Aa
Reservoirs, SVR, Relapse, Barriers, etc.
Thanbey does raise quite a few questions, but very few answers.
There is little scientific proof at this point that SVR status means one is still carrying the virus in 'reservoirs'. I have discussed this issue with several leading virologists, and hepatologists. All seemed to agree unequivocally that the virus is not in hiding anywhere else in the body after a TRUE SVR is achieved.
The question one must ask is this: If the HCV virus initially is introduced into the body via the bloodstream, and infects the blood and liver, at minimum, and then if migrates to the brain, spinal cord, lymphatic system, etc. Then WHY does the reverse not seem to happen after SVR is achieved in blood and liver???
WHY, when SVR is achieved, does the virus NOT seem to travel back through those same routes, FROM the brain, spinal tissue, lymphatic system, etc. to REINFECT the blood and liver????
You would think that IF THERE WERE reservoirs of virus remaining in the body, that it would not take very long for it to pass back into the blood, and become detected again by PCR. Also, the liver would become affected and would generally be demonstrated by LFT abnormalities.
THIS is the logic that the reservoir theory proponents DO NOT address. Will it now take , let's say, 50 years for the reverse to take place? 80 years???? Because it does not seem to be happening in SVR's after 2, 3, 5, or 10 year periods.
Thanbey, believe me I have wrestled with this issue for a long time, and have asked many pointed questions to docs in all fields. So far, logic and research points to real SVR.
There is little scientific proof at this point that SVR status means one is still carrying the virus in 'reservoirs'. I have discussed this issue with several leading virologists, and hepatologists. All seemed to agree unequivocally that the virus is not in hiding anywhere else in the body after a TRUE SVR is achieved.
The question one must ask is this: If the HCV virus initially is introduced into the body via the bloodstream, and infects the blood and liver, at minimum, and then if migrates to the brain, spinal cord, lymphatic system, etc. Then WHY does the reverse not seem to happen after SVR is achieved in blood and liver???
WHY, when SVR is achieved, does the virus NOT seem to travel back through those same routes, FROM the brain, spinal tissue, lymphatic system, etc. to REINFECT the blood and liver????
You would think that IF THERE WERE reservoirs of virus remaining in the body, that it would not take very long for it to pass back into the blood, and become detected again by PCR. Also, the liver would become affected and would generally be demonstrated by LFT abnormalities.
THIS is the logic that the reservoir theory proponents DO NOT address. Will it now take , let's say, 50 years for the reverse to take place? 80 years???? Because it does not seem to be happening in SVR's after 2, 3, 5, or 10 year periods.
Thanbey, believe me I have wrestled with this issue for a long time, and have asked many pointed questions to docs in all fields. So far, logic and research points to real SVR.
Your time dedicated to inquiries and research is truly appreciated.
The bottom line is, there are no absolutes in science and you do not hear doctors making statements that do not include; "it seems, it is likely, possibly", etc. For anyone to make absolute statements like; you will not die, Hcv will not kill you, is to say the least, unscientific. Unless it is stated as an opinion. Maybe that is why Med help has started that disclaimer in the comment section. To make it clear that they are opinions, since some individuals make such blatant statements as I stated above. There are more unknowns in medicine than knowns, especially in hcv.
We could quote experts and studies, and it still would not make it an absolute truth. The thing about hcv is that they are all making scientific guesses and we should take them as such. Theories, and not absolute facts.
TY for your contribution to this forum, the good thing about Pt to pt is that we state our arguments as opinions, not irrevocable truths.
The bottom line is, there are no absolutes in science and you do not hear doctors making statements that do not include; "it seems, it is likely, possibly", etc. For anyone to make absolute statements like; you will not die, Hcv will not kill you, is to say the least, unscientific. Unless it is stated as an opinion. Maybe that is why Med help has started that disclaimer in the comment section. To make it clear that they are opinions, since some individuals make such blatant statements as I stated above. There are more unknowns in medicine than knowns, especially in hcv.
