Outcomes of Treatment for Acute Hepatitis C

The question as to whether to treat acute hep c comes up fairly often here. This is a US based study that confirms  the very high rates of SVR in those treated in the acute stage.

In simple terms if you treat in the acute stage you have a 90% plus chance of SVR.

http://www.hivandhepatitis.com/hep_c/news/2006/120806_d.html

[Myown]

Okay here comes a stupid question,,but i really don't know the answer.. how does a doctor know the difference between acute hep and chronic? Is is just because the acute hep has a very low viral load? most people don't know exactly WHEN they contracted, so I guess time frame can't always be indicative. Just wondering.

[Cindy10]

I have been told Acute is when you first get the virus and get sick. Some dont get sick but some know when the contracted the virus. When my husabnd got the virus 28 years he was very sick and dx with hepatitis, although at that time they did not know of Hep C, it was consider acute at that time.

[Myown]

Thanks for your responses.

Cindy,since your husband was in 'acute' stage, if they tx him immediately with drugs they had at that time,,,, shouldn't it have been easy or easier for him to clear since it was acute? Maybe the non A and B they didn't do anything for??You would think they would at least try what ever tx they had for hep b at the time? I really don't know, so I may be asking dumb questions. I really wonder if they did anything for the non a/b back then or if it was left up to the choice of the doctor to attempt to tx or not, since little to nothing was known about the disease.

I was just curious. you may not have an answer, so you need not feel you have to respond. I'm very good at confusing people too, so maybe my wording could have been better in looking this over.

[Cindy10]

Well at that time they just called it viral hepatitis. He got the flu (or so he thought) and went to the docs. They asked him if he had eaten seafood recently and he said yeah. But at the time he had the seafood he was at the beach and got a tatoo, they never asked him that. They told him to rest, drink lots of water and juice and it will go away. Well he thought it did until about three years ago he found out it was Hep C. So there was no treatment then. When he told his Hep doc now he said it was Hep c all along but no one knew until now. It is to bad.
Now he has gone from stage 2 to cirhosis in two years, with no booze. It does progress quickly I guess.

[Myown]

Boy, thats terrible. Tatoo's have changed many lives,, who would have know back then. No one. Anyone getting a tatoo today is really taking a chance.
I hope and pray your husband's liver heals through meds or a direct touch from God. To God be all the glory, either way.

[Myown]

Sorry Cindy, didn't realize you are treating right now also,,well may God touch you too!He will.

Thanks Cuteus,, thats interesting what you said. the t cell being different in the acute stage than chronic.  It almost seems that'if'the doctors were able to keep the t cells from 'changing' or what ever it is they do when someone becomes chronic,,,, maybe(?) that would push someone into spontaneous clearance. Do ya know what I'm saying? Being spontaneous recovery (or whatever its called) happens in 'acute' stage only ,,and you just pointed out that there is a change in the t cells from acute to chronic,,,logic would say, "what can doctors do to keep the t cells from changing over?" Maybe that would give the body extra time to clear the virus on its own?

I guess here is where more of integrated medicine is needed.

Good night, I'm beat. I keep keep my eyes open after 10pm anymore,,getting old.

[Cindy10]

Thank you very much. He is starting treatment soon and I'm already on it. So it will be difficult, but we will get through like many others here. Thanks again!

[cuteus]

it is pure luck sometimes, finding out that someone is in the acute stage.  A few get sick, so that is easy, but others might find out by chance.  If they donate blood regularly, that alone can be a clue as to whether it is acute, since you have a 6 month window in which you are acutely infected. So, if you give blood each month, and one time comes back positive, bingo!
Also, the immune system creates different t cells in the acute stage than in the chronic stage, there are certain markers, that most drs don't test for, that can tell at what stage of fight the immune system is.

[aiuta]

Thanks for the post and link information.  It was very helpful.  I am currently finishing 24 weeks of Peg Int/Riba tx for Acute Hep C.  I got REALLY sick a few weeks after getting it and that was how it caught my attention.  

I'm trying to decide if I should extend tx beyond 24 weeks and am meeting my Dr. next week. The link you posted HepCboy was great.  I just wish they included how LONG the people treated for.  I asked a Dr. friend to try and find out before my appt. (deciding whether to extend).  I hope he can.  Thanks, Aiuta

[HepCBoy]

All the European studies I have read have been 24 weeks regardless of genotype.

I know of a UK Doctor, consultant gastro, who got hep c from a needlestick. He researched and consulted and went for  peg and riba while acute for 24 weeks. That's a strong enough signal for me.

[aiuta]

How long ago did your Dr. clear?  
How much Riba did he take?  How much did he weigh?
What week post-infection did he start tx at?  
Has he maintained his SVR?  
What genotype did he have?  
Did he ever do a biopsy or fibroscan?
How is his liver now?  
How are his post-tx symptoms?  

[HepCBoy]

>How long ago did your Dr. clear?

SVR reached May 06.

>How much Riba did he take? How much did he weigh?

1200mg, don't know weight.

>What week post-infection did he start tx at?

Infected March treatment commenced May.

>Has he maintained his SVR?

Yep

>What genotype did he have?

3a

>Did he ever do a biopsy or fibroscan?
How is his liver now?
How are his post-tx symptoms?

Don't know.

[aiuta]

THANKS!  I really appreciate this information as well as this entire post.  Both were very helpful.  Most sincerely, Aiuta