Aa
Clearing the virus
Just wondering..does anyone know how quickly its possible to clear the virus? From what I can tell from my pcr results today, I cleared it on my own..but I thought I got it like 4 months ago..? I figured it might take awhile to a virus like this to just clear. Does anyone have any knowledge about this? Thank you!
The definition of a Chronic HCV is infected 6 months or more. Acute is less than 6 months. So, generally, it would be in the range of 6 months or less.
As a veteran of the Army, where I got HEP-C 40 years ago, and a research junkie for the past 15 since being diagnosed, it is my understanding that you never really get rid of the virus. It may remain what is called "undetectable" which is under 50, but you will always carry the antibodies in your blood. I have met people who tried to resume a lifestyle that included alcohol intake and they weakened their liver enough for the virus to get started up again. By the way, what are your ALT, AST levels? If they are normal you should be fine.
If your virus never really became detectable, you may be one of the lucky ones who was able to fight it off on your own. I hope so because that would be very good new for you!
Good luck!
If your virus never really became detectable, you may be one of the lucky ones who was able to fight it off on your own. I hope so because that would be very good new for you!
Good luck!
Hi Veteran,
"a research junkie for the past 15 since being diagnosed, it is my understanding that you never really get rid of the virus"
Through your 15 years of research, obviously you collected study links, lord knows I have (lol), could you please post one that suggests one never rids themself of the virus after obtaining a sustained reponse?
I also would like to see a link to a research study suggesting alcohol or a weakend liver results in the "for the virus to get started up again".
Thanks in advance.
Pro
(who figure's most studies and results prior to ribavirin are far to outdated to be considered.)
"a research junkie for the past 15 since being diagnosed, it is my understanding that you never really get rid of the virus"
Through your 15 years of research, obviously you collected study links, lord knows I have (lol), could you please post one that suggests one never rids themself of the virus after obtaining a sustained reponse?
I also would like to see a link to a research study suggesting alcohol or a weakend liver results in the "for the virus to get started up again".
Thanks in advance.
Pro
(who figure's most studies and results prior to ribavirin are far to outdated to be considered.)
PS: I didn't mean to sound so sarcastic in my previous post, I apologize.
by the by, there are now viral load tests to determine "undetectable" measuring down to 2 iu/ml
by the by, there are now viral load tests to determine "undetectable" measuring down to 2 iu/ml
As far as I know, I will always test positive for the antibodies. As for the alt/ast levels, I'm not sure they did those tests because nothing came back on my report..Maybe I should ask the doc to run those tests. However, I think I'm probably just going to wait awhile and get another pcr to see if anything has gotten worse. I believe I got this in early summer of this year. So maybe I just need a little more time for accurate results. Thanks for the info
Hi Veteran - I would like to know the same thing that Proactive asks regarding the "drinking." I know that alcohol is not good for the liver but when I reach SVR I plan on having a glass of wine to celebrate.
Hi. I don't want to come across as a know it all, I am not that way. I believe very strongly in research and my 60 years on earth has taught me that a person is always learning. Below is a link that will give you a bit more info on drinking and hepatitis-c. I can provide you with a lot more similar information. Being a veteran of the Army and having end stage with severe cirrhosis, I can't get medical coverage from anyone else. Plus the VA has some really good specialists, especially as the incidence of Hep-C is five times higher in Vietnam era veterans, like me, than in the rest of the population. A lot of what I learn comes from the infectious disease specialists in the VA. Anyhow, here is the link showing the correlation between alcohol consumption and hep-c. If you would like more to read, just let me know.
http://alcoholism.about.com/cs/hepc/a/blupa030626.htm
http://alcoholism.about.com/cs/hepc/a/blupa030626.htm
Thanks for the article Veteran, although I fail to see it's relevance in regards to your statement of alcohol facilitating the virus to "start up again" I as well have read 100's of articles and studies, and have never seen anything suggesting alcohol as a cause of relapse after reaching svr.
Even the va has changed it's guidelines:Here is a link that quotes the va's hcv program director
" The doctor in charge of VA's program sees it as a matter of developing the right tools.
"Until recently, hepatitis C antiviral treatment was felt to be inadvisable in patients with psychiatric disorders and recent or ongoing substance abuse problems, including alcohol use," said Michael Rigsby, director of VA's National Hepatitis C program. "This was based on concerns that such treatment might not be safe for these patients and that the efficacy of antiviral therapy would be diminished.
"However, there has been a recent change, reflected in VA treatment recommendations and in the recent National Institute of Health (NIH) consensus statement, toward individualizing decisions about treating these patients. In general, such conditions, which are commonly encountered in patients with hepatitis C, are no longer felt to be absolute barriers to effective antiviral therapy."
http://findarticles.com/p/articles/mi_m0LIY/is_1_91/ai_107759683/
Even the va has changed it's guidelines:Here is a link that quotes the va's hcv program director
" The doctor in charge of VA's program sees it as a matter of developing the right tools.
"Until recently, hepatitis C antiviral treatment was felt to be inadvisable in patients with psychiatric disorders and recent or ongoing substance abuse problems, including alcohol use," said Michael Rigsby, director of VA's National Hepatitis C program. "This was based on concerns that such treatment might not be safe for these patients and that the efficacy of antiviral therapy would be diminished.