We could quote experts and studies, and it still would not make it an absolute truth. The thing about hcv is that they are all making scientific guesses and we should take them as such. Theories, and not absolute facts.
TY for your contribution to this forum, the good thing about Pt to pt is that we state our arguments as opinions, not irrevocable truths.
I know of no reservoir theory proponents.
I would be fascinated to know what actual original work the virologists you spoke to have done on this question because the experts in this area have only a limited amount of pilot data themselves and are still formulating hypothesis, the best being Aronow in Los Angeles. He has autopsy tissue samples and the beginning of a tissue bank for study on these and other questions. (check out Dr. Aronow's presentation on video at the NIH Consensus Management Conference, 2002)I would look askance at anyone who purports to have a conclusive answer at this point in time. Certainly interpreting anything I say as anything more than sharing data or raising questions about the ****-sure statements I see made is way beyond anything I have said, or would ever say, given that I only had a small part in one such neurological research study.
I don't know anyone, including me, who is putting forward a theory at this point. The data is what it is and interpretations and strategies are a way off. There are questions of enormous significance that, for lack of research dollars, are going unasked and unanswered. Too many assumptions and opinions: too little data, lots of conclusions being drawn from abstracts and articles that may, or may not, be relevant to this question.
Sure the virus, in theory, can go in both directions, but blood flow in the brain is not quite that simple. I personally spoke with Jay Hoofnagle about this in the presence of Dr. Aronow and Hoofnagle poo-pooed this right in front of one of the leading experts in the world! So, I am not terribly impressed at this point with anyone throwing out guesses or making statements no matter who they are. I'll stick with the researchers who are doing the work and asking the right questions. That is key: asking the right questions. It is tough to do in an environment of cross currents, inadequate data, and conflicts of ego and interest.
The Journal of the American Medical Association (July 2003) undertook the question of risk versus benefit with respect to interferon therapy and published results of a Harvard School of Public Policy study on risk versus benefit for the use of interferon. It is a sobering report for anyone considering interferon therapy and I urge you to read it.
Bottom line is WE DON'T KNOW at this time what the actual benefits and consequences are of interferon therapy despite all the studies that have been done by the drug companies and others. The parameters being used to measure "{cure" and successful outcome" are, themselves open to question.
There is a point where risk outweighs the potential for benefits regardless of the possibily of an SVR. Where that point is depends on many factors, but the reality is that this treatment can induce problems that hepatologists know nothing about identifying or dealing with and the follow up is done by other specialtites, namely pulmonology, cardiology, psychiatry, rheumatology, endocrinology, gynecology, hematology, neurology.
Yet, the vast majority of the information comes from gastroenterology and hepatology whose knowledge pretty much stops at the liver. At SVR, you are released from care and sent to another appropriate specialy if you need follow up care for the after effects of interferon therapy, despite "cure."
I am NOT anti-treatment. I am for full disclosure to patients and doing my part to inform people of their options. If you want an anti-treatment proponent, try <a href="http://www.objectivemedicine.com/hepcfree.htm">Interview with Loyd Wright</a>. My true and honest opinion is that treatment should be something certain patients consider and for any reason a patient and their doctor chooses to consider it. But, both doctor and patient should be informed about the considerable questions surrounding the use of interferon and both the risks and the potential benefits that its use poses. Staying on treatment at all costs is not even recommended by the manufacturers. Even they recognize that the cost may be too high.
Like you, I have asked the hard questions of drug companies, researchers, and experts. I have attended and been vocal about this for about 12 years now. Regardless of whether I am a doctor or not, I have a large amount of knowledge gained by attending post graduate courses (the ones hepatologists take), speaking, teaching and serving on scientific advisory boards.
You can ridicule me, but you cannot silence me. The facts are what they are, independent of anyone's opinion. An SVR is the best result there can be at this point in our history, and there are many studies showing that an SVR may very well "cure" liver disease. That is a long way from saying that it comes at no cost to the health of a person or that it is a guarantee of anything. And, for those who do not achieve an SVR , those with minimal liver disease in the first place, and women, there appears (according to JAMA and Harvard) to be more risk than potential for benefit.
