READY FOR SEX DO I TELL ABOUT HEP-C

[laytex]

I HAVE BEEN DONE WITH TREATMENT FOR A FEW YEARS NOW. I WAS MARRIED 16YRS. FOR THE PAST 2YRS I HAVE BEEN SINGLE (WITH NO SEX/DATING).I AM READY TO HAVE SEX. IT IS NOT A IN LOVE RELATIONSHIP JUST DATING. DO I TELL HIM I HAVE HEP C OR DO I TAKE ALL PRECAUSIONS AND SAY NOTHING. FOR THE LAST TWO YEARS I HAVE AVOIDED SEX TO AVOID THIS ISSUE. THE LACK OF LIVING/LOVING ISOLATION IS JUST TO MUCH ANY MORE. AND IF I TELL HOW DO I DO IT AND WHEN? SCARED AND CONFUSED

[Kalio1]

PS trying to make the leap from occult virus to transmission is just that, a leap. This study does not in any way conclude that finding occult virus then indicates transmission is possible, far from it.

In my view, the Tram study has nothing to do with the point of the discussion, the discussion is if it was possible to pass on this virus once you are SVR and the answer according to all authorities I can find is NO, you can not pass on a virus you don't have replicating in your blood.


Sexual contact is considered a RARE form of transmission anyway even if you DO have replicating virus.

Why people here would overblow the risk is beyond me. That is the last thing we need, more stigma and false info. To extend that to ALL SVR's, and suggest they can in any way be contagious is beyond belief to me. That just is not true and scares people for no reason. The Tram study in no way suggests that people with occult virus can pass it on to others sexually!
We are talking about normal human sexual interaction, obviously a transplant situation would be a different scennario. The average person does not "interact" with other humans by exchanging organs, on that I would hope you agree. Having sex is a far cry from sharing organs.

SVR's can be confident they are not capable of passing this virus to anyone sexually and that they are no longer contagious to others in any way.

[Kalio1]

There is no evidence that undetectable levels of virus can be transmitted. If you have some info showing that it can be, I'd like to see it. People who acheive SVR are considered free of this virus and there is no evidence there is even a remote possibility of passing it to others.

The fact that some viral particles could be found through extensive testing does not mean that it can be transmitted nor does it mean the virus can even replicate. In fact, the evidence I have seen all shows that it can NOT be transmitted and that it does NOT replicate, it doesn't matter if it can be found at "undetectable" levels, it isn't replicating and harming the patient nor is it transmittable to others.


SVR's are considered DISEASE FREE. You can not pass on a disease you do not have. You can find evidence of many past illnesses in humans, this in no way means you can pass that illness on nor does it mean you "have" that illness any longer. No one has posted any info to the contrary, if you have some data showing there is even a remote possibility of SVR's passing undetectable virus on, then let's see it.

[dragonslayer1]

Hi,

I think that you are kind and sweet for your concern for others. However, I have been married twice while with chronic hepC, the first time for 9 years and the second for 8 years. I didn't find out about the bug until about 10 years ago. Both spouses tested neg for hepc...and the first used to regularly use my razor on her legs! No, this razor sharing did not please me and ofcourse I did not yet know about the hepC, but the point is between that and lots of sex still NO transmission of the bug!

HepC is very RARELY transmitted via man/woman sex...it requires blood to blood contact. Knowing what I know about this now I do not  believe I would care to have a date spill out the whole story right off...even and especially if sex was in the air.

BTW...I'm in week 39 of treatment and tested "undetectable" at 12 and 24 weeks. Crossing my fingers. But honestly, even if my treatment turned out to be a cure, which is ofcourse my hope, I would not be put off or apprehensive about having a meaningful relationship with a partner with active hepC...including getting physical.

Hope this helps, John

[mikesimon]