"However, there has been a recent change, reflected in VA treatment recommendations and in the recent National Institute of Health (NIH) consensus statement, toward individualizing decisions about treating these patients. In general, such conditions, which are commonly encountered in patients with hepatitis C, are no longer felt to be absolute barriers to effective antiviral therapy."
http://findarticles.com/p/articles/mi_m0LIY/is_1_91/ai_107759683/
PS: I'm sorry to hear about the condition of your liver, and wish you the very best possible outcome. As to the alcohol/hcv thing, I confess I really have never put much thought or done much research on the subject. I really practiced drinking alot when I was younger, but never learned how to do it right (g), hence had to it up some 17 years ago.--if I hadn't given it up, hcv would have been the least of my worries, I most likely would have been dead long before being diagnosed with hep c!!
Hi, Proactive. I appreciate your need to verify information. I'm the same way. I was a Senior Vice President with Bank of America for 15 years where I created a wholesale lending division. I also owned 3 mortgage companies, have written two books on mortgage lending and developed a continuing education course of study for Realtors. I've also created a non-profit organization for Veterans called Helping American Veterans Endure which is currently successfully functioning in San Francisco funding research into Post Traumatic Stress Disorder. I had to leave work two years ago due to the effects of Hep-C and have been going nuts with boredom ever since. I'm saying this to point out that in order to accomplish the above mentioned tasks, I had to do extensive research.
I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus.
Below is an informative questions and answers bulletin put out by the Alaska Native Medical Center in Anchorage, Alaska, where there is a serious problem with hep-c relapse. If you read under the question, "How long will the effects last" you'll see the statement regarding relapse due to alcohol consumption. Also here is the website for the ANMC in Alaska: http://anmc.org/index.cfm
As I said in an earlier posting, I can provide you with a lot of documented evidence that alcohol can trigger relapse. Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too. Such a horrible waste!
Hepatitis C
What is hepatitis C?
Hepatitis C is a viral infection of the liver. The liver becomes inflamed. It may be tender and swollen.
How does it occur?
Hepatitis C is caused by the hepatitis C virus. The virus is spread mainly through contact with infected blood. Sometimes it is spread through sexual contact. You can get it from:
receiving infected blood, blood products, or transplanted organs
long-term kidney dialysis if you unknowingly shared supplies or equipment that had someone else's blood on them
contact with infected blood on the job if you are a health care worker, especially from accidental needlesticks
your mother if she had hepatitis C at the time she gave birth to you
intravenous (IV) drug abuse
sharing razors or toothbrushes with an infected person
getting a permanent tattoo with unsterile equipment
having unprotected sex with someone infected with hepatitis C.
Before 1990 one of the most common ways to get hepatitis C was blood transfusion. However, now blood donors can be screened for the virus.
The disease can be spread by people who do not have any symptoms and may not know they carry the virus. These people are called asymptomatic carriers.
What are the symptoms?
You may not have any symptoms of hepatitis until several weeks or months after you are infected with the virus. Or you may never have any obvious symptoms.
If you have symptoms, the illness usually begins with these flulike symptoms:
loss of appetite
weight loss
fever
general aching
tiredness.
Other early symptoms may include:
itching hives
painful joints
a loss of taste for cigarettes if you are a smoker.
After several days you may also have these symptoms:
nausea and vomiting
foul breath and bitter taste in the mouth
dark brown urine
yellowish skin and eyes (jaundice)
pain just below the ribs on your right side, especially if you press on that part of your abdomen
bowel movements that are whitish or light yellow and may be looser than normal.
Some people develop a chronic form of the disease without any obvious symptoms, even though damage to the liver may be occurring. The symptoms of chronic hepatitis may be persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.
How is it diagnosed?
Your health care provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse.
Your health care provider will examine your skin and eyes for signs of hepatitis. Your provider will check your abdomen to see if the liver is enlarged or tender. You may have blood tests to see if your liver is inflamed and if you are infected with the hepatitis C virus.
If your health care provider thinks you may have chronic hepatitis or serious liver damage, or if the diagnosis is uncertain, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests to check for damage to your liver.
How is it treated?
The usual treatment is rest, having a healthy diet, and avoiding alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.
You may be given shots of an antiviral drug, such as interferon.
Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
How long will the effects last?
Symptoms may last 1 to 6 weeks and usually go away completely. It is common, however, to have hepatitis again (relapse). Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection.
Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your health care provider may check your blood every few months for signs of chronic liver disease.
Infection with the hepatitis C virus increases your risk for liver cancer.
How can I take care of myself?
Follow your health care provider's instructions for taking medicine to relieve your symptoms. When the hepatitis C virus is active, you need to avoid taking certain medicines (for example, acetaminophen). Ask your health care provider which medicines you can safely take for your symptoms (such as itching and nausea).
Follow your health care provider's advice for how much rest you need and when you can return to your normal activities, including work or school. As your symptoms improve, you may gradually increase your level of activity. It is best to avoid too much physical exertion until your health care provider tells you it's OK.
Eat small, high-protein, high-calorie meals, even when you feel nauseated. Soft drinks, juices, and hard candy may help you feel less nauseated.
Do not drink alcohol until your health care provider says it is safe.
Ask your health care provider if you need shots to prevent hepatitis A and hepatitis B.
Contact your health care provider if:
Your appetite continues to decrease.
You have worsening fatigue.
You have vomiting, diarrhea, or abdominal pain.
You develop jaundice.
You have a new rash.
What can be done to help prevent the spread of hepatitis C?
There are no shots that protect against hepatitis C. If you have hepatitis C, you can help prevent its spread by following these guidelines:
Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
Do not share needles, razor blades, and toothbrushes with others.
Avoid high-risk sexual activity.
Do not donate blood.
I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus.
