Is someone a carrier of hepititis C if they have spontaneously cleared the virus?

[magpie266]

Is someone a carrier of hepititis C if they have spontaneously cleared the virus?

I am researching reasons that the armed forces may not accept somene with the above...

help would be appreciated

thanks :o)

[GrandmaA]

Technically no, however I don't think they can donate blood or organs.

[magpie266]

Does that mean they could join the forces? The army website states that they may not consider someone if they are a carrier of hep C....

Thanks for the quick response :o)

[jmjm530]

I couldn't find a reference to Hep C on the army site, but I did see a discussion group there. Why don't you post your question -- anonymously of course and not using your real email address -- and see what kind of answers you get. You also might want to do the same and ask a recruiter, although no one seems to know anything these days, if other experiences in finding out things is a guide.

That said, if you spontaneously cleared the virus, you will not have any viral load and your liver enzymes are probably normal. The only way they could detect someone who spontaneously cleared would be if they did an antibody test. Not sure if they do it or not.  My feeling is that this would not be a problem but always better to check it out. And do let us know what you find out.

BTW when you post (or ask) your question. Make sure you are clear that you do not have Hepatitis C (no virus) and that you only carry the antibodies because you spontaneously got rid of it. Not that anyone will probably understand that which is part of the problem. Come to think of it, maybe you might try contacting the medical recruitment unit -- if there is such a thing -- and speak to one of the doctors. Maybe they will know a bit more.

-- Jim

[mremeet]

You're only a "carrier" of hep C is you have an active infection. There are two type of infections, one is acute which is the early phase of infection and the other is chronic which is a permanent long lasting form of the infection. Some people either clear the virus themselves (about 1 in 5) after becoming acutely infected, and others get treatment after becoming infected and become "SVR". If you SVR, what this means is that the virus is no longer detectable in your blood, the virus has been eradicated and you no longer have an active infection. You consistently test negative for the virus with sensitive blood tests for many years afterwards (and probably for life). However, there is some dispute and ambiguity within the medical community about whether the virus is really completely gone and harmless and non-infectious after successful treatment though. Since this is true, if you have ever had HCV you cannot donate organs or blood. It is not known with 100% certainty if the blood or organs of a "cured" HCV patient might infect an uninfected person. And since those who had HCV have come into contact with foreign infected blood, they may also have come into contact with some other pathogen that has yet to be identified (and hence cannot be screened in current blood testing). So just to be on the safe side we are excluded from sharing our blood and organs (sensibly so in my opinion).

Otherwise, some hepatitis B patients can be "carriers". As far as I know, they can have the virus and be infectious and yet the virus is not harming them. Maybe the source of information you read about HCV "carriers" mistakenly intermixed the two? There's a lot of misinformation and ignorance about HCV out there, even amongst many within the medical community. If you or someone you know wants to get into the army, I wouldn't just assume you won't be able to just because you test + for HCV antibodies but are - for the virus itself (i.e. you naturally cleared or are SVR). A well informed doctor should recognize that you're ok for service and could probably write you up a recommendation for an exception to any rule that may exclude someone formerly infected with HCV. You can also contact your local congress(wo)man to help get that through. I knew several people who didn't have perfect uncorrected eyesight and wanted to fly jets for the military and were able to get a waiver through the influence of their congressional representatives.

But with all that said....are you suuuurreeee you want to join the army?? ;-)

[GrandmaA]

Viruses never leave the body completely. I know a lady who cleared the virus with treatment. She also had lupus. Another doctor gave her prednisone and the chronic hep. C came back. She waited a year and treated again. So to all who become SVR please be careful what meds you take in the future.

[Trish77]

This may be of no help at all but I'll include it anyway.  There are three phases of Hep B.  Acute, Carrier and Chronic.  Acute means you had, it cleared it and while the antibodies remain in your blood, you are non-infectious and immune by virtue of the properties of the antibodies that you have.  You are NOT considered a Carrier.  A Carrier is as mremeet describes...IS infectious however the disease is not harming you.

