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A study on HCV Cellular Immune Responses and non-serum transmission implications

Here is a study I came across that addresses one of my ongoing concerns, and a concern that HR addressed in response to some of my