Below is an informative questions and answers bulletin put out by the Alaska Native Medical Center in Anchorage, Alaska, where there is a serious problem with hep-c relapse. If you read under the question, "How long will the effects last" you'll see the statement regarding relapse due to alcohol consumption. Also here is the website for the ANMC in Alaska: http://anmc.org/index.cfm
As I said in an earlier posting, I can provide you with a lot of documented evidence that alcohol can trigger relapse. Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too. Such a horrible waste!
Hepatitis C
What is hepatitis C?
Hepatitis C is a viral infection of the liver. The liver becomes inflamed. It may be tender and swollen.
How does it occur?
Hepatitis C is caused by the hepatitis C virus. The virus is spread mainly through contact with infected blood. Sometimes it is spread through sexual contact. You can get it from:
receiving infected blood, blood products, or transplanted organs
long-term kidney dialysis if you unknowingly shared supplies or equipment that had someone else's blood on them
contact with infected blood on the job if you are a health care worker, especially from accidental needlesticks
your mother if she had hepatitis C at the time she gave birth to you
intravenous (IV) drug abuse
sharing razors or toothbrushes with an infected person
getting a permanent tattoo with unsterile equipment
having unprotected sex with someone infected with hepatitis C.
Before 1990 one of the most common ways to get hepatitis C was blood transfusion. However, now blood donors can be screened for the virus.
The disease can be spread by people who do not have any symptoms and may not know they carry the virus. These people are called asymptomatic carriers.
What are the symptoms?
You may not have any symptoms of hepatitis until several weeks or months after you are infected with the virus. Or you may never have any obvious symptoms.
If you have symptoms, the illness usually begins with these flulike symptoms:
loss of appetite
weight loss
fever
general aching
tiredness.
Other early symptoms may include:
itching hives
painful joints
a loss of taste for cigarettes if you are a smoker.
After several days you may also have these symptoms:
nausea and vomiting
foul breath and bitter taste in the mouth
dark brown urine
yellowish skin and eyes (jaundice)
pain just below the ribs on your right side, especially if you press on that part of your abdomen
bowel movements that are whitish or light yellow and may be looser than normal.
Some people develop a chronic form of the disease without any obvious symptoms, even though damage to the liver may be occurring. The symptoms of chronic hepatitis may be persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.
How is it diagnosed?
Your health care provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse.
Your health care provider will examine your skin and eyes for signs of hepatitis. Your provider will check your abdomen to see if the liver is enlarged or tender. You may have blood tests to see if your liver is inflamed and if you are infected with the hepatitis C virus.
If your health care provider thinks you may have chronic hepatitis or serious liver damage, or if the diagnosis is uncertain, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests to check for damage to your liver.
How is it treated?
The usual treatment is rest, having a healthy diet, and avoiding alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.
You may be given shots of an antiviral drug, such as interferon.
Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
How long will the effects last?
Symptoms may last 1 to 6 weeks and usually go away completely. It is common, however, to have hepatitis again (relapse). Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection.
Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your health care provider may check your blood every few months for signs of chronic liver disease.
Infection with the hepatitis C virus increases your risk for liver cancer.
How can I take care of myself?
Follow your health care provider's instructions for taking medicine to relieve your symptoms. When the hepatitis C virus is active, you need to avoid taking certain medicines (for example, acetaminophen). Ask your health care provider which medicines you can safely take for your symptoms (such as itching and nausea).
Follow your health care provider's advice for how much rest you need and when you can return to your normal activities, including work or school. As your symptoms improve, you may gradually increase your level of activity. It is best to avoid too much physical exertion until your health care provider tells you it's OK.
Eat small, high-protein, high-calorie meals, even when you feel nauseated. Soft drinks, juices, and hard candy may help you feel less nauseated.
Do not drink alcohol until your health care provider says it is safe.
Ask your health care provider if you need shots to prevent hepatitis A and hepatitis B.
Contact your health care provider if:
Your appetite continues to decrease.
You have worsening fatigue.
You have vomiting, diarrhea, or abdominal pain.
You develop jaundice.
You have a new rash.
What can be done to help prevent the spread of hepatitis C?
There are no shots that protect against hepatitis C. If you have hepatitis C, you can help prevent its spread by following these guidelines:
Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
Do not share needles, razor blades, and toothbrushes with others.
Avoid high-risk sexual activity.
Do not donate blood.
I have no idea who is answering the questions in the Alaska Q&A. Is it a doctor, a hepatologist, a gastro or a layperson?
From the Q&A
"Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection."
If by "before you are fully recovered" you mean before you are proven to be a SVR then, yes, the virus can become serum detectable again. I have no idea what the support is for stating that "Relapses are generally milder than the initial infection" but I do not believe that is true and I have never seen anything to support it. Neither have I seen colds or lack of rest as risks for relapse - relapse POST SVR, that is. Please provide support for that aside from the Q&A.
Merely because it appeared in a "question and answer session" in Alaska does not mean that it is accurate. I went to the Alaska site and I could find no mention of a hepatologist on staff. Perhaps there is one and perhaps they have a gastroenterology department as well but, there is no mention of it. Frankly, it doesn't appear to be an advanced medical center from looking at their site.
You say: "I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus."
Well, it is true that some people who are SVR have sustained liver damage and that alcohol can have a negative impact on their liver histology but that is independent of and irrespective of HCV relapse. The alcohol in and of itself can be harmful to the liver as I am sure you well know. That is what this looks like to me.
You also said: "Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too."
How do you know that? Were they proven to be SVR - serum undetectable 6 months after discontinuing treatment per a sensitive PCR? Did you see the tests? Did you see serum tests after the 6 months which showed a detectable HCV in the serum?
