Cure

[Debbie223]

Dear Dr.

There seems to be a lot of discussion surrounding the word cure where Hep c is concerned. I have been told if at 6 months I am still clear then I am cured..I have read that many times also but today on this site under Hep C it states right on the first page THERE IS NO CURE and that medication can suppress the virus for long periods of time. That was somewhat concerning to read.

Can you shed any light on this.

Thanks

[IMstacie]

I suppose it is in what context you use the word "CURE."  There is 'NO" cure because HCV's frequent mutations allow it to evade the immune system, defeating attempts to develop a cure as with any virus.  BUT, what we do have is a treatment or therapy to allow or help the body's own defenses CURE (or get rid of the virus) in a portion of patients who have contracted the virus.

[Deb_c430]

potatoes potatoes, Tomato tomato,   rhetoric

As long as its gone who cares!

[mkp13]

While the tests cannot detect viral load below some point, it still seems like the word "cure" is reasonable.  Dr. Gordon at the Lahey Clinic in Burlington MA (a leading research doc in this area) said at a lecture last week that only four people in the world have relapsed after six months and in all four cases there were significant risks for re-infection.  So if the docs are being absolutely paranoid, they could refuse to call it a cure if four cases relapsed and they can't *prove* reinfection.  But for my purposes, the 6-month test counts as a cure.  The virus replicates fast enough that even if there were one good copy left in your body at the end of treatment, you'd relapse back to detectable levels within days to weeks.

[Debbie223]

Well I know from reading posts here and other information that SVR and Cure are often not seen as the same thing.

I feel I am getting the best of the best in care. I am being seen by the doctor's at Cedar Sinai in Los Angeles. They have a well know Hep Dept. I have been told that if at 6 months I am still clear of the virus and I am done and don't have to look back. I will take that and run with it.

Here's wishing everyone SVR.....

[jdwithhcv]

What's in a name?  SVR by any other name will be as sweet!

[nygirl7]

I had the chicken pox but I don't have them anymore.  I look at hepc the same way.

Part of the reason we treat so much longer after we are UND is that we are training our immune systems to take care of keeping down and killing off any bits of the virus that might be left.  IF it were apparent that we were just keeping the virus down I would say no we would never be truly cured however I do believe that the reason they say after six months you are SVR is because after that long not being on the meds your body has taken care of the situation. When the virus doesnt' come back at that time period most likely there is nothing left to come back.

If the virus is not detectible and I have no symptoms of the diseased I consider myself cured of the disease completely.  It's really just semantics.

[zazza]

"Review date: February 20, 2008"

"A 'sustained response' means that the patient remains free of hepatitis C virus 6 months after stopping treatment. This does not mean that the patient is cured, but that the levels of active hepatitis C virus in the body are very low and are probably not causing more or as much damage."

This paragraph made me fall off my chair. No maybe or anything, just "the levels of active hepatitis C virus in the body are very low". What is "active hepatitis C virus" anyway? I thought HCV was always active. Is there something like inactive HCV now?

[jmjm530]

since your question was addressed to a doctor, I'll paraphrase the only doctor on this website, Dr. Dietrich who says there definitely is a cure for hepatitis C. I have no idea why that page on med help says there is no cure. My guess is that the page is outdated and has not been currently reviewed properly, regardless of whose names are underneath it.

[geterdone]

Yes, just a teenage wasteland anymore. It was in the day that the hammering of iron workers building floor after floor to get to the summit of ones knowledge and understanding of the engineering feats of the complex infrastructure of the stresses exposed to the elements to ensure the soundness of its foundation in which contradictions arises in the varying points of view for the complexity of such a structure and that it must withstand the test of time and it is because of this the structure still stands in a hallow shell of incompleteness.    

[DoubleDose]

Gee, I'm glad that Drs. Stone and Zieve made the above comments, on an HCV website no less.  If I had said something like this, I would have spent three weeks responding to the cries of 'crackpot' from various forum posters.
I wouldn't touch this issue with a ten foot pole.  Been there, done that!  
Persistent Virus????  What's that?  I personally have no idea.  Not even a stray, undetectable thought.  My arguments and theories have gone into remission.  So now I guess I really am Cured!!

Regards to all, and happy holidays!!!

A happy and content, DoubleDose.

[epiphiny]

As per Geter's last post that is also my understanding of SVR.  

I also understand that it is the closest thing to a cure for HCV and therefore it has been called a cure.  It's just that, at this stage, there is no universal cure ie: one that works 100% for 100% of the people.

