'Healthy carrier' status

[jaroen]

Good morning,

After being pronounced to be a healthy chronic carrier by a hepatologist at Duke Medical Center I was advised to begin tx with Sofubuvir when it became available end of 2013.

While I was in Kuala Lumpur, Malaysia this summer I went to a very modern
comprehensive clinic to consult with a specialist there. He told me that I was a
healthy carrier with a reactivity number of 15 and that he recommended a yearly blood test to monitor that number. With such a low score he maintains tx is not
necessary. I ought to add that I acquired the virus 40 years ago.

Does anyone have any opinion on my 'course of action'?
Thank you, Lili C.

[klonny55]

There is no such thing as a healthy carrier. Have you had a liver biopsy or fibroscan? I was told I was a healthy carrier as well by my primary care physician in March 2013 and that I did not need treatment since I was asymptomatic. I looked into it and decided to go ahead and see a specialist here in the US. They told me there was no such thing as a healthy carrier and not having symptoms not does not mean that your liver is OK. A biopsy showed significant fibrosis. I underwent treatment with Sovaldi and Ribavirin this past spring and am now cured. If I had listened to my PCP I would have  ended up with cirrhosis. I'm not sure what the reactivity number you refer to means but are you sure you have the virus and not just the antibodies? Some are exposed to the virus and clear it on their own and will have the antibodies even though there is no active virus. My advice is to get the treatment if you do indeed have the virus..

Best of luck!

[AWorriedMom]

Klonny gave you an excellent answer. There is no such thing as a healthy carrier. We used to hear this back in 90's and I am amazed to see that some doctors are still saying this. We know that if you have a viral load, you have the virus and it has the potential to do serious damage. Make sure your HCV/RNA by PCR shows a viral load, and if it does, get treated.

[nan535]

I agree with Klonny55. Confirm you have the virus, get treated and finally put this threat to your healthy life to bed. I wish my husband had that option.

Nan

[JDB1964]

I agree that treatment might possibly be unnessesary but you must first determine the true health of your liver. Then you can make a fully informed desision to NOT treat.

[FlGuy]

The liverheads at Duke are some of the best. I'd consider their recommendations.

[jaroen]

My doctors measured the antibody level which led to their decisions; the results said merely "reactive" at a level of 15. I was told that unless the level measured 200-300 tx was not necessary. The doctors I saw were in no way 3rd world physicians. HVC genotype 3 is an East Asian genotype so I consulted with a first class doctor there. He told me that advising me to seek tx with a level of 15 after being reactive for 40 years was "over-reacting".

I am trying to get the results from my husband's tests done by a local clinic and they do not know what this reactivity number is. Rather, they consistently tell us to get tx via the colonoscopy racket network.

[Livelife777]

Well gotta give Klonny a big thumbs up, as he's right.
I go to Mayo clinic and have early stage cirrhosis.  My viral load was 52.
Wow!!!!!!  Talk about damage and a low viral #.   Had nooooo idea.
They advised immediate treatment with the newest meds Sovaldi/Ribavirin
as I was (yes was) genotype 2.
The good news is that with such a low viral load your virus should be a snap
to treat.  I was undetected at 4 weeks and am now cured of this deadly virus.
Get treated!   Overreacting????    I don't so.
It was the best decision I've ever made, and with no regrets.
Best wishes
.....Kim

[Livelife777]

Sorry about the repost.   Undetected at 2 weeks!

[sunru]

Yes that's what they used to say 10 or 15 years ago. A hepatologist said I was a "slow fibroser" he said come back in 3 years to get another check up. I did not want to treat back then anyway due to being a non-responder to interferon/rbv there was no choice back then. Then last year was diagnosed with f3/f4 cirrhosis. Get treated now, cirrhosis is nothing to fool around with. Everything changes when you turn 60.

[can-do-man]

I'm a little confused by your post. Have you ever had a PCR done to see if you even have hep c? I see where you are talking about having an antibody test done but nothing about a PCR. Many people are "reactive" but do not have the actual virus as their immune system beat it back.

As for being a "healthy carrier" are they talking about just the antibodies?

[jaroen]

The local clinic and the doctor in KL did regular bloodtests and the doctor at Duke referred to the clinic's test. The clinic had also informed me that I was genotype 3 .
The doctor in KL measured the antibody presence and that score was 15. I have not been to a doctor for anything but trigger finger since I don't know when and I am 65.
They said the virus is not doing anything but hanging around (my words) thus the Duke hepatologist said I was a healthy chronic carrier and there was no hurry to treat. He also said that he knew all that just by looking at me when he met me. An individual on this forum last year catagorically proclaimed that no doctor would ever say such a thing. However, a Duke hepatologist said such a thing.
What is PCR.
?

[hrsepwrguy]

"What is PCR.?"

NUCLEIC ACID DETECTION

The diagnosis of HCV infection can also be made through detection of HCV RNA using reverse transcriptase polymerase chain reaction (RT-PCR) techniques (Figure 1). HCV RNA can be detected within one to two weeks after exposure to the virus, weeks before the onset of ALT elevations or the appearance of anti-HCV.42 In some patients, the detection of HCV RNA may be the only evidence of HCV infection.

http://www.aafp.org/afp/1999/0101/p79.html

[can-do-man]

What blood tests are used to detect HCV infection?