That is not my theory. I have no theory. That is what the independent scientific researchers are telling us. My moral compass tells me to tell the truth even when I do not like the truth or agree with it. I want a cure for hepatitis C. I would be personally affected if there were such a thing. I know better treatments are coming. I also know they are not coming fast enough and interferon is the only option for some people.
In scientific jargon: "that sucks."
Thank you for the opportunity to expand on this topic a little bit and to have an open exchange of ideas and information.
thanbey
<a href="http://www.hcop.org/">Hepatitis C Outreach Project</a>.
I would be fascinated to know what actual original work the virologists you spoke to have done on this question because the experts in this area have only a limited amount of pilot data themselves and are still formulating hypothesis, the best being Aronow in Los Angeles. He has autopsy tissue samples and the beginning of a tissue bank for study on these and other questions. (check out Dr. Aronow's presentation on video at the NIH Consensus Management Conference, 2002)I would look askance at anyone who purports to have a conclusive answer at this point in time. Certainly interpreting anything I say as anything more than sharing data or raising questions about the ****-sure statements I see made is way beyond anything I have said, or would ever say, given that I only had a small part in one such neurological research study.
I don't know anyone, including me, who is putting forward a theory at this point. The data is what it is and interpretations and strategies are a way off. There are questions of enormous significance that, for lack of research dollars, are going unasked and unanswered. Too many assumptions and opinions: too little data, lots of conclusions being drawn from abstracts and articles that may, or may not, be relevant to this question.
Sure the virus, in theory, can go in both directions, but blood flow in the brain is not quite that simple. I personally spoke with Jay Hoofnagle about this in the presence of Dr. Aronow and Hoofnagle poo-pooed this right in front of one of the leading experts in the world! So, I am not terribly impressed at this point with anyone throwing out guesses or making statements no matter who they are. I'll stick with the researchers who are doing the work and asking the right questions. That is key: asking the right questions. It is tough to do in an environment of cross currents, inadequate data, and conflicts of ego and interest.
The Journal of the American Medical Association (July 2003) undertook the question of risk versus benefit with respect to interferon therapy and published results of a Harvard School of Public Policy study on risk versus benefit for the use of interferon. It is a sobering report for anyone considering interferon therapy and I urge you to read it.
Bottom line is WE DON'T KNOW at this time what the actual benefits and consequences are of interferon therapy despite all the studies that have been done by the drug companies and others. The parameters being used to measure "{cure" and successful outcome" are, themselves open to question.
There is a point where risk outweighs the potential for benefits regardless of the possibily of an SVR. Where that point is depends on many factors, but the reality is that this treatment can induce problems that hepatologists know nothing about identifying or dealing with and the follow up is done by other specialtites, namely pulmonology, cardiology, psychiatry, rheumatology, endocrinology, gynecology, hematology, neurology.
Yet, the vast majority of the information comes from gastroenterology and hepatology whose knowledge pretty much stops at the liver. At SVR, you are released from care and sent to another appropriate specialy if you need follow up care for the after effects of interferon therapy, despite "cure."
I am NOT anti-treatment. I am for full disclosure to patients and doing my part to inform people of their options. If you want an anti-treatment proponent, try <a href="http://www.objectivemedicine.com/hepcfree.htm">Interview with Loyd Wright</a>. My true and honest opinion is that treatment should be something certain patients consider and for any reason a patient and their doctor chooses to consider it. But, both doctor and patient should be informed about the considerable questions surrounding the use of interferon and both the risks and the potential benefits that its use poses. Staying on treatment at all costs is not even recommended by the manufacturers. Even they recognize that the cost may be too high.
Like you, I have asked the hard questions of drug companies, researchers, and experts. I have attended and been vocal about this for about 12 years now. Regardless of whether I am a doctor or not, I have a large amount of knowledge gained by attending post graduate courses (the ones hepatologists take), speaking, teaching and serving on scientific advisory boards.