You might want to determine what they mean by "Carrier" which could be their way of saying "infectious" and able to pass it on to others.  And then determine if that is your status.

Hope this helps.

[magpie266]

I have never had treatment for this but I was only 15 when contracted and therefore my body cleared it withiut me even knowing i had it..... I found out 3 years later accidently .... lets hope they let me in.... many thanks for your help and i will keep you informed as to whether they do let me in.... many thanks again

[magpie266]

One more question - will I always have the anti-bodies in my blood?

[jmjm530]

Trish mentioned "hep b" so not sure if a mistake or if she's talking about hep b. In any event, Hep C is different.

There is no such thing as a Hep C "carrier". You either have Hep C or you don't. And since you don't have any viral load, you don't have Hep C.

-- Jim

[jmjm530]

You probably will always have Hep C antibodies but some people do lose them over time. I suppose you could test for antibodies every year or so if really interested, just don't have too high an expectation they will disappear.

[magpie266]

Just one more thing this is the UK army... :o)

[mremeet]

Trish you stated above that "acute" means you "had" the virus but cleared it. An acute infection simply means you are in the early phases of the infection with no regard to whether or not you will clear the virus later (either naturally or via antiviral drug therapy). And as far as "carrier", I've never heard of HCV being referred to that way. Other than simply being chronically infected and being asymptomatic with no liver damage. But whatever, I guess a rose by any other name is still a virus.

magpie - I don't think anyone really knows for sure if the antibodies will last your entire life. Especially considering how young you were when you contracted and then naturally cleared the virus. As the decades roll by, you may eventually no longer test + for HCV antibodies. They do typically decrease over time, just like other antibodies for other viruses or vaccines you may have had. But depending on how old you are now, I seriously doubt they'll test negative within the window of time that you'll be eligible for service.

[jmjm530]

Oh. Then I would ask the Queen :)

[mikesimon]

From:
Occult hepatits C virus persistence: identification and characteristics
By Tram N.Q. Pham, PhD, and Tomasz I. Michalak, MD, PhD

Antibodies to HCV (anti-HCV) are detectable by commercially available enzyme-linked immunoassays in 50% to 70% of patients at the onset of symptoms,increasing to more than 90% after three months, and completely disappearing 10
to 20 years after resolution of hepatitis.

The reference citation for that statement according to the footnote is:
Takaki A, Wiese M, Maertens G, Depla E, Seifert U, Liebetrau A, Miller JL, Manns
MP, Rehermann B. Cellular immune response persist, humoral responses decrease
two decades after recovery from a single source outbreak of hepatitis C. Nature
Med. 2000;6:578-582

Mike

[l-horn]

is a retired Army Colonel and was head of gastroenteroloy at Walter Reed before going into private practice. He may be able to help you. His name is Shaleish Kadakia and he is now in private practice in San Antonio, Texas.

[mremeet]

Thanks for that information about the antibody decay, first time I've ever seen something like that. I suppose they're only talking about people who naturally cleared the virus in the study you've referenced? Any word on people who had been chronically infected for many years prior to getting their SVR? Like would they lose their antibodies at the same rate as a naturally cleared person? And also, how do they know that a complete resolution of HCV antibodies may take up to 20 years since the test for HCV hasn't been around that long? In other words, they would have to know exactly when someone was infected before they could start their clock, and since there was no test for HCV in 1980 (this citation was referenced in 2000), and wasn't even widely available in 1990 either, how could they know for certain how long ago some "natural SVR" people had been initially infected?

[jmjm530]

I wonder if something is missing from the translation or just a difference of opinion. The statement "and completely disappearing 10 to 20 years after resolution of hepatitis' seems wrong and seems to need the modifer "in many patients" added -- as did the study you posted some time ago showed and others as well:
http://www.medhelp.org/forums/hepatitis/messages/42207.html

[jmjm530]

"In a study of a cohort of Irish women infected with HCV via contaminated anti-D immunoglobulin in 1977, 47.1% of 68 women who had spontaneous clearance of HCV still had anti-HCV antibodies 18 years after the initial infection."
http://www.medscape.com/viewarticle/432543 (free Medscape Registration Required"

[GrandmaA]

What a conincidence I'm part Irish and I was infected in 1977 through a blood transfusion. I only carried antibodie for hep. C, I had no acute or chronic condition until 2 or 3 years later after I took 1 1/2 bottles of kava kava and it brought on the chronic condition. I never had the acute one.

