Aa
When to treat
I'm confused about why a newly diagnosed person (got infected in the last 6-9 months) would not be offered treatment yet. Is it just to see if the person will clear the virus on their own? Isn't the chance of a good response and cure better before the virus has been present very long? Is all this changing now that treatments are out that are so much better tolerated?
Best Answer
How soon after exposure to HCV can anti-HCV be detected?
HCV infection can be detected by anti-HCV screening tests (enzyme immunoassay) 4–10 weeks after infection. Anti-HCV can be detected in >97% of persons by 6 months after exposure.
How soon after exposure to HCV can HCV RNA be detected by PCR?
HCV RNA appears in blood and can be detected as early as 2–3 weeks after infection.
Under what circumstances might a false-negative anti-HCV test result occur?
Persons with early HCV infection might not yet have developed antibody levels high enough that the test can measure. In addition, some persons might lack the (immune) response necessary for the test to work well. In these persons, further testing such as PCR for HCV RNA may be considered.
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c5
It's really not a chicken or the egg situation, HCV RNA has to be present to initiate an antibody response, the AB's kick HCV butt (if your lucky) and the RNA is no longer detectable, I only suggested more testing because you think she might be acute and there might be a very very small chance the virus could reappear, highly doubtful though.
Have a great day
HCV infection can be detected by anti-HCV screening tests (enzyme immunoassay) 4–10 weeks after infection. Anti-HCV can be detected in >97% of persons by 6 months after exposure.
How soon after exposure to HCV can HCV RNA be detected by PCR?
HCV RNA appears in blood and can be detected as early as 2–3 weeks after infection.
Under what circumstances might a false-negative anti-HCV test result occur?
Persons with early HCV infection might not yet have developed antibody levels high enough that the test can measure. In addition, some persons might lack the (immune) response necessary for the test to work well. In these persons, further testing such as PCR for HCV RNA may be considered.
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c5
It's really not a chicken or the egg situation, HCV RNA has to be present to initiate an antibody response, the AB's kick HCV butt (if your lucky) and the RNA is no longer detectable, I only suggested more testing because you think she might be acute and there might be a very very small chance the virus could reappear, highly doubtful though.
Have a great day
Thanks for your thoughts, Dee. My daughter really does seem to know when she was exposed. She had blood work a year ago and was negative for HCV antibodies. She never shared any gear until about 2 1/2 months ago. She has communicated with the person she shared a needle with who does admit she has tested positive in the past. So, nothing's 100% but it seems pretty clear when the exposure occurred.
But are you sure having no viral load now means she has beaten it? Couldn't it just be too soon since exposure for the virus to be "countable?" Thanks again for your expertise. I will certainly post back when she gets her next blood work done.
But are you sure having no viral load now means she has beaten it? Couldn't it just be too soon since exposure for the virus to be "countable?" Thanks again for your expertise. I will certainly post back when she gets her next blood work done.
Hi looking back I see that you found out about your daughter doing heroin when she was 18. She could have gotten it at any time during the time she was doing IV drugs or if she snorted it at first sharing straws or dollar bills.
Also IV drug use is not the only way one can get it.
I recently read on this forum that they have discovered that the virus can live out side of the body for up to 6 weeks where originally it was said 4 days.
This would account for the many people who do not know how/ where/when they got it and had no risk for it.
People are cautioned not to share nail files, toothbrushes, dollar bills or straws to snort drugs up their nose because a microscopic bit of blood could transfer from one mucus membrane to another.
I worry about all the people who got home made tattoos and don't realize they are at risk, or even had a clean needle but the ink was contaminated.
I am afraid to get a manicure or a pedicure.
I read that 75% of the people who have it do not know they have it. This is why the CDC is recommending everyone born between 1945 and 1965 be tested.
Again, really happy that your daughter has no viral load, she may want to do some research as to how it is possible to spread.
Good luck
Also IV drug use is not the only way one can get it.
I recently read on this forum that they have discovered that the virus can live out side of the body for up to 6 weeks where originally it was said 4 days.
This would account for the many people who do not know how/ where/when they got it and had no risk for it.
People are cautioned not to share nail files, toothbrushes, dollar bills or straws to snort drugs up their nose because a microscopic bit of blood could transfer from one mucus membrane to another.
I worry about all the people who got home made tattoos and don't realize they are at risk, or even had a clean needle but the ink was contaminated.
I am afraid to get a manicure or a pedicure.
I read that 75% of the people who have it do not know they have it. This is why the CDC is recommending everyone born between 1945 and 1965 be tested.
