Acute Hep C

[R3179]

If you tested for HCV Antibodies and cleared the virus on your own in 6 months, but had bloodwork to determine you once caught the virus, would you still ever test for a Genotype?

[desrt]

http://www.clevelandclinicmeded.com/hcv/lab.htm#antibody

From what I gather, you need HCV RNA to test genotype - not just antibodies. But...

since 80%-90% of us who are SVR still have detectible HCV RNA in our livers, you could probably get a biopsy and have it tested, if you're really curious. Don't know what that would cost though.

[Kalio1]

Just wondering where you get the 80 90% figure you state of people who have virus in their livers? How would you know this? People do not have biopsies after they clear the virus in general, even if a few do, that isnt representative. There arent even 80 to 90% of people who have biopises before they treat.

This seems like a made up figure to me since there is no way anyone has "80 90%" of biopsy liver samples of those who cleared the virus.

[desrt]

Give me a few to look up the study(s) I've read this figure in. They refer to both people who clear on their own and those who clear using IFN. The one that comes to mind was an Italian study that refered to both groups.
It's not a made up figure.

[desrt]

Detection of HCV in the Liver of Healthy, Anti-HCV Antibody-Positive, Serum HCV RNA-Negative Patients with Normal Alanine Aminotransferase Levels

The Journal of Infectious Diseases  July 1, 2006 ;194:53-60

Admittedly small study, but seems to have been carefully done, gave a result of 83% detectible in liver biopsies when serum undetectible. Still looking for the other study that used the 80%-90% figure.

[Kalio1]

Hmmm...well, that is a very small study. It doesn't go so far as to say 90% of all SVR's either. 83% of those in the study is not the same thing as "80-90% of all SVR's" which is a very broad statement. To me there is a very big difference between the two, thanks for psoting your reference though!

[desrt]

I understand the mistrust of small, unduplicated studies. It's like the sexual transmission thing - for years everyone took it as writtten in stone that there was a 3-5% chance of sexual transmission based on half a dozen couples in a single study. Then they went back, did some genotyping and gene sequencing and found that most, if not all, of the couples got their HCV from different sources.
Oops.

[chcnme]

If you spontaneously cleared, and if you're asking if you should know what genotype you had, I'd say - no.  I don't know any reason to know the genotype unless you are going to treat (I'm assuming a GI doc didn't recommended treatment for you.)  If a GI doc told me I had acute hep and had cleared it and didn't need treatment, I'd try not to worry about what geno I had. If I had just recently had a case of acute Hep, I'd want to be followed, and I might get another opinion from another GI doc, but even if I did that - I wouldn't worry about geno type yet.

[desrt]

See also: medhelp.org/forums/hepatitis/messages/43954.html

19/20 detectible for +strand RNA in liver biopsy = 95%
15/20 detectible for -strand RNA in liver biopsy = 75%

The point being that similiar results have been coming in from multiple studies for the last year. Whatever the final numbers are, I don't feel like I'm going too far out on a limb to say 80%-90%.
But hey - I've been wrong before ;-)
Take care.

[Kalio1]

The study had 20 people. I don't find it suprising at all that "occult" virus cna be found, Im sure that is true of many if not all viruses we are exposed to in our lifetime.