You can ridicule me, but you cannot silence me. The facts are what they are, independent of anyone's opinion. An SVR is the best result there can be at this point in our history, and there are many studies showing that an SVR may very well "cure" liver disease. That is a long way from saying that it comes at no cost to the health of a person or that it is a guarantee of anything. And, for those who do not achieve an SVR , those with minimal liver disease in the first place, and women, there appears (according to JAMA and Harvard) to be more risk than potential for benefit.
That is not my theory. I have no theory. That is what the independent scientific researchers are telling us. My moral compass tells me to tell the truth even when I do not like the truth or agree with it. I want a cure for hepatitis C. I would be personally affected if there were such a thing. I know better treatments are coming. I also know they are not coming fast enough and interferon is the only option for some people.
In scientific jargon: "that sucks."
Thank you for the opportunity to expand on this topic a little bit and to have an open exchange of ideas and information.
thanbey
<a href="http://www.hcop.org/">Hepatitis C Outreach Project</a>.
Is it a 44 kd (Pegasys) or a 38 kd (Peg Intron) pegylated molecule? How is it administered? What is the dose it takes to get any of the interferon into the brain tissue?
thanks
thanbey
thanks
thanbey
There is absolutely nothing in the article that you have linked to that has a scintilla of evidence that interferon has any effect at all for hepatitis c or that it crosses the blood brain barrier.
Are you suggesting that because chemotherapy, which includes a number of drugs applied directly to a brain tumour during neurosurgery (opening up the skull), has some benefit for a metastatic brain cancer there is a logical relationship between that and a subcutaneous injection of a pegylated interferon?
I doubt that there is any doctor anywhere that would suggest drilling into the patient's brain to inject interferon, pegylated or otherwise, would be worth the risks for someone with hepatitis C.
thanbey
Hepatitis C Outreach Project
Are you suggesting that because chemotherapy, which includes a number of drugs applied directly to a brain tumour during neurosurgery (opening up the skull), has some benefit for a metastatic brain cancer there is a logical relationship between that and a subcutaneous injection of a pegylated interferon?
I doubt that there is any doctor anywhere that would suggest drilling into the patient's brain to inject interferon, pegylated or otherwise, would be worth the risks for someone with hepatitis C.
thanbey
Hepatitis C Outreach Project
I thought I would find an issue with the statements of your above comment, I always do, but most of it was well expressed as as an opinion, and emphasizing the limitation of the lack knowledge in hcv. I actually found myself agreeing with almost everything.
Up to the mention of follow up by other specialties post tx. You must take into account that many of us women were already going to those specialists for extrahepatic manifestations WAY prior to tx. So to assign that expense as only an after effect of tx is selling the effects of the actual infection short.
Any tx for any illness should have the pt to dr exchange of benefit vs risk. there can be no argument about that.
No one can attribute the post tx expense as the effect of only interferon without also acknowledging the actual effect of the virus in other organs.
Of course, you already know how I feel about the plug ins...so no need to mention :-]
Up to the mention of follow up by other specialties post tx. You must take into account that many of us women were already going to those specialists for extrahepatic manifestations WAY prior to tx. So to assign that expense as only an after effect of tx is selling the effects of the actual infection short.
Any tx for any illness should have the pt to dr exchange of benefit vs risk. there can be no argument about that.
No one can attribute the post tx expense as the effect of only interferon without also acknowledging the actual effect of the virus in other organs.
Of course, you already know how I feel about the plug ins...so no need to mention :-]
You are correct. Some of the extrahepatic manifestations of hepatitis C are, indeed , present befre treatment with interferon.
Yet to be determined is whether, long term, things are made better.
However, there are many documented cases of interferon induced effects of interferon therapy and these are well documented in the literature prior to the use of interferon therapy for hepatitis C.
This is a topic worthy of much more attention than it currently receives, funding for research-wise and in every other way.