First of all I am a liver transplant patient and I know a lot of liver transplant patients and I might know "several" patients who achieved SVR - documented SVR. The SVR rate for liver transplant patients range from 20% to 32% percent so there are not many who achieve SVR and a lot fewer who "began drinking".
I don't know of one SVR liver transplant patient or non-transplant SVR who drank and the disease returned. I have not heard from any of my HCV friend that they know of a documented case of relapse in an SVR. The only reported cases, and there are very few of those, are in the setting of initiating immune suppressive drugs and I also believe that cancer was involved in some, if not all, of the few I have seen. And, believe me, since I am immunosuppressed I look for this stuff all of the time.
I'm not saying that you are lying but I don't think you really know what you're talking about. The studies do not show that drinking is a risk for relapse. Of course, drinking can be harmful to a healthy liver and worse for a liver damaged by hepatitis but, that is not relapse. Furthermore let's assume that your patients really were SVR and let's also assume that they died from drinking. If they were not serum detectable at their death then the only way to detect HCV would be to perform a liver biopsy and do a PCR test on the liver tissue. I sincerely doubt that was the case with your "acquaintances", so once again: How do you know this?
From your writing I believe you are a highly intelligent man and that your motive is pure. I simply believe that you are mistaken and that, while believing your opinion on this issue wouldn't put anyone at risk, I believe strongly in accurate information. If alcohol was a risk for relapse it would be known and there would be professional articles discussing it. If there are, I have not seen them and, if you have, please provide them.
One point: I am not convinced that upon achieving SVR every trace of Hepatitis C has been eradicated. Some traces may, and probably do, exist post SVR. But, SVR has been shown to be durable over many years and relapse post SVR is very very low. I think it would be naive to think that some, if not more than just a few, SVRs don't consume alcohol post SVR. If drinking resulted in relapse we would certainly have heard about it by now. I believe a lot of the confusion and mistaken statements are the result of poor documentation and unreliable viral testing. People were thought to be SVR who weren't. And, of those who sere presumed to be SVR, how many were tested at 6 months with reliable and sensitive tests?
Mike
From the Q&A
"Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection."
If by "before you are fully recovered" you mean before you are proven to be a SVR then, yes, the virus can become serum detectable again. I have no idea what the support is for stating that "Relapses are generally milder than the initial infection" but I do not believe that is true and I have never seen anything to support it. Neither have I seen colds or lack of rest as risks for relapse - relapse POST SVR, that is. Please provide support for that aside from the Q&A.
Merely because it appeared in a "question and answer session" in Alaska does not mean that it is accurate. I went to the Alaska site and I could find no mention of a hepatologist on staff. Perhaps there is one and perhaps they have a gastroenterology department as well but, there is no mention of it. Frankly, it doesn't appear to be an advanced medical center from looking at their site.
You say: "I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus."
Well, it is true that some people who are SVR have sustained liver damage and that alcohol can have a negative impact on their liver histology but that is independent of and irrespective of HCV relapse. The alcohol in and of itself can be harmful to the liver as I am sure you well know. That is what this looks like to me.
You also said: "Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too."
How do you know that? Were they proven to be SVR - serum undetectable 6 months after discontinuing treatment per a sensitive PCR? Did you see the tests? Did you see serum tests after the 6 months which showed a detectable HCV in the serum?
First of all I am a liver transplant patient and I know a lot of liver transplant patients and I might know "several" patients who achieved SVR - documented SVR. The SVR rate for liver transplant patients range from 20% to 32% percent so there are not many who achieve SVR and a lot fewer who "began drinking".
I don't know of one SVR liver transplant patient or non-transplant SVR who drank and the disease returned. I have not heard from any of my HCV friend that they know of a documented case of relapse in an SVR. The only reported cases, and there are very few of those, are in the setting of initiating immune suppressive drugs and I also believe that cancer was involved in some, if not all, of the few I have seen. And, believe me, since I am immunosuppressed I look for this stuff all of the time.
I'm not saying that you are lying but I don't think you really know what you're talking about. The studies do not show that drinking is a risk for relapse. Of course, drinking can be harmful to a healthy liver and worse for a liver damaged by hepatitis but, that is not relapse. Furthermore let's assume that your patients really were SVR and let's also assume that they died from drinking. If they were not serum detectable at their death then the only way to detect HCV would be to perform a liver biopsy and do a PCR test on the liver tissue. I sincerely doubt that was the case with your "acquaintances", so once again: How do you know this?
From your writing I believe you are a highly intelligent man and that your motive is pure. I simply believe that you are mistaken and that, while believing your opinion on this issue wouldn't put anyone at risk, I believe strongly in accurate information. If alcohol was a risk for relapse it would be known and there would be professional articles discussing it. If there are, I have not seen them and, if you have, please provide them.
One point: I am not convinced that upon achieving SVR every trace of Hepatitis C has been eradicated. Some traces may, and probably do, exist post SVR. But, SVR has been shown to be durable over many years and relapse post SVR is very very low. I think it would be naive to think that some, if not more than just a few, SVRs don't consume alcohol post SVR. If drinking resulted in relapse we would certainly have heard about it by now. I believe a lot of the confusion and mistaken statements are the result of poor documentation and unreliable viral testing. People were thought to be SVR who weren't. And, of those who sere presumed to be SVR, how many were tested at 6 months with reliable and sensitive tests?
Mike
Michael,
It sounds like someone was just typing out of a very, very old text book and hasn't done any research into the disease in a long time. Remember there are still doctors that test to <615 and believe that nobody with HepC is really 'cured' - which understanding the function of SVR and Interferon we know is ridiculous, let alone the concept that having a glass of wine is going to make it 'come back'.