As far as I'm concerned if the virus is unable to replicate itself in my tissues I will be happy and I will call myself cured of active HCV.

[geterdone]

It would seem to me that after treatment and for the lucky ones that do achieve SVR the virus may still be at work trying to replicate BUT the immune system has it under control and the virus is unable to replicate out of control to where detection can see it, jmo.

jasper

[geterdone]

This may help explain SVR ans not so sure... Here are the Big guns hashing it out.

jasper

http://www.medhelp.org/posts/show/566672?camp=36

[Deb_c430]

ditto here trin, i say 9 months tho! Just to be safe, antibodies never go away!

[Trinity4]

After 6 months, if I'm SVR, I'm cured.  I will not look back.  I wouldn't give it a second thought about infecting anyone or testing positive for antibodies.  It would give me endless joy to tell someone I was cured but will always test positive for antibodies.  Regardless of whether there are mutant HCV ninjas hiding out in my liver or brain, they can't hurt me or anybody else once I'm SVR.   It's so strange because I'm UND.....cured temporarily... right now at week 38 but I can't enjoy it because of the meds.  During treatment may be only time I ever see UND (just trying to keep it real here) but I wish I knew how that feels physically and emotionally.  Hope I get that chance to know.
Trin

[Marcia2202]

I have also noticed that on the Hep C tracker there is a column for crossing of antibodies... positive or negative....  I wonder if they actually meant viral load or if they didn't know that one will always test positive for antibodies.

[zazza]

What?

[zazza]

"There is no cure for hepatitis C, but medications in some cases can suppress the virus for a long period of time.

Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin. Interferon alpha is given by injection just under the skin and has a number of side effects, including:

Depression
Fatigue
Fever
Flu-like symptoms
Headache
Irritability
Loss of appetite
Low white blood cell counts
Nausea
Thinning of hair
Vomiting

Treatment with interferon alpha may also affect the production of white blood cells and platelets. Most patients receive weekly injections with a form called pegylated interferon alpha. Interferon is given along with antiviral medication, most commonly ribavirin.

Ribavirin is a capsule taken twice daily. The major side effect is low red blood cells (anemia). Ribavirin also causes birth defects. Women should avoid getting pregnant during, and for 6 months following treatment.

A "sustained response" means that the patient remains free of hepatitis C virus 6 months after stopping treatment. This does not mean that the patient is cured, but that the levels of active hepatitis C virus in the body are very low and are probably not causing more or as much damage.

Rest may be recommended during the acute phase of the disease when the symptoms are most severe. All patients with hepatitis C should get vaccinated against hepatitis A and B.

People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their health care provider.

People with hepatitis C should avoid any substances that are toxic to the liver (hepatotoxic), including alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of treatment.

Review date: February 20, 2008
Reviewed by: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis, School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. � 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited."

http://www.medhelp.org/medical-information/show_section/25679

[zazza]

I think it is because they are afraid that somewhere deep down in our cells there will be some virus copy lingering. They just cannot prove that the virus is all gone, so they dare not say we are cured. There are no viral load tests that go down to 0. That is why it is called undetectable - not possible to detect.

But really, HCV loves to replicate. My belief is that if you are SVR, you are cured.

[Marcia2202]

If they use the fact of testing positive for antibodies as not being cured, it would be strange. How about testing positive for hep A and hep B antibodies, even though one does not have the illness.

[can-do-man]

From our own Doctor Dieterich at this forum.

There has been a cure for HCV since 1991. The response rates have increased steadily from about 6% then to about 60% now. The new drugs that we are using in clinical trials have increased that number to about 70% so maybe that is what you are hearing. The odds are getting better but you are getting older so go get evaluated for treatment now! DTD

[Marc1955]

Debbie – It is my understanding that the medical establishment is unwilling to discuss "cure" in the context of HCV treatment. Perhaps that is because of the positive antibody tests, or perhaps it reflects an earlier time in research where the incidence of relapse was less well established.

My NP says that if you hit 6 months after treatment with SVR you are for all intents and purposes cured, since your chances of recontracting the virus are no higher than that for the general population. But he also says that "officially" they don't discuss cure.

Perhaps someone here knows why the medical establishment is unwilling to use the term "Cure."

[122 Tactical Fighter Group]

I dont consider myself cured - always come back positive with standard antibodie tests - - but I am in year 13 of a sustained viral response.....no viral load again this last test - PCR - negative ...........I will settle for that .....

[NashPred]

http://www.medhelp.org/medical-information/show_section/25679