Thanks,
thanbey
Yet to be determined is whether, long term, things are made better.
However, there are many documented cases of interferon induced effects of interferon therapy and these are well documented in the literature prior to the use of interferon therapy for hepatitis C.
This is a topic worthy of much more attention than it currently receives, funding for research-wise and in every other way.
Thanks,
thanbey
It is important because, while the viral infection may not show up in the blood tests, it may still be acting on the very part of the body that makes us all human.
If there is continued infection in the brain, or any other part of the body, we need to look for a better way to treat it than we have now. There are studies that have found virus in the liver beyond an SVR. There are studies that have found that there isn't. So, the possibility of that happening is there, at least.
And, finally, there may be better ways right now for people to feel better. Interferon impacts only about 10% of the population infected with hepatitis C at this time.
It is important do that people whose infection and symtoms do not resolve are not simply sent home and told it is all in their heads, when in fact, it well may be and there may be startegies found to improve their quality of life in a way that interferon is not able to do.
That's why I think it is important. But this is, in fact, just my opinion and I'm not a doctor.
thanbey
for articles, www.hcop.org
If there is continued infection in the brain, or any other part of the body, we need to look for a better way to treat it than we have now. There are studies that have found virus in the liver beyond an SVR. There are studies that have found that there isn't. So, the possibility of that happening is there, at least.
And, finally, there may be better ways right now for people to feel better. Interferon impacts only about 10% of the population infected with hepatitis C at this time.
It is important do that people whose infection and symtoms do not resolve are not simply sent home and told it is all in their heads, when in fact, it well may be and there may be startegies found to improve their quality of life in a way that interferon is not able to do.
That's why I think it is important. But this is, in fact, just my opinion and I'm not a doctor.
thanbey
for articles, www.hcop.org
The statement: Interferon impacts 10% of the infected population, needs a little clarification. Is not sarcasm but true confusion. Is it 10% of Known infections or 10% of the estimated 4 million infected of which the majority don't know of this infection, or 10% of the few that know they are infected and chose to treat or does it include the ones that did not choose to treat? Ok, now my head is spinning...
Clinical trials only hand select certain patients for inclusion. So, those resulting numbers apply only to the same population of people reflected in those criteria.
That limits response rates for all-comers in a community setting.
For those who would not meet the inclusion criteria due to a multiplicity of reasons, for whom interferon is not a safe option, who choose not to treat, for those who cannot afford it or have not insurance, for those who are too young, too old, African American, homeless, incarcerated, those who have co-morbidities, autoimmune complications, heart patients, and those who do not realize an SVR.
Why is this important? Because those patients matter, too. And they represent the vast majority of those affected by and infected by hepatitis C. As an individual patient you can afford to disregard those patients, but if you are an educator or a researcher, or a compassionate human being, I don't think you can.
The fact is we have a treatment that applies to a narrow minority of patients infected with hepatitis C and that poses a public health, humanitarian, and clinical problem. Can we afford to think that it isn't an important problem?
<a href="http://www.hcop.org/hcvinfo/articles/index.cfm?articleid=97">SURPRISINGLY LOW IMPACT OF INTERFERON ON HEPATITIS C PATIENTS IN A METROPOLITAN HOSPITAL LIVER CLINIC SETTING</a>
thanbey
That limits response rates for all-comers in a community setting.
For those who would not meet the inclusion criteria due to a multiplicity of reasons, for whom interferon is not a safe option, who choose not to treat, for those who cannot afford it or have not insurance, for those who are too young, too old, African American, homeless, incarcerated, those who have co-morbidities, autoimmune complications, heart patients, and those who do not realize an SVR.
Why is this important? Because those patients matter, too. And they represent the vast majority of those affected by and infected by hepatitis C. As an individual patient you can afford to disregard those patients, but if you are an educator or a researcher, or a compassionate human being, I don't think you can.