And as everyone knows I've always been one the most vocally anti-alcohol people on this forum but it's just not true.
It sounds like someone was just typing out of a very, very old text book and hasn't done any research into the disease in a long time. Remember there are still doctors that test to <615 and believe that nobody with HepC is really 'cured' - which understanding the function of SVR and Interferon we know is ridiculous, let alone the concept that having a glass of wine is going to make it 'come back'.
And as everyone knows I've always been one the most vocally anti-alcohol people on this forum but it's just not true.
I never said that one glass of wine would trigger anything except for a mild buzz. I said that renewing a consistent consumption of alcohol COULD trigger a relapse.
I do constant research and confer with Heptologists at the VA's infectious disease department on a regular basis. I make certain that my research reflects the latest known results.
I really don't care if anyone follows up on the research I've already conducted or if anyone believes me or not. I've had the disease for 40 years and have been attempting to control it for the past 18. Now, I am in the end stage and have severe cirrhosis. I'll be dead in another few years without a transplant and it is a pretty horrific way to go.
If anyone has more experience with the disease than I or is better at researching it, then please speak up and post the results of your findings.
Oh, and by the way, the findings of the Alaska Native Medical Center, which deals with an abnormal amount of Hep-C patients, were posted in a Hospital Bulletin and not by some moron who managed to hack into the hospital's website.
And the people I personally know who relapsed and died WERE diagnosed as having a "non-detectable" viral load.
As I said, I was merely offering some very basic findings from a CURRENT source for the people who are members of this forum but don't have a fundamental understanding of Hep-C.
Does anyone else out there have more than 18 years experience and has gone through all three known protocols? Is anyone else who is responding to this posting experience the pain and anxiety of end stage liver disease with cirrhosis? Oh, yeah, and I also have hepatic Portal Vein Hypertension, Gastropathy with Esophageal Varices and congested mucosa with snakeskin pattern, significant Splenomegaly (enlarged spleen due to fluid retention) and Thrombocytopenia (lack of blood platelets which causes spontaneous nosebleeds and clotting difficulties. I won't even mention the thyroid that was destroyed by Interferon or the diabetes type II that has developed as a result of the Hep-C. Plus Chronic Depression, Chronic Pain which is severe enough for the Dr's to prescribe 120 MG's of morphine daily, and fatigue, vomiting, and my body's inability to process nutrients. I've lost 40 pounds in the past 6 months and I wasn't overweight to begin with.
If I'm going to be doubted and criticized by someone with a few years experience at dealing with the disease, then I won't bother posting any of my own experiences or findings. I don't need this aggravation in addition to the medical issues that are currently killing me.
I do constant research and confer with Heptologists at the VA's infectious disease department on a regular basis. I make certain that my research reflects the latest known results.
I really don't care if anyone follows up on the research I've already conducted or if anyone believes me or not. I've had the disease for 40 years and have been attempting to control it for the past 18. Now, I am in the end stage and have severe cirrhosis. I'll be dead in another few years without a transplant and it is a pretty horrific way to go.
If anyone has more experience with the disease than I or is better at researching it, then please speak up and post the results of your findings.
Oh, and by the way, the findings of the Alaska Native Medical Center, which deals with an abnormal amount of Hep-C patients, were posted in a Hospital Bulletin and not by some moron who managed to hack into the hospital's website.
And the people I personally know who relapsed and died WERE diagnosed as having a "non-detectable" viral load.
As I said, I was merely offering some very basic findings from a CURRENT source for the people who are members of this forum but don't have a fundamental understanding of Hep-C.
Does anyone else out there have more than 18 years experience and has gone through all three known protocols? Is anyone else who is responding to this posting experience the pain and anxiety of end stage liver disease with cirrhosis? Oh, yeah, and I also have hepatic Portal Vein Hypertension, Gastropathy with Esophageal Varices and congested mucosa with snakeskin pattern, significant Splenomegaly (enlarged spleen due to fluid retention) and Thrombocytopenia (lack of blood platelets which causes spontaneous nosebleeds and clotting difficulties. I won't even mention the thyroid that was destroyed by Interferon or the diabetes type II that has developed as a result of the Hep-C. Plus Chronic Depression, Chronic Pain which is severe enough for the Dr's to prescribe 120 MG's of morphine daily, and fatigue, vomiting, and my body's inability to process nutrients. I've lost 40 pounds in the past 6 months and I wasn't overweight to begin with.
If I'm going to be doubted and criticized by someone with a few years experience at dealing with the disease, then I won't bother posting any of my own experiences or findings. I don't need this aggravation in addition to the medical issues that are currently killing me.
I had a liver transplant in June 2000 with an underlying disease of HCV so yes, I know all about it. I had the disease for about 34 years.
I'm sorry you're sick - I truly am - but being sick does not make you right.. I too have been researching this disease incessantly - continually - for a long time and I have never seen even one reference from any reputable hepatologist which remotely suggests that alcohol can trigger relapse. BTW, I speak with hepatologists and liver transplant surgeons and medical staff too and have been since 1998.
And I think you are misinformed and no Alaska Bulletin is going to convince me otherwise. Come up with something real - a real study or article by a named hepatologist.
You didn't answer any of my questions and that certainly isn't surprising.
Mike
I'm sorry you're sick - I truly am - but being sick does not make you right.. I too have been researching this disease incessantly - continually - for a long time and I have never seen even one reference from any reputable hepatologist which remotely suggests that alcohol can trigger relapse. BTW, I speak with hepatologists and liver transplant surgeons and medical staff too and have been since 1998.
