Interesting Research Study on people exposed to HCV carriers in households.

This study on people who are exposed daily or live with those who have HCV discusses some of the issues that I have pondered frequently over the years.  In the study they observe a frequent 'cellular immune reaction' to HCV in household members or close contacts.  In the discussion section they propose several theories as to what this 'cellular immune reaction' by close contacts represents.  Here is the link to the study:

http://www.ajtmh.org/content/73/1/44.full


And here is a copied portion of their discussion, which includes their interpretation of what this phenomenon may represent:       (From the article in quotes below)

"An explanation for the presence of HCV-specific CMI in otherwise seronegative persons could be that cross-reactive antigens from unrelated organisms primed these T-cell responses. Cross-reactivity of CD4+ T-cells against epitopes of different herpes viruses has been observed in humans,29 and CD8+ T-cell cross-reactivity between non-homologous viruses like influenza A and HCV was also reported.30 However, in this latter study a T-cell response elicited by influenza A cross-reacted with a single epitope from the HCV NS3 protein after repeated in vitro re-stimulations with the NS3 peptide. It seems unlikely that the CMI observed in our study would result from T-cell cross-reactivity, because several different HCV proteins stimulated ISC in the ex vivo ELISPOT assay without re-stimulation. Thus, we believe these T-cell responses were elicited by exposure to HCV, and the virus was subsequently cleared leaving an “immunological scar” in the form of antigen-specific CMI.

None of the subjects with HCV-specific CMI responses had a history of hepatitis or symptoms compatible with hepatic disease. The majority of HCV infections are asymptomatic, even during the acute phase.2 Therefore, we speculate that our CMI-positive seronegative subjects had a transient very mild infection, possibly associated with low-dose exposure to the virus, which was cleared. Infection is supported by most of the immune responses being to non-structural epitopes of HCV, an indication of replicating virus. A less likely, in our opinion, alternative is the CMI positive individuals have a healthy carrier state with the virus being present in some body compartment (i.e., in the liver) and not in the blood or it is replicating at levels below the sensitivity of our PCR assay (100 copies/mL). "
(end of quote)

My comments below:

The issue that I have been concerned about in the past is that family members and close contacts (intimate partners, etc.) seem to have often developed a set of similar symptoms to my own, over the years.  I have often been concerned that family members are exhibiting the same extra-hepatic effects as I developed from HCV, even though they are sero-negative on testing.  Maybe THEY have developed this cellular immune response, from constant exposure, and are showing immune system responses to the virus...even though they do NOT seem to have the true infection.  Look at the several things that the researchers speculate about why these contacts have this CMI detected, and note that ONE possibility is that they now may have a very low level "carrier state" harbored in a body compartment!  This is EXACTLT what I have speculated in past years, on the forum.  I did catch a LOT of flack, and derision....but I still stand by my observations and deductions.  I think there may be more there than meets the eye with 'modes of infection' and HCV.  Maybe some contacts develop chronic 'reactions' to the virus, without ever developing the full blown blood infection.  I have elaborated in the past on the symptoms I have seen in close contacts, and so I won't cover that ground again in this comment.

Any thoughts or comments after reading the research study, or my thoughts?  

DoubleDose

[desrt]

The study was conducted in a rural Egyptian community (an area where medical practices are such that epidemiology and exposure are almost impossible to trace). I woud have to see these results duplicated somewhere that had been using modern medical practices for the last thirty years to take the conclusions seriously.

[Willy50]

Understand I am not dismissing the idea but for me I'm still not certain that there is enough proof to support the idea.  As they often say; further study is needed.

First off, I'm not sure that the concept of "carrier" is supported, or maybe I just would need the term defined so that we all agreed what it meant/ didn't mean.  It seems like the point of the study is that even in small amounts, even undetectable amounts that damage IS done.  If so, I'm not sure the word "carrier" is appropriate.