Several blood tests are performed to test for HCV infection, including:
•Screening tests for antibody to HCV (anti-HCV)◦enzyme immunoassay (EIA)
◦enhanced chemiluminescence immunoassay (CIA)

•Recombinant immunoblot assay (RIBA)
•Qualitative tests to detect presence or absence of virus (HCV RNA polymerase chain reaction [PCR])
•Quantitative tests to detect amount (titer) of virus (HCV RNA PCR)
-----------------------------------------
Being that you have been genotyped then you do carry the active virus and would have a viral load. I've got to be honest with you and say if any Doctor said I was fine by just looking at me I would run as fast as I could. When I found out I had cirrhosis no doctor could have told by just looking at me as I wasn't the least bit sick looking I would at least be curious as to their reason for just repeating the antibody test as that does not tell you what your viral load is nor does it tell anything about liver damage.

Best to you.

[can-do-man]

Hi there hrsepwrguy

[keepingOnkeepingOn]

There isn't anything remotely healthy about having the virus. It's in a constant fight to kill the 'host'. Sooner or later it will do it's damage if left untreated. The body is under a tremendous amount of stress with this virus even if the infected person doesn't recognize it because they are few and far between in the beginning or explains symptoms away altogether.

Why anyone has to wait on the treatment to prevent damage is beyond me. That's the dumbest thing I have ever heard of. The famous line of "you've got time" is hogwash. Each day you have the virus, puts you one step closer to severe damage. It attacks the entire system and not just the liver. My guess is if you got cleared of the virus you would notice an improvement in your health regardless if they think you are now "healthy". They do refer this as a "Deadly Virus" so why all the minimizing?
You don't have to "look" sick to be sick. People only see sick people when they are having good days and feeling okay. Doctors should Know that. I'm one of those people who doesn't "look sick" either. We have turned the page to getting well. What went on in the past with all the 'jargon' is in the past. It's a new day and by 2016 everyone with the disease will get the cure.

[keepingOnkeepingOn]

4.4 people in U.S.A. have the deadly virus and need treatment.

[dontworry_behappy1]

I have heard this " healthy carrier" comment before.  The person tested positive for hepatitis C on employment at a University Hospital.   This was the term used due to the fact her PCR test (to see if you active hepatitis C in your blood) came back negative.  She didn't have hepatis C.  So she was healthy.  

25 percent clear the virus on their own and don't need treatment.   They are "healthy carriers" of the "hepatitis C antibodies".  It is chronic.

Hope this is the case and you don't have Hepatitis C.

Best to you

[klonny55]

As mentioned before by can-do-man if you have a genotype you have the virus. If you have the virus it is in your best interest to get rid of it.

It's very tempting to accept bad information when it is presented in a "don't worry you will be fine" wrapper. In March 2013 My PCP sat me down and told me in a sweet reassuring manner that I would be fine. That "active" Hepatitis C has viral loads in the millions and mine was only 44,000 "proving" that I was indeed healthy. She also told me that treatment was brutal and I should avoid it at all costs. I wanted to believe her and for a few days I did. In March 2013 the SOC for genotype 2 was 24 weeks of Ribavirin and Interferon. I imagined the worst and was scared ****less.

Luckily for me I did my own research, got myself to a specialist and realized just how wrong the advice I was being given was. Also lucky for me the new drugs were just around the corner and I did wait a few months to treat. The treatment was a breeze for me with no side effects. As a genotype 3 you would do the same treatment of Sovaldi and Ribavirin but for 24 weeks not the 12 weeks I did.

Not everybody has an easy time as I did but it is a HUGE improvement over interferon treatments and for most very do-able.

Viral load is an indication of how much virus is free floating in your blood. The virus lives and replicates in liver cells. The viral load test does not say ANYTHING about viral activity in the liver.

Hope this is of help.

[jaroen]

When is the newer drug coming out? I do not know what
stage it is in. It is said it will be superior to Sofosbuvir.

[jaroen]

By the way, I should mention that I do want to be clesr of it but I am trying to get as much information as possible.
one question I have is for the folks who thoght they were healthy carriers: during that time  what were your #s? What were the reactivity #s?

[klonny55]

I'm not sure what is in the pipeline for genotype 3. Maybe someone on here can shed some light on that. Harvoni which was just approved by the FDA is for genotype 1 only. There are trials for Gileads GS-5816 that are recruiting now. Most treatments do use Sovaldi in combination with another drug. I think AbbVie and Merck have some drugs about to be approved but you would have to look into what genotypes they are for. It's a complicated landscape out there with different treatments for different genotypes with different SVR rates.

The info is out there but you have to go looking for it.

I did find this from January 2014:

http://hcvadvocate.org/hepatitis/factsheets_pdf/GT_2_and_3.pdf

[can-do-man]

If your talking about Harvoni which just hit the market it is for genotype 1. And if I'm not mistaken so isn't the ABBvie drugs that are about to be approved soon.

[hrsepwrguy]

"What were the reactivity #s?"

The numbers associated with an antibody test don't mean anything other than you are positive for HCV antibodies, there is no connection between those numbers and how far the disease has progressed.

[hrsepwrguy]

Hey Can-do :)