And I think you are misinformed and no Alaska Bulletin is going to convince me otherwise. Come up with something real - a real study or article by a named hepatologist.
You didn't answer any of my questions and that certainly isn't surprising.
Mike
BTW, I also suffered 2 massive esophageal bleeds in 1995 losing about 4 units of blood each time. So, I guess you could say that I had pretty significant portal hypertension.
You're not the only sick person here. There are some other end stage members - that's what HCV can do to a liver.
Mike
You're not the only sick person here. There are some other end stage members - that's what HCV can do to a liver.
Mike
Just for the record.... according to my research:
You said: "....Splenomegaly (enlarged spleen due to fluid retention)...."
"The obstructed flow of blood through the portal vein (portal hypertension) causes the spleen to enlarge by causing an increase in pressure inside the vessels of the spleen."
http://www.janis7hepc.com/spleen_hepatitis_c.htm
Increased pressure inside the vessels and not fluid retention is trhe cause of an enlarged spleen. And the the spleen traps and sequesters platelets which results in a low platelet count which leads to Thrombocytopenia.
Mike
You said: "....Splenomegaly (enlarged spleen due to fluid retention)...."
"The obstructed flow of blood through the portal vein (portal hypertension) causes the spleen to enlarge by causing an increase in pressure inside the vessels of the spleen."
http://www.janis7hepc.com/spleen_hepatitis_c.htm
Increased pressure inside the vessels and not fluid retention is trhe cause of an enlarged spleen. And the the spleen traps and sequesters platelets which results in a low platelet count which leads to Thrombocytopenia.
Mike
Ive heard most "relapses" after years of being SRV,are just the result of getting re-infected by going back to drug use.The true relapse rate for SVR` ers may never be known in my opinion because of possible reinfection( known or unknow reasons),but the fact remains,relapse rates after 6 month SVR are EXTREMELY low...i think its 1or 2 in 1000 will "relapse"..or is it re-infect...my study nurse has been workn with HCV about 20 years and she tells me she never seen one of her patients relapse yet
Just my thinkn and dont mean no dis-repect.
"I have learned from experience that the greater part of our happiness or misery depends on our dispositions and not on our circumstances."
Just my thinkn and dont mean no dis-repect.
"I have learned from experience that the greater part of our happiness or misery depends on our dispositions and not on our circumstances."
Just my 2 cents worth...I was told by my hepatologist, who is also a Dr out of UW Medical Center and one area expert on Hep c treatment that, if a person infected with my genotype (3A) is RVR at 4 weeks of treatment, and SVR at 6 months after treatment, I have only a 2% chance of relapsing ever as long as I maintained a liver healthy lifestyle. He said an occasional social drink wouldn't change those odds, -but why take the risk? I am 16 months post treatment now, still SVR, and liver enzymes at AST -15, ALT-16. I may have a rare sip of wine on holidays, or a even rarer piece of rum cake, but that's it, and I don't feel like I'm missing out on life and I celebrate daily that this cr@p is gone from my system~MM
Veteran....I was reading through the article you posted and it seems they're talking about an acute Hepatitis C infection ... not even chronic Hep C and certainly not SVR .... I'll explain as I go .. which begs the question...why would you use an article about treatment phase for acute Hep C as supporting evidence for resurgence for the virus in SVR post-chronic Hep C?:
----------------------------------------------------------------------------------
How is it treated?
The usual treatment is rest, having a healthy diet, and avoiding alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.
>>>>>The usual treatment is rest, having a healthy diet and avoiding alcohol for at least 6 months? I'm reading this and I'm thinking they're talking about an acute Hepatitis infection here ... because this is certainly not the usual treatment for chronic Hepatitis C. So..with that in mind, I keep reading ....
You may be given shots of an antiviral drug, such as interferon.
>>>>>>>>>>>>>Okay...you MAY be given shots of interferon...what about the ribavirin, I'm thinking? .. so I'm thinking we're still talking about acute Hep C, not chronic Hep C ... because this isn't the treatment for chronic Hep C.. and I keep reading......
Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
How long will the effects last?
Symptoms may last 1 to 6 weeks and usually go away completely. It is common, however, to have hepatitis again (relapse). Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection.
>>>>>>>>>>>>>>>>>>>Okay...relapses can be triggered by drinking alcohol....we're still talking acute Hep C and we're talking during that treatment phase before the acute Hep C has been fully treated....it mentions that relapse occurs if you don't take the proper precautions "before you are fully recovered"...... fair enough...I get this.......and I keep reading....
Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months.
>>>>>>>>>>>>>>>>>>Okay. This is where it's CLEAR that they're talking about acute Hepatitis C as evidenced by the comment ...."some people who have Hepatitis C develop the chronic form of the disease" .... so all along this has been talking about someone in the acute phase of Hepatitis C ....and this is what you're using as your supporting evidence that alcohol can trigger relapse in those with chronic Hepatitis C who have achieved SVR?
They're not even accurate... they say SOME people who have (acute) Hepatitis C develop the chronic form of the disease. It would be immensely more accurate to say MOST people develop the chronic form of the disease. It would be immensely more accurate to say that some people clear the virus but most go on to develop chronic Hepatitis C.
It gets worse....they continue on to say that "This means the virus continues to affect their liver for several months."
Several months?? I'm thinking they don't have a whole lot of knowledge about Hepatitis C if they're saying that having chronic Hep C means the virus continues to affect the liver for several months.....we all know it means a whole lot more than several months, doesn't it.
I'm a little surprised you would include this article as supporting documentation when a) it's talking about acute Hepatitis C during treatment phase and you're suggesting that relapse can occur for chronic Hep C after SVR from alcohol. The one has absolutely nothing to do with the other. This isn't even apples and oranges. It's more like onions and peaches.