You say that SVRs do not have virus in their serum. Will you not admit the possibility that in some SVRs the virus may still be in their serum but at levels that are below the level which current tests can detect? That is really what I was saying. 6 years ago the RNA/PCR tests that were available were not capable detecting the low level of HCV they can today and therefore people were considered clear when they weren't clear - yeah, I know, they would rebound once they stopped TX and show the virus but that's not the point I am addressing. Today we have tests that detect 5 and 2 IU/ml but in the future tests might be far more sensitive and perhaps we'll see tiny traces in serum in cases where it was presumed that no trace existed. I wasn't taking issue with your position that SVRs couldn't pass the virus. It was your flat out unequivocal statement that SVRs don't have the virus that I believe is inaccurate. The fact that some doctors use the word "cure" doesn't convince me. You know my situation Kalio - how do you explain me? You might say it's the immunosuppressive drugs that I take or the fact that I am a transplant recipient but I don't think those factors can explain the fact that I have been serum undetectable <5 IU/ml since April 2003 and stopped TX June 2004 and test undetectable monthly and yet I still showed HCV on biopsy in June 2006. I think it is clear that I, like other SVRs who have shown HCV on biopsy, still do have the virus. Now, that doesn't mean we can transmit it sexually or otherwise but I really don't know that for a fact. I had a lot of partners in the 70s and 80s and early 90s and never infected any that I know about and I contacted quite a few of them so it isn't easy to transmit the virus when you have a high serum VL. You also say: "The only possible way to pass it would be through a transplant not through any other normal human interaction." I just don't know how you can make these statements Kalio and that is really my problem with your post. You arrive at conclusions that are not supported by any serious research studies with which I am familiar. The research into SVRs is still in its infancy and I am not prepared to make categorical statements about what is or isn't a fact regarding any of this stuff. I know we want to believe that once we attain SVR status that we are cured and HCV will never rear its ugly head again but, as yet, I don't think that has been proven. A major immune treatment has triggered a "relapse" in at least one patient that I have read about and if, in fact, the virus was not there how could anything trigger it, aside from a new infection?
From the Tram article @ http://jvi.asm.org/cgi/content/full/78/11/5867?view=long&pmid=15140984
"The present study shows that HCV RNA can persist, albeit at very low levels, in the serum and circulating lymphoid cells for years after apparently complete clinical and virological resolution of chronic hepatitis C. If the present findings reflect the existence of the biologically competent, infectious virus, this silent persistence may have important epidemiological and pathogenic implications. Among other factors, these trace amounts of the virus may lead to reactivation of hepatitis C after termination of antiviral therapy or due to severe immunosuppression and may support perpetuation on the subclinical level of liver disease which becomes symptomatic years after exposure to the virus. They may also constitute a source from which HCV may spread through blood and organ donations to susceptible individuals."
From http://www.springerlink.com/content/h8767181tw711422/
"Despite favorable longterm data with regard to viremia, liver histology and serum liver enzymes in treated patients who comply with the criteria of sustained virological response, a complete elimination of the hepatitis C virus (HCV) is rarely observed. Besides liver tissue, peripheral blood mononuclear cells (PBMCs) could be proven as locations of HCV persistence."
And from the same article:
"The precise significance of the HCV persistence in the host organism is still inconclusive; according to first research results, however, it can lead to a deterioration of the liver histology. At present, it is also unclear if patients with occult hepatitis C as well as with evidence of HCV RNA in the liver and/or extrahepatic compartments after seemingly successful antiviral treatment are to be regarded as infectious."
If you haven't studied the Tram article I suggest that you do because if you accept his study, and many experts in the field regard it very highly, then I think it is clear that your unequivocal statements about SVRs not having the virus are unsupported and are actually rather careless. I know that it feels good and sounds good but it isn't proven to be correct despite what some doctors might tell their patients.
Mike

[Kalio1]

SVR's do not have virus in their serum. No virus in your serum, how can you possibly be contagious? To suggest that people who cleared the virus could possibly pass it on, as was being done here, is what I took issue with. There is not one shred of data I can find that indicates that is possible. The fact that there is some evidence that the virus might be found in small amounts in our livers does not mean you could pass it on to others at all. Nothing indicates that has happened in all the people who have cleared this virus. Many doctors use the word CURED and tell their patients to go on with their lives, they are free of this disease. They are not instructed that there is even a remote chance of passing it on sexually or otherwise. The only possible way to pass it would be through a transplant not through any other normal human interaction.

[mikesimon]

Kalio said: "There is already enough stigma and misinformation surrouninding (sic) this disease, we don't need to add to that by suggesting it is possible to pass on this virus once you are SVR. It is not medically possible to pass something you don't have to another person."
The fact that one is SVR doesn't necessarily mean that one does not have the virus. While some people apparently do completely eradicate all traces of the virus others reach SVR (serum undetectable 1 year post TX) and still have evidence of the virus. We've all read the articles or references to them. I am not disagreeing with your assumption Kalio that sexual transmission is very, very, very unlikely (it's difficult enough to transmit with active high VL HCV in a monogamous heterosexual relationship) but to say it is impossible might be reaching just a bit. The fact that there are no documented cases of transmission by an SVR is compelling but considering the amount of research on this particular issue I don't think it is conclusive - at least not yet anyway.
Mike