely on corpses - presumably the only ones who could be talked into  signing the consent forms.. Best wishes.

ps the link to the paper layla cited is <a href="http://hivandhepatitis.com/hep_c/news/081803a.html">here</a>.

[Indiana]

I treated my Hcv without a biopsy so I have no clue as to what my damage level might be. My reasons for not having one were pretty straightforward. I was going to treat it anyways once the Pegylated interferons were shown to work. I did not need a biopsy to convince me to do the tx. I never di have any real symptoms either. After researching this stuff on my own I pretty much concluded that eventually I certainly would have damage and symptoms though. It's just a matter of time. At 50+ years old I did not have the luxury of waiting any longer. Tx is tough on the old bod. If you're gonna treat this anyways then the earlier the better. Biopsies are not without risk. Little things like internal bleeding, pain, and death. I saw no need to add these to my list of problems. I could always have one later after tx if the need arose. Since then I have seen many come through here and most had biopsies. Most of them went fine. Some did not. Those who didn't ranged from major pain during the proceedure to one who had her pancreas nicked and was permanently damaged by that to the point where she could not even do tx and instead was fighting other problems as a result of the botched biopsy. Wasn't worth the risk for me.
The odds of actually improving your overall scores on biopsy are about 30-40%. But for most folks, what you start with is what you end up with in the overall damage area. That's another reason to jump on this BEFORE you have symptoms.
Hope this answered your question.

[cmurphy]

Thanks for your comments here, and on the previous post.  Hope you are doing well.

[ral]

Man you guys know your stuff!!

Thanks

ral

[karan77]

Thanks u all for having given ur valuble comments........

[vin]

It is a pleasure to see how such forums r fruitful mand knowledge appraisers. I am HCV type 4 with age 57. No symptoms of any kind....leading a normal life style. Viral load is 3.2 million per ml. Some people say...interferon will treat me alright but there are various reservations against interferone and pygasys vis-a-vis type b4 HCV. Can anyone guide me.....money is no problem for me. I have no symptoms that I am ill.

[vin]

I am HCV type 4 with age 57. No symptoms of any kind....leading a normal life style. Viral load is 3.2 million per ml. Some people say...interferon will treat me alright but there are various reservations against interferone and pygasys vis-a-vis type b4 HCV. Can anyone guide me.....money is no problem for me. I have no symptoms that I am ill.

[vin]

I am HCV type 4 with age 57. No symptoms of any kind....leading a normal life style. Viral load is 3.2 million per ml. Some people say...interferon will treat me alright but there are various reservations against interferone and pygasys vis-a-vis type b4 HCV. Can anyone guide me.

[vin]

I am HCV type 4 & age 57. Leading a normal life style. Viral load is 3.2 million per ml. Some people say...interferon will treat me alright but there are various reservations against interferone and pygasys vis-a-vis type b4 HCV. Can anyone guide me.