The fact is we have a treatment that applies to a narrow minority of patients infected with hepatitis C and that poses a public health, humanitarian, and clinical problem. Can we afford to think that it isn't an important problem?
<a href="http://www.hcop.org/hcvinfo/articles/index.cfm?articleid=97">SURPRISINGLY LOW IMPACT OF INTERFERON ON HEPATITIS C PATIENTS IN A METROPOLITAN HOSPITAL LIVER CLINIC SETTING</a>
thanbey
I don't think it is better to use metaphors of liver cooking dragons, dragon slayers, death and the holy grail of an SVR or any other superstitions to scare people into a treatment or to stay on a treatment they may not need and may do more harm that good. It is not a balanced view of the situation and it oversimplifies the issues and diminishes the serious nature of what is being considered.
Better that people make personal decisions having had the opportunity for decisionmaking based on facts and data. At least having the informaiton on what is and is not known about the treatment they are considering.
That is my point of view.
Taking comments out of the context in which they are written is a desperate attempt to bolster a weak case. Why bother? It is what it is and people are adults and can research for themselves, discuss with their physicians, and do whatever fact finding they feel personally comfortable with. I cheer on those who undertake the treatment and and those who do not, equally.
At the end of the day, it is the patient and the knowledgeable physician who are the best combination therapy and we are but voices on an internet board. Nothing I do or say is intended as a substitute for a person's own good judgement and that of their provider.
best thoughts,
thanbey
Better that people make personal decisions having had the opportunity for decisionmaking based on facts and data. At least having the informaiton on what is and is not known about the treatment they are considering.
That is my point of view.
Taking comments out of the context in which they are written is a desperate attempt to bolster a weak case. Why bother? It is what it is and people are adults and can research for themselves, discuss with their physicians, and do whatever fact finding they feel personally comfortable with. I cheer on those who undertake the treatment and and those who do not, equally.
At the end of the day, it is the patient and the knowledgeable physician who are the best combination therapy and we are but voices on an internet board. Nothing I do or say is intended as a substitute for a person's own good judgement and that of their provider.
best thoughts,
thanbey
Ok I got that the 10% minority comes from the data from clinical trials? There are scores of us under tx not in that data and will not be, how can anyone then conclude that the majority or at least, a larger minority than 10% of the infected population is not impacted by interferon Tx? That the actual benefit vs risk is not higher?
How many stats like me, on Tx, not included thus making that estimation quite inaccurate. The only thing I am learning from stats recently is that they reflect a lot of inaccuracies. whew!
How many stats like me, on Tx, not included thus making that estimation quite inaccurate. The only thing I am learning from stats recently is that they reflect a lot of inaccuracies. whew!
I know that alot of people do believe here that if they are in fact on the treatment and don't come out of it....The big holy word "SVR". That in fact this disease will put them in their grave. I'm sorry...I don't feel that way at all in fact my dr when I first went to him and was crying...He said this is not a death sentence and I do truly believe that. I'm not so naive as to believe that it does not have the potential in some cases to kill. I have done lots and lots of research on this and know each and everyone of you do also and there is not that many cases of death. I know that alot of deaths are probably due to liver failure and noone even knew they had hep c. However, we all in this forum are fully aware that we have it which is a godsend on our part. We can be evaluated yearly and so on. If you are in fact a SVR...Congratulations but....Please remember that alot of us are either still in process of working on it or didn't make it and we don't need the doom and gloom comments of non--SVR's.
Some of these posts are coming dangerously close to being personal attacks instead of disagreements of opinion. Please think twice before posting; I don't think any of us wants to go down that road again.
G
G
ROFL....This could be "personal" ya think?