Again, really happy that your daughter has no viral load, she may want to do some research as to how it is possible to spread.
Good luck
I am really happy to hear that your daughter has no viral load. This is wonderful news. I hope she will take this second chance and fly with it.
I know of a couple of people who have been exposed to HCV and their body was able to fight it off. Your daughter is very lucky
Take Care
Dee
I know of a couple of people who have been exposed to HCV and their body was able to fight it off. Your daughter is very lucky
Take Care
Dee
I was thinking no detectable virus meant it's too soon and it WILL become detectable in the future. Sounds like you're saying it's possible her immune system has already squashed the infection and maybe she'll never have detectable virus. That would be nice. She is young and healthy generally.
Her "doctor" is a family practice physician's assistant who I have not met but who sounds like he knows what he's doing. He has an interest in addiction and cares for lots of at risk persons.
Her "doctor" is a family practice physician's assistant who I have not met but who sounds like he knows what he's doing. He has an interest in addiction and cares for lots of at risk persons.
Thank you for the replies. My daughter went to the doctor today to get the results of viral load and genotyping. I was not able to go with her. She called me afterwards to say it's too early to know any more than she has been exposed (positive antibodies to hep C). Her viral load is undetectable and I guess genotype cannot be done when there is no detectable virus (makes sense). She now admits to me that she knows when she was infected; it was only about 2 1/2 months ago when she had a heroin relapse in an inpatient rehab center she was at. Makes me so mad--years of injecting heroin with the clean needles you can buy in any pharmacy in our state and she gets hep C in the rehab facility (where clean needles are scarce)!!
I guess from a scientific point of view it's interesting to follow the natural history of this virus starting so soon after the time of infection. I'm surprised that virus is undetectable 2 1/2 months later. Slow moving disease, indeed. Probably not many people know they have it so soon after contracting it.
So for now she will get her blood drawn every 3 months or so and just wait until there is virus to measure.
I guess from a scientific point of view it's interesting to follow the natural history of this virus starting so soon after the time of infection. I'm surprised that virus is undetectable 2 1/2 months later. Slow moving disease, indeed. Probably not many people know they have it so soon after contracting it.
So for now she will get her blood drawn every 3 months or so and just wait until there is virus to measure.
If I were you, I would wait a year or two. As has been said the virus moves very slowly. Time is on your side. These are very powerful drugs and no one really knows what kind of effects they may have a couple of years after treatment. Those of us treating now are essentially your guinea pigs. Wait and see what happens to us. I would not be treating now if I was not already sick.
Another reason to wait is that there are many new drugs just around the corner that may be better than the ones we presently have. We will be hearing a lot more about them after the first of the year.
Welcome to the forum.
Another reason to wait is that there are many new drugs just around the corner that may be better than the ones we presently have. We will be hearing a lot more about them after the first of the year.
Welcome to the forum.
Welcome, I am hoping that your daughter's body was able to fight the virus off. If not, she is very young and the virus moves very slowly.
Once you find out her geno type you can look at the tx options to see what is the best fit for her.
Tx is no longer a one size fits all of interferon and ribavirin. There are new drugs, shorter tx times, depending on the geno type.
As others have said, HCV is a very slow moving virus, if she has it.
I would suggest doing research about the various tx's, once you find out the geno type. As you can see there are many people on here more than willing to help out, provide support and information.
Take Care
Dee
Once you find out her geno type you can look at the tx options to see what is the best fit for her.
Tx is no longer a one size fits all of interferon and ribavirin. There are new drugs, shorter tx times, depending on the geno type.
As others have said, HCV is a very slow moving virus, if she has it.
I would suggest doing research about the various tx's, once you find out the geno type. As you can see there are many people on here more than willing to help out, provide support and information.
Take Care
Dee
sage: Welcome to the Forum. You will truly find support, information and answers here.
Kim: Well said!!!
Hi and welcome
I believe the medical community is at a crossroad currently as the newest meds for treatment of Hep C are coming out within 2 weeks. The other reason stems from the fact that the virus takes typically 20 years of being infected before showing liver damage.
You are right since treating early would give you a better shot before the virus settles in. I know in my situation my viral load was a mere 357, and clearence was anticipated. Many of us have viral loads in the millions which can have more of a stronghold. Might add, even if your #s are extremely high curing the virus is definitely not a problem.
As you mentioned up to 25% of infected patients can clear the virus with a strong immune system. Have they given you a viral load or genotype? Until recently many are treating with Interferon and this tends to have bothersome side effects for some. They may be waiting for the interferon free meds to become available.