Do you consider this to be part of your supporting documentation?? With all due respect, it's not that authoritative overall, not very accurate and not relevant to the topic. Odd choice...perhaps there's something I'm missing as to why you chose this to back up your theory?
I did read your other article, btw....it seems you're of the camp where we never really have a cure - am I correct in that assumption? That you think the virus never really goes away, even though it remains undetectable in the blood for many years, it's still lying in wait in the body somewhere and can re-emerge? If that were the case, I can see where you would think that alcohol can trigger a relapse...see if I'm on point where you get this from....
"The researchers found that alcohol increases the activity of a protein called nuclear factor kappa B, and thereby causes the hepatitis C virus to replicate, or produce multiple copies of itself. That protein is an important cellular regulator of gene products involved in inflammation. Furthermore, they found that alcohol interferes with the antiviral activity of interferon-alpha, a key therapy used for patients infected with hepatitis C"
This is fascinating stuff, btw...and a wry thanks for triggering yet another research direction.
The thing is .. if there is no virus in the blood to intermingle with, then there's nothing to replicate. So if there is no virus to replicate in the blood, there is nothing for the alcohol to trigger.
So I go back to your comment that the virus is never really gone. If we agree that it's gone from the blood but not necessarily completely from the body......are you suggesting that alcohol can intermingle with the traces of the virus that are known to be found in organs of the body and whatnot in other forms than is found in the blood and that this triggers the replication and passes it back into the bloodstream? Is that your contention? I'm not agreeing or disagreeing at this point .. not that it matters to you, I'm sure...just saying :) ... I just want to be clear on what you base your supposition on.
Trish
----------------------------------------------------------------------------------
How is it treated?
The usual treatment is rest, having a healthy diet, and avoiding alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.
>>>>>The usual treatment is rest, having a healthy diet and avoiding alcohol for at least 6 months? I'm reading this and I'm thinking they're talking about an acute Hepatitis infection here ... because this is certainly not the usual treatment for chronic Hepatitis C. So..with that in mind, I keep reading ....
You may be given shots of an antiviral drug, such as interferon.
>>>>>>>>>>>>>Okay...you MAY be given shots of interferon...what about the ribavirin, I'm thinking? .. so I'm thinking we're still talking about acute Hep C, not chronic Hep C ... because this isn't the treatment for chronic Hep C.. and I keep reading......
Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
How long will the effects last?
Symptoms may last 1 to 6 weeks and usually go away completely. It is common, however, to have hepatitis again (relapse). Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection.
>>>>>>>>>>>>>>>>>>>Okay...relapses can be triggered by drinking alcohol....we're still talking acute Hep C and we're talking during that treatment phase before the acute Hep C has been fully treated....it mentions that relapse occurs if you don't take the proper precautions "before you are fully recovered"...... fair enough...I get this.......and I keep reading....
Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months.
>>>>>>>>>>>>>>>>>>Okay. This is where it's CLEAR that they're talking about acute Hepatitis C as evidenced by the comment ...."some people who have Hepatitis C develop the chronic form of the disease" .... so all along this has been talking about someone in the acute phase of Hepatitis C ....and this is what you're using as your supporting evidence that alcohol can trigger relapse in those with chronic Hepatitis C who have achieved SVR?
They're not even accurate... they say SOME people who have (acute) Hepatitis C develop the chronic form of the disease. It would be immensely more accurate to say MOST people develop the chronic form of the disease. It would be immensely more accurate to say that some people clear the virus but most go on to develop chronic Hepatitis C.
It gets worse....they continue on to say that "This means the virus continues to affect their liver for several months."
Several months?? I'm thinking they don't have a whole lot of knowledge about Hepatitis C if they're saying that having chronic Hep C means the virus continues to affect the liver for several months.....we all know it means a whole lot more than several months, doesn't it.
I'm a little surprised you would include this article as supporting documentation when a) it's talking about acute Hepatitis C during treatment phase and you're suggesting that relapse can occur for chronic Hep C after SVR from alcohol. The one has absolutely nothing to do with the other. This isn't even apples and oranges. It's more like onions and peaches.
Do you consider this to be part of your supporting documentation?? With all due respect, it's not that authoritative overall, not very accurate and not relevant to the topic. Odd choice...perhaps there's something I'm missing as to why you chose this to back up your theory?
I did read your other article, btw....it seems you're of the camp where we never really have a cure - am I correct in that assumption? That you think the virus never really goes away, even though it remains undetectable in the blood for many years, it's still lying in wait in the body somewhere and can re-emerge? If that were the case, I can see where you would think that alcohol can trigger a relapse...see if I'm on point where you get this from....
"The researchers found that alcohol increases the activity of a protein called nuclear factor kappa B, and thereby causes the hepatitis C virus to replicate, or produce multiple copies of itself. That protein is an important cellular regulator of gene products involved in inflammation. Furthermore, they found that alcohol interferes with the antiviral activity of interferon-alpha, a key therapy used for patients infected with hepatitis C"
This is fascinating stuff, btw...and a wry thanks for triggering yet another research direction.
The thing is .. if there is no virus in the blood to intermingle with, then there's nothing to replicate. So if there is no virus to replicate in the blood, there is nothing for the alcohol to trigger.
So I go back to your comment that the virus is never really gone. If we agree that it's gone from the blood but not necessarily completely from the body......are you suggesting that alcohol can intermingle with the traces of the virus that are known to be found in organs of the body and whatnot in other forms than is found in the blood and that this triggers the replication and passes it back into the bloodstream? Is that your contention? I'm not agreeing or disagreeing at this point .. not that it matters to you, I'm sure...just saying :) ... I just want to be clear on what you base your supposition on.