[jmjm530]

Kava Kava has been linked to liver damage. Kava Kava couldn't have brought the virus back if it was truly gone, but it could have caused an enzyme flare which is what you may have experienced. Technically you were "chronic" six months after you were infected via the blood transfusion. Often there are no symptons in either the acute or chronic stage. BTW I had a similar reaction around 4 years ago from some Chinese Herbs of unknown origin, or perhaps the Hep B vaccine -- not sure as I took them at the same time.

-- Jim

[mikesimon]

I don't know whether the absence of antibodies can occur with SVR from treatment. I did find this which seem to support a loss of antibodies after acute infection and recovery. Treatment/SVR was not addressed - only resolution of acute vs chronic HCV.

"In contrast to a detailed understanding of antiviral cellular immune responses, the impact of neutralizing antibodies for the resolution of acute hepatitis C is poorly defined. The analysis of neutralizing responses has been hampered by the fact that patient cohorts as well as hepatitis C virus (HCV) strains are usually heterogeneous, and that clinical data from acute-phase and long-term follow-up after infection are not readily available. Using an infectious retroviral HCV pseudoparticle model system, we studied a cohort of women accidentally exposed to the same HCV strain of known sequence. In this single-source outbreak of hepatitis C, viral clearance was associated with a rapid induction of neutralizing antibodies in the early phase of infection. Neutralizing antibodies decreased or disappeared after recovery from HCV infection. In contrast, chronic HCV infection was characterized by absent or low-titer neutralizing antibodies in the early phase of infection and the persistence of infection despite the induction of cross-neutralizing antibodies in the late phase of infection. These data suggest that rapid induction of neutralizing antibodies during the early phase of infection may contribute to control of HCV infection. This finding may have important implications for understanding the pathogenesis of HCV infection and for the development of novel preventive and therapeutic antiviral strategies."

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1851610

[Trish77]

Yes, I was truly referring to Hep B and only as a comparison and that's why I said "I don't know if this is of any help at all"...simply referring to the fact that Hep B antibodies remain in the blood even if you've cleared it and are non-contagious/immune.  So.. all in all, pretty useless information really when she's asking about HCV ....  however I wanted her to distinguish what THEY mean by being a carrier.. if it means being contagious or simply having antibodies of ANY kind.  

[mikesimon]

I have been thinking about the Pham article. If he is right, and I believe that he is, that  Occult/Persistent HCV remains in many, if not the majority, of SVRs then it would be reasonable that hepatitis C antibodies would also remain in SVRs. This may be a significant distinction between those who experience spontaneous recovery and those who achieve SVR following treatment. Now, I am not suggesting or implying that SVR does not confer dramatic benefits because I believe that it does. I do believe, however, that traces of replicating virus remain and exactly how or if that affects  overall health has yet to be determined. I believe that as the sensitivity of viral detection tests improves these issues will come to the forefront and that DoubleDose may finally get some answers to his myriad questions. Mike

[jmjm530]

I'm OK with SVR as it now exists. In the future it may turn out that Pham is correct, incorrect, or partially correct. It may also turn out that if he's correct, the persistent/occult virus has no clinical significance or it may turn out it has some clinical significance. My personal opinion is that there will be no clinical significance to what he says he's found.

That said, I hope I'm wrong. I hope he's correct and there is a clinical signficance, because that potentially means that some of the symptons many of us report -- like DD and myself -- post treatment might therefore be treated with some future anti-viral. It's a nice thought but I really don't believe it nor am I waiting with held breath :)

-- Jim