I'm not sure that there is enough proof to show that there IS disease in close family members, that it had it's roots in HCV, or what the vector was.  It doesn't seem to connect the dots well enough for me, but then..... I have no medical training.  : )

The fact that a close knot group may share common issues/ symptoms does not provide cause.  
It could be genetic predisposition, environmental (they all live downwind of 3 mile island or love Canal neighborhoods), cultural (you ever see that if you co-exist with fat or thin people you tend to become as they are.  There may also be other explanations..... numerous ones for the commonalities.  I recall how HCV sexual transmission was thought to be higher in heterosexual couples and then upon closer examination they found discordant genotypes and quasi-species?  
For me...... looking at all the transmission cases that still occur in spite of all of the medical procedures and protocols, it almost seems to me that many of us may have gotten this from medical/institutional vectors instead of trading saliva, having sex or sharing silverware.   We may be LESS of a transmission vector than thought via ordinary co-habitation factors.  (that's my little theory)  : )

Hep C started as a disease that they knew existed, but they could only prove what it wasn't.  (Non A, Non B)  But there was sufficient evidence that there was something out there.  It would seem to me that if this type of infection were easily transmitted then there would be lots of infections .....even if they were undetectable by earlier methods.  One would think that there would be more "occult" or below the radar issues in families or populations where such infections would show up.

I'm not pooh-poohing the idea.  Look at the concept of "prions" in Creutzfeldt–Jakob disease (human form of Mad Cow Disease).  We don't know it all ....yet.... and it is possible even though huge numbers of infections do not exist, it does not serve as proof that the disease/ transmission vector does not exist.  

Even so.....technology and the ability to test and prove existence may be closing the gap.  However, one may have to weigh the importance.  For instance, if Creutzfeldt–Jakob disease exists in about case per million people in the USA one may have to temper the reaction and respond accordingly to the numbers.

For instance, in the case of HCV I hope that we won't have to stop kissing or living with loved ones.  : )  I think some people may become reactive to such discussion because they fear.....well...... the fear that it may instill in either the general populace (hell.....we even see ignorant doctors) of even in amongst ourselves.  We already have ample amount of fear and uncertainty as it is in our lives.  And so..... if we discuss it I think it may be worth mentioning that this doesn't seem to occur in widespread numbers.  I guess the question is if it is possible, in what numbers does it occur?  

A side problem is there are huge groups of OCD people who are ready to take up the banner and start displaying symptoms without any real infection.  In this arena this would be an *ideal* disease; they caught it from a tainted door handle, instant teller, breathing the steam that wafts off of the office microwave after a suspicious co-worker previously used it, etc.  : )

I jest, but when I read some of the "am I infected" posts here I would mention that this is not outside of the realm of possibility.  : )

best,
Willy

[spanky595]

   HCV is a Liver disease, it can only be transmitted through sharing needles using drugs from blood.  There is a lot of retrospect on other theories but thats all they are is theories.

[Aaron57]

You are 100% completely wrong with your assertion that hcv has only be transmitted by using sharing needles while drugs ..

Get your facts strait before you start posting misinformation like this ... or prove what you claim with some hard clinical data !

Organ transplants & blood that was given during transfusion's which was not checked for hcv until 1992 ... Mothers giving birth can also transmit the virus to their newborn .. along with a host of other transmission methods.

Recipients of clotting factor concentrates made before 1987
Recipients of blood transfusions or solid organ transplants before July 1992
Patients who have ever received long-term hemodialysis
Persons who have snorted drugs (eg, cocaine); due to blood on shared straw or bill
Persons with known exposures to hepatitis C, such as
Healthcare workers after needlesticks involving hepatitis C-positive blood
Recipients of blood or organs from a donor who later tested hepatitis C-positive
Patients with signs or symptoms of liver disease (eg, abnormal liver enzyme tests)
Children born to hepatitis C-positive mothers (to avoid detecting maternal antibody, these children should not be tested before 18 months of age)


http://www.pegasys.com/pegasys/basics/hepatitis-c-spread.htm

[lynda607]

Interesting concept but why in your case are your household family members or friends exhibit the same extra-hepatic effects as you have developed from HCV, even though they are sero-negative on testing and most others do not.  If there were real validity to it we wouldn't we see this occurring more often.  IMO, it a bit far-fetched, kinda like they say people who are together long enough start looking like each other?