Trish
"remains undetectable in the blood for many years," - I read this later and no idea why I stated it in this way. I should have said "remains undetectable in the blood." Period. Full stop. Not just for many years. Forever. That's SVR.
Wow, this certainly DID trigger a major response. Trish, I must say you have posted a very intelligent and well researched response. Not just argumentative like some others. I do have to say that Chronic Hep-C by definition is just that; chronic. It never goes away. The acute phase is just the beginning of Hep-C. From there it generally progresses to the chronic phase. As you pointed out the antibodies stay in your blood forever. Please read the article on this site. It is an accurate, well written article by Dr. Robert O'Shea, a heptologist in the transplant center at The Cleveland Clinic.
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatitis-C/
It is one of the most concise explanations I've yet come across.
I am glad to have triggered this debate and it is refreshing to find someone who is seeking accurate answers and not discounting the findings of the medical community.
Good posting, Trish.
MARTY
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatitis-C/
It is one of the most concise explanations I've yet come across.
I am glad to have triggered this debate and it is refreshing to find someone who is seeking accurate answers and not discounting the findings of the medical community.
Good posting, Trish.
MARTY
Just thought of something,is it possible that the people you say who SVR`ed and relapsed after going back to heavy drinking was just a coincidence because as we know normal relapses do happen...BTW..in my above post mentioned my nurse never seen a relapse in her 20 years/...i meant to say she never had anyone who SVR`ed go on to end stage liver problems.I remember asking her about the occult virus lingering in the liver after SVR .
I have been hearing that from several people here on the Medhelp forum, they say they've never heard of it. I personally know of two and a Dr. I am dating who is also an instructor at a medical college has seen three. All five had completed treatment and were declared SVR with a non-detectable viral count but they all relapsed after returning to a drinking lifestyle. Three are now dead.
I may be wrong about this, and if I am I'll gladly post a retraction.
I've got an e-mail in to Dr. Robert O'Shea, Fellowship Director of Heptology and a physician in the transplant department at the Cleveland Clinic asking him to speak about the direct relation between relapse and alcohol use. We're not talking about a glass of wine or a couple of beers, it's about habitual drinking. What he says in his published paper on Hep-C is, "Complete abstinence from alcohol is an extremely important behavioral modification, and has been shown to affect the likelihood of progression as well as the efficacy of therapy."
I am spending too much time on this subject when I already know the answer, but I'm doing it for those who ARE naive about it. I believe that many people want to hear that the virus is gone forever and they can drink and party again. If anyone DOES believe the virus is completely gone, just go to your local blood bank and try to give blood. Don't tell them you had Hep-C, just let them take your blood and test it themselves. Believe me, they will know you are still carrying the anti-bodies and will NOT accept your blood for donation.
At any rate, I'll post Dr. O'Shea's response to my inquiry just as soon as he contacts me.
Considering the number of people and the extent of the responses to this subject, I would say it's worthy of pursuing.
I just can't believe that anyone would even consider drinking or doing anything that might even remotely harm the liver after enduring tx. I wish to God that I had that opportunity. I've been told that without a transplant, I have another year or so to live. I'm waiting for the VA to approve my transplant request and then I'll pray they find a healthy liver for me. I wish the same for anyone else who is at this point in their disease.
I may be wrong about this, and if I am I'll gladly post a retraction.
I've got an e-mail in to Dr. Robert O'Shea, Fellowship Director of Heptology and a physician in the transplant department at the Cleveland Clinic asking him to speak about the direct relation between relapse and alcohol use. We're not talking about a glass of wine or a couple of beers, it's about habitual drinking. What he says in his published paper on Hep-C is, "Complete abstinence from alcohol is an extremely important behavioral modification, and has been shown to affect the likelihood of progression as well as the efficacy of therapy."
I am spending too much time on this subject when I already know the answer, but I'm doing it for those who ARE naive about it. I believe that many people want to hear that the virus is gone forever and they can drink and party again. If anyone DOES believe the virus is completely gone, just go to your local blood bank and try to give blood. Don't tell them you had Hep-C, just let them take your blood and test it themselves. Believe me, they will know you are still carrying the anti-bodies and will NOT accept your blood for donation.
At any rate, I'll post Dr. O'Shea's response to my inquiry just as soon as he contacts me.
Considering the number of people and the extent of the responses to this subject, I would say it's worthy of pursuing.
I just can't believe that anyone would even consider drinking or doing anything that might even remotely harm the liver after enduring tx. I wish to God that I had that opportunity. I've been told that without a transplant, I have another year or so to live. I'm waiting for the VA to approve my transplant request and then I'll pray they find a healthy liver for me. I wish the same for anyone else who is at this point in their disease.
"I am spending too much time on this subject when I already know the answer, but I'm doing it for those who ARE naive about it."
While your posted credentials seem most impressive, unfortunately imo the information you've posted so far has not been. Perhaps you may be used to talking down from a high pedestal to us "naive"'s, but you know what they say about those on high pedestals......I for one would certainly appreciate clinical trial info, studies etc. as opposed to hearsay and opinion...Where is the beef?
Thanks Pro
While your posted credentials seem most impressive, unfortunately imo the information you've posted so far has not been. Perhaps you may be used to talking down from a high pedestal to us "naive"'s, but you know what they say about those on high pedestals......I for one would certainly appreciate clinical trial info, studies etc. as opposed to hearsay and opinion...Where is the beef?
Thanks Pro
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