I do believe its very smart of you for asking these questions. We need to stay on top of our medical issues as at times we can get lost in the shuffle. If I were in your shoes treating would be a good idea sooner then later for the reasons you've stated. Some of the newest meds are still in clinical trials so the verdict is still not 100% available. Would strongly suggest once you've established your genotype and you see success in the recommend treatment then it would be a good time to jump on the bandwagon.
Your very lucky to have found out that you do harbor this virus before any repercussions are felt. It's truly a silent killer as many contribute their feelings of fatigue and other issues to overdoing it or working way to many hours.
You've come to the right place for advice, knowledge, and support. We are all either patients or caregivers of patients, and can help guide you thru this maze of unanswered questions.
Take Care
....Kim
I believe the medical community is at a crossroad currently as the newest meds for treatment of Hep C are coming out within 2 weeks. The other reason stems from the fact that the virus takes typically 20 years of being infected before showing liver damage.
You are right since treating early would give you a better shot before the virus settles in. I know in my situation my viral load was a mere 357, and clearence was anticipated. Many of us have viral loads in the millions which can have more of a stronghold. Might add, even if your #s are extremely high curing the virus is definitely not a problem.
As you mentioned up to 25% of infected patients can clear the virus with a strong immune system. Have they given you a viral load or genotype? Until recently many are treating with Interferon and this tends to have bothersome side effects for some. They may be waiting for the interferon free meds to become available.
I do believe its very smart of you for asking these questions. We need to stay on top of our medical issues as at times we can get lost in the shuffle. If I were in your shoes treating would be a good idea sooner then later for the reasons you've stated. Some of the newest meds are still in clinical trials so the verdict is still not 100% available. Would strongly suggest once you've established your genotype and you see success in the recommend treatment then it would be a good time to jump on the bandwagon.
Your very lucky to have found out that you do harbor this virus before any repercussions are felt. It's truly a silent killer as many contribute their feelings of fatigue and other issues to overdoing it or working way to many hours.
You've come to the right place for advice, knowledge, and support. We are all either patients or caregivers of patients, and can help guide you thru this maze of unanswered questions.
Take Care
....Kim
That's a very good question to ask your doctor. I guess the sickest are getting treated first but all that is about to change soon.
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STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Is it possible for someone to become infected with HCV and then spontaneously clear the infection?
Yes. Approximately 15%–25% of persons clear the virus from their bodies without treatment and do not develop chronic infection; the reasons for this are not well known.
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c5
What is Hepatitis C?
Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the Hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person. Hepatitis C can be either “acute” or “chronic.”
Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection.
Chronic Hepatitis C virus infection is a long-term illness that occurs when the Hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.
http://www.cdc.gov/hepatitis/C/cFAQ.htm
The only way to know if someone has Hepatitis C is to get tested. Doctors use a blood test, called a Hepatitis C Antibody Test, to find out if a person has ever been infected with Hepatitis C. The Hepatitis C Antibody Test looks for antibodies to the Hepatitis C virus. Antibodies are chemicals released into the bloodstream when someone gets infected. The antibody test results will take anywhere from a few days to a few weeks to come back, although new Rapid Antibody Tests are available in some settings.
A Non-reactive or a negative Hepatitis C antibody test result means that a person does not have Hepatitis C. However, if a person has been recently exposed to the Hepatitis C virus, he or she will need to be tested again.
A Reactive or a positive Hepatitis C antibody test result means that Hepatitis C antibodies were found in the blood and a person has been infected with the Hepatitis C virus at some point in time.
A reactive antibody test does not necessarily mean a person still has Hepatitis C. Once people have been infected, they will always have antibodies in their blood. This is true if even if they have cleared the Hepatitis C virus. A reactive antibody test requires an additional, follow-up test to determine if a person is currently infected with Hepatitis C.
http://www.cdc.gov/knowmorehepatitis/LearnMore.htm
NUCLEIC ACID DETECTION
The diagnosis of HCV infection can also be made through detection of HCV RNA using reverse transcriptase polymerase chain reaction (RT-PCR) techniques (Figure 1). HCV RNA can be detected within one to two weeks after exposure to the virus, weeks before the onset of ALT elevations or the appearance of anti-HCV.42 In some patients, the detection of HCV RNA may be the only evidence of HCV infection.
http://www.aafp.org/afp/1999/0101/p79.html
She already has 1 neg HCV RNA test, I would wait a month and check again to be sure she is neg
Have a great day