[DoubleDose]

I don't have any hard answers either, and am just personally very curious to this line of testing.  As I have stated, past intimate contacts developed similar issues to mine (ie:  sjogren's type eye and salivary problems, fatigue, brain fog, arthralgias,etc.) sometimes within three or four years into the relationship.  This was decades ago, and before I even knew I had anything!  So as for psychological causes, or other potential causes due to 'suggestion'....there was never any discussion of my problems...I just observed their symptoms as they slowly unfolded.  Its the same in my current household, which I have been in for over 20 years.  My observations of their symproms were well before I was diagnosed with HCV.

The study of 'cellular immune responses' to HCV exposure is also an area that has a variety of researchers have pursued.  Its an accepted scientific finding that sometimes close contacts often harbor a 'cellular immune response' to HCV in various tissues.  I think Dr. John McHutchenson also has carried out studies in that area.  No one is really sure what the significance of these cellular reactions represents.  I don't have any specific belief either, other than I do think there may either be an ongoing immune system response to a long gone viral exposure that may just keep going....or that the virus might just transmit and replicate at very low levels in certain tissues or organs of intimate contacts....thus indicating a sub-clinical, sort of low level infectious state.  These are two of the possible conclusions mentioned by the researchers in the linked article...though they said they have doubts about their second hypothesis...a carrier state.  I don't know either, but I am quite certain that the cellular immune response issue is well worth further research, if only so we can understand more clearly all the modes this virus.  Who knows, maybe already many millions of people have a 'cellular immune reaction' to the virus, from sexual or other contact....and it may just be a very benign or sub-clinical issue.  Just as most have Epstein Barr, Herpes I, and many other chronic viruses in their systems.  

I am open to learning more.  The only reason I ever have been interested in this line of study is from what I have observed over the years personally.  For decades I was perplexed, and had no idea why I was seeing this reaction.  Then after finding out what I had, and reading studies such as the one linked....I started to make the connection.  I may be all wrong, and it may not be connected to the HCV at all......but I still strongly suspect that it is.  More study needed!!!

DoubleDose

[DoubleDose]

And just another semi-related comment:

Also, I don't know how many of you read the recent article in the Wall Street Journal about heriditary viruses, and the newly discovered role of viruses in human behavior...but they said basically that medical scientists are learning more and more that virus are often passed from generation to generation in various forms in a sort of DNA transmission, and that there is now evidence that viral patterns may have as much influence on individuals from birth onward as pure 'genetic' influences, etc.  They discussed in the article how the field of virology as it relates to human behavior and generational genetics is moving to the forefront with these findings.  Not that this directly relates to this thread, or my concerns on the cellular immunity, but it just shows there is very much to be learned about viral behaviors, that we have very little clue about in today's world.

DD

[copyman]

I agreed with your theory back then and I agree with it now. I say it is very possible. Thanks for posting

[curiouslady1]

I think the idea that we can "vaccinate" our lovers over a period of time is not in the least bit outlandish and I hope/think it is probably true and can be applied to other viruses as well.  It would stand to reason that serology would not expose such a transmission.  However, the idea that an intimate partner has manifestations of an illness does not prove this point in the least.  Family members give each other unconscious messages and communications all the time and identifications with a partner's or a parent's or child's distress is common.

[Willy50]

You know, the thing that I am resistant to is that if it was ONLY HCV we might see it universally amongst our partners, which we don't seem to

I absolutely would feel the same way if I had seen it over and over so closely in my family or with loved ones

When you mention other viruses though..... I think it may be possible that viruses could work together synergistically.  
--------------------------------------------
http://en.wikipedia.org/wiki/Epstein-Barr_virus

The Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is a virus of the herpes family, which includes herpes simplex virus 1 and 2, and is one of the most common viruses in humans. It is best known as the cause of infectious mononucleosis. It is also associated with particular forms of cancer, particularly Hodgkin's lymphoma, Burkitt's lymphoma, nasopharyngeal carcinoma, and central nervous system lymphomas associated with HIV.[1] Finally, there is evidence that infection with the virus is associated with a higher risk of certain autoimmune diseases, especially dermatomyositis[citation needed], systemic lupus erythematosus,[2][3] rheumatoid arthritis,[3] Sjögren's syndrome,[3] and multiple sclerosis.[4]

[DoubleDose]

I also agree with you that some of these viruses may work together synergistically.  I think there is a whole line of research in that area by a team of Doctors on the west coast, which they term 'stealth viruses'.  

Apparently the CDC does not like to look at this group's research studies or proof of these 'stealth viruses' involved in causing things like CFS, Fibromyalgia, and other syndromes.  I think the CDC does not like to acknowledge anything that does not fit 'neatly' into their own fixed vision of how everything works.  They also refute the existance of XMRV virus in those with CFS, and are working hard to label all other research studies on that topic as probably 'cross contamination' causation.  

I am not sure why they are so inflexible on studies that present new or unexpected findings...other than that the studies are usually not done by the CDC.  Maybe they don't want to create widespread paranoia, or over concern about chronic viruses impacting a great many citizens.

DoubleDose

[Willy50]

I have wondered if some remnants could remain, even in some SVR people.

I wonder how this stuff will play out.  They continue to make amazing gains with viruses.  You see this one?

http://www.sciencedaily.com/releases/2010/02/100201113801.htm

[nygirl7]

Very interesting stuff DD and with all your interest in occult virus and etc. of course you would be the one to find this.

Most interesting thing I've read on here in some time - nice to have a change of pace!!

[DoubleDose]

Thanks Willy, excellent article.  Wouldn't it be great to have an 'all-purpose' antiviral that we could take to knock out all the chronic, nasty stuff!!!  Those will be the days!!  I also wonder about remaining HCV in SVR's, especially in non-blood related 'compartments', such as brain, spinal cord, lymphatic system, and salivary glands, etc.  It could even be a targeted varient that just stays put in those organs...and does not stir up a full blown blood infection...or it may also be the 'typical' virus, but pushed back into 'safe' hideouts, where it stays below the threshhold of provoking an immune system attack against it.  If there is still 'residual' virus hanging around, I will bet money it is doing something 'not good' to our systems, or organs.

nygirl, how are you?  Thanks for the nice comment.  I am still hanging around, and visiting the forum somewhat regularly.  I try not to be too 'off the wall' or controversial these days, (it can wear you out, dealing with some of the responses), but sometimes I can't resist chiming in on a subject that I have wrestled with, when I see a relevant study, or commentary.   I hope you are doing well, and hanging in there.  Best wishes to you.

DoubleDose

[DoubleDose]

I guess another observation that can be made is that often times (as the study indicates) people who are in close, long term contact with actively infected HCV persons seem to frequently develop a measurable 'cellular immune reaction' to HCV in various tissues or organs (not the blood).
The question then becomes, what is the internal physiological consequence, short term and long term, to the individual and their body and internal organs/systems.  Maybe the virus is not there, or left quickly after attempting to infect these tissues (and maybe not, who knows at this point), but the bigger question, is: what harm or damage is done by this ongoing immune reaction on the tissues...whether the virus is present or not?  

Hopefully its all very benign, and causes no damage at all, but I would like that concept validated.  I also would like more large scale, US based studies on 'close, and intimate contacts' to see if they also show the same signs of 'cellular immune responses' in various tissues and organs.  Then, maybe with the help of highly sensitive PCR testing, it can be determined is any active replicating virus is present...and if so, is it identical to the same genotype of the virus that is harvested from blood samples in the infected person.  

Thanks for all the responses and comments.

DoubleDose