This site is viewed by 10s of 1000s, unlike some others. (A subtle peek behind the curtain
This site is viewed by 10s of 1000s, unlike some others. (A subtle peek behind the curtain
after having read several of thanby's posts.
it seems to me that she is against treating, i may be wrong
and she is entitled to her opion.
she does give decent advice at times and just when i think she is here to support us she starts her anti treatment campaing again.
if i'm wrong i appologise but this is the interpation that i get from her posts.
dan
it seems to me that she is against treating, i may be wrong
and she is entitled to her opion.
she does give decent advice at times and just when i think she is here to support us she starts her anti treatment campaing again.
if i'm wrong i appologise but this is the interpation that i get from her posts.
dan
haha Ok...I'm joining in bleachers but...not cleaning em!! LOL Pass the peanuts!! Awww..I just read Audrey is off tx...Lucky her!! Just kidding but I would love to walk away at times from tx LOL
What was said earlier (by Thanbey) about being shunted off to other specialisms when tx has left you with long term damage struck a chord with me. Since I finished tx a year and a half ago I have been pronounced "cured"/SVR by the liver unit and discharged from the hospital. They don't want to see me anymore (understandably) and now I have to rely on my GP, my family doctor, who is not an expert in endrinocology (sp). My thyroid was damged by the interferon, not the hepatitis. I have been told it is permanent damage. The thing is that I have to hassle to get appointments, to get blood tests, to find out idf I am on the right dose of medication. I know our system in the UK is different from the US, but it's the same principle of liver specialists not being able to follow up any damage done by the interferon. I am not "anti-tx", but I think we are right to be wary of this very toxic medicine. I am always amazed when people come on here and say how they have begged their doctors to do extra weeks, when they have minimal chances of achieving SVR. Don't they realise that each extra week is potentially the one that does the damage? I think treatment is not to be undergone lightly, and demanding to have extra tx against the wishes of your doctors is inadvisable.
That is such a relief as I had been wondering how she was and getting worried. So glad you told us that as I would not have gone down that far on the thread...haha too much energy..ya know
I can relate to your experience. When I developed thyroiditis on tx, my GI told me he does not treat it in his practice and that I'd need to go to my PCP. She eventually refered me to an endocrinologist. Now I'm seeing three doctors. So far, I have not been told it's permanant damage, but that we'll have to wait and see what happens as my thyroid levels come down. All my docs are saying it MAY be caused by the INF and that there is no way we'll ever really know. Seems very suspect to me! I don't have any problems getting appointments, just very tired of going to them so often, but I think it's going to get better now that I'm done with tx.
This is a VERY interesting discussion, folks. I like finding lively minds. (Mine, about to enter week #12, often gropes in the semi-dark, right now.) Well,britgirl, the thing about the thyroid is, if you hadn't done treatment and reached SVR, the HCV might have got to your thyroid, and done the damage. It's a gamble. Thyroiditis is, I think, a more common result of long-term infection with HCV than many realize. Along with diabetes, pancreatitis, gall-bladder disease, cryoglobulinemia (I've heard a whole bunch of experts theorize at least 1/3 with HCV will develop cryoglobulinemia, and I've seen, in others, how painful that can be... not to mention it will put some on the kidney transplant wait-list). Anyway, thanbey, why "women"?? Why do you think the risks of treatment might be so much greater, for all WOMEN, you would lump us together like that? The risks of NOT getting treatment are just as great for women, as for men. No? From the point of view of someone who is one (a woman) and waited and watched until the last minute, sort of (I'm 59) -- I'm not being just irritable, here, I really am interested to know why you would lump all women together like that, irregardless of age, stage of fibrosis, non-hepatic HCV conditions, etc.?? thanks, cheri'
Can I get a seat up there in the bleachers too?
This is gettin funny again.
I'll bring the Hot Dogs...............
This is gettin funny again.
I'll bring the Hot Dogs...............
Sorry to get off topic, but does anyone have any information on the probabilities for SVR if test results show undetectable virus at week 12.
I suspect that the odds jump dramatically but I haven't seen any statistics that isolate on the success/relapse rates for people who are undetectable early in treatment.
Thanks,
Dave
I suspect that the odds jump dramatically but I haven't seen any statistics that isolate on the success/relapse rates for people who are undetectable early in treatment.
Thanks,
Dave
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