One of the reasons I am trying to understand the mechanisms of relapse/being found detectable is: When you become undetectable (I am cirrhotic) as early as I did (2 weeks) on triple tx you get hopeful Until you read there is a 14% chance your "undetectability" will be sustained when cirrhotic.....d
Good luck to you. Sorry about your history with tx. but the triple is clearly superior to the dual therapy. I have been undetectable since week 2-3 via Incivek....
I just had my post treatment appt with my liver specialist yesterday. i treated for 48 months and was und at 12. i finished tx in December and i relapsed 1 month after. he said that the virus possibly is in the lymphatic system, pancreas and he mentioned a few other organs (i can't remember) and after treatment this is how it gets back in your system. this questions has bothered me too; especially now. although the biopsy and the mri came back negative for cirrhosis, he said i probably have it; although in the early stage....wow, how lucky for me.......he also said that there is a 25% relapse rate with SOC; that i didn't know. i was of the understanding that it was around 5%.......(&*#&# #&#^ ^# #&#) i'll be starting triple tx in july or august. he suggested Incivek because he said it was a bit stronger. oh the joy, i can't wait...good luck yodennis...we'll beat this someday.
Just cause I had a transplant doesn't mean I know anything about it, LOL !
Ask Hector, if I'd known what he knows I'd have been scared crazy.
Yes, its supposed to be harder to clear the virus with cirrhosis, the further along, the harder. My understanding is it has to do with the scarring.
I'm convinced I relapsed the first time I did tx because my liver was already so badly decompensated.
Many people here have reached SVR with beginning cirrhosis.
rivll said: I am very interested in your theory. Can you send some links so that I can investigate your sources more in depth.
OH will probably chime in on this,( hopefully esp if I get it wrong) but she had a transplant and the virus return to attack the new liver. Check it out.
Reply: It came up in a conversation with my doctor. I had been reading some studies when I was trying to decide whether to start treatment. They indicated people with cirrhosis are more likely to relapse, even if they were UND during treatment. I asked the doctor why, and he said something to the effect the pegatron isn't as effective at neutralizing the virus when it's inside damaged/dead liver tissue.
http://www.tropicalgastro.com/articles/30/4/Sustained-virological-response-to-pegylatedinterferon-and-ribavirin-in-patients-with-genotype3-HCV-cirrhosis.html
For genotypes 2 and 3 (I'm a 3a) the pegatron treatment is highly effective for people without cirrhosis, but the success rate is much lower for those of us at stage 3 or 4.
This DOESN'T mean there is a zero chance of a relapse in people with no cirrhosis or who had a liver transplant. It just means the chances of a relapse are higher and the chances of SVR are lower if you have cirrhosis.
Terrific articles (as opposed to terrific news). Thank you for taking the time. d
Yes: You're right! Strike my last comment. I think my brain is dehydrated....d
I guess this is why we get tested six months post tx. The meds keep the numbers down, the real test is what happens without them.
Hi Dennis: You may want to check out this link too.
http://www.hindawi.com/journals/ijmb/2012/647581/
In 2009, my viral load went from UND to 1.8M within a month after I stopped peg & riba treatment. I'm convinced the virus had to have been in hiding for it to re-emerge at that level in my blood stream. Maybe it was hiding in my liver. Maybe it was hiding in my lymphatic system. Maybe it was hiding somewhere else. Maybe there is another explanation .......
My hepatologist explained that undetected in the blood does not mean it's undetected in your liver. That's why you keep doing treatment even when your blood test says undetected.
Hi Dennis, You may want to search for "Can the HCV virus exist in the lymphatic system?" or "Can the HCV virus exist in lymphoid cells?"
Here are some hits:
http://jvi.asm.org/content/78/11/5867.full
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC415836/
Hi Peter,
I am very interested in your theory. Can you send some links so that I can investigate your sources more in depth.
OH will probably chime in on this,( hopefully esp if I get it wrong) but she had a transplant and the virus return to attack the new liver. Check it out.
dennis....you would have to get a transplant while on tx and und to test that out wouldn't you?
Saying residual undetected HCV exists within damaged liver tissue only answers the question partially (at best). If that were the only place it was hiding or latent a liver transplant would not reinfect....I have tried doing some research but have not found the answer...
I was hep c 1a and my liver was stage 2 level 2.It still came back after 9 months of UND
What it means is that is was undetectable, but not really gone.
Do you have cirrhosis? Sometimes the virus is undectable by the blood tests, but still exists inside damaged liver tissue. People with cirrhosis have higher relapse rates.
This is a question I hope someone here answers.When I did my 11 month of SOC I was UND the last 9 months.After completing tx,on my 1st month blood work,my dr told me it was back.I was mad as hell.Where was the hep in those 9 month of UND?