New occult paper

"Sternal hepatocellular carcinoma metastasis revealing occult hepatitis C-related cirrhosis in an 88-year-old woman."

http://www.ncbi.nlm.nih.gov/pubmed/18801709?dopt=AbstractPlus


As an aside, I haven't been able to update the Occult Health Page in a while (still waiting to hear back something from MedHelp on how to overcome some software issues) and have a bit of a backlog as a result.


TnHepGuy

[Bobby1952]

  There is nothing there !!!

[frijole]

Right - I don't even see the abstract there.  For a mere $31.50 it can be yours -- oh well, I am too cheap.
frijole

[desrt]

I like the title, though. I'm pretty sure MickeyDs or RJReynolds will get me long before I'm 88.
We carry viral frags of everything we and our ancestors have battled for the last 100,000 years. If my g'g'g'g'g'g'g'grandmother Lucy fought off some virus back in Olduvai Gorge, I don't worry too much that the remanants of that battle are going to effect my golden years. Low probability.
Would like to read the article when you post it. Would also be interested in reading anything that shows a complete 9,000+ nucleotide sequence being found anywhere in an SVR.

[DoubleDose]

Just to fully educate you to the facts, Occult HCV is NOT fragments...did you get that...NOT remnants or vestiges or anything like that.  Occult happens to be chronic, replicating HCV in organs other than the blood, and often is undetectable by any sort of blood testing, whether by antibody or PCR.  Occult in the liver causes cirrhosis just as readily as standard good old boilerplate HCV.  It is called Occult only because its presence is not detectable by blood testing.  Doctors have been finding people with Occult in a wide range of organs, with aggressive damage taking place.  Occult is NOT the same as persistent HCV, or any of the controversial stuff you may vent about.  Occult is treated with SOC in most cases, and if you let it go it WILL kill you just like chronic serum positive HCV.  Get your facts straight before you shoot arrows.  Occult is not what is found in SVR's, it is a different form of infection entirely, and has been described and treated by the MAINSTREAM HCV medical community for years now.  

DoubleDose

[DoubleDose]

Here is a medical article that will tell you everything you ever wanted to know about "Occult HCB" but were afraid to ask.  Again, remember, this is not the 'persistent HCV' we often discuss and disagree about on the forum...this is actual liver INFECTION.  See the study:

http://www.natap.org/2005/HCV/090505_20.htm

DoubleDose

[willing]

frijole: good call ( you should consider investment banking)

bobby: many congratulations on your SVR! and I think you nailed this one; here's the full text

"An 88-year-old self-sufficient woman was admitted for weight loss and pruritis. She had no history of alcoholism or previous jaundice. She did not take any hepatotoxic drugs.

Clinical exam revealed a poor clinical condition, scraping lesions without icterus, no hepatosplenomegaly and a painless sternal bump which had appeared few months earlier (Fig. 1). Initial investigations showed bilirubin 24.4 µmol/l, aspartate aminotransferase 2940 U/l, alanine aminotransferase 57 U/l, alkaline phosphatase 120 U/l, and ?-glutamyltransferase 224 U/l. Further investigations revealed hepatitis C virus (HCV) antibodies and a positive HCV RNA by PCR. Alpha fetoprotein was 2108 µg/l. Ultrasound of the abdomen and abdominal CT imaging revealed a cirrhotic liver with micronodular cirrhotic nodules without any other hepatic focal lesions. Chest CT showed a sternal osteolytic lesion with infiltration of adjacent soft tissues. Pathological examination of the sternal lesion identified hepatocellular carcinoma (HCC) metastasis (immunohistochemical stains positive for polyclonal CEA, EMA, CD56, CD10 (Fig. 2) and negative for vimentine, cytokeratine AE1/AE3, cytokératine 7). Tc-99m bone radionuclide scan identified additional bone metastases in the lumbar vertebrae. After multidisciplinary deliberation, a conservative approach was proposed.

Metastatic disease as the initial presentation of HCC is unusual, reported in less than 5% of cases [1]. Among metastatic sites, bones metastases are frequently observed but sternal metastasis, as the first manifestation of the HCC is very infrequent [2] and [3]"

I believe the 'occult' in this one modifies 'cirrhosis' - ie until her hcc metastasized unexpectedly in her sternum,  which apparently is rare, her record did not indicate cirrhosis.

[CoWriter]

"Occult is NOT the same as persistent HCV, or any of the controversial stuff you may vent about."


According to the article you quoted, it is......


"Extending the clinical implications raises the concern that patients we consider "cured" after a sustained virologic response to therapy may still have occult HCV infection if their liver tissue was evaluated using these newer techniques.'

[desrt]

From the "everything you ever wanted to know" link.

"Whether the HCV infecting these patients harbors mutations affecting its translation capacity, its encapsidation capacity, or the formation and release of virions into circulation that lead to such an extremely low viremia that it is below the detection limit of our RT-PCR is currently under investigation."

One of the few times they say "HCV" rather than "HCV RNA".


"Detection of the HCV RNA of negative polarity was performed by use of a cRNA probe spanning 390 nt of the HCV core coding region."

390 out of 9030


At least we're learning which sequences and what size frags. It all sort of supports what I've  been saying for 2 years - whatever changes the virus makes to cross over into the 'privileged' or 'compartmentalized' systems leaves it unable to cross back over into serum.
Good link.

[CoWriter]

I wonder why they're calling it "occult" if she had a positive HCV antibody test and positive HCV RNA by PCR.

[TnHepGuy_]

willing - thanks for finding and posting the rest of the paper. It explains how the word 'occult' fits into this context.

CW - 'willing' mentioned it above: "I believe the 'occult' in this one modifies 'cirrhosis' - ie until her hcc metastasized unexpectedly in her sternum,  which apparently is rare, her record did not indicate cirrhosis."

So, they are referring in the paper to 'occult cirrhosis', not 'occult Hep C'. Can't say I've run into that one before.


TnHepGuy

[frijole]

thanks guys.  I need a dictionary to read this stuff.  I always appreciate the condensed version (of the condensed version).

Guess I don't worry too much about the occult since the actual virons are still running around me.  I will worry about the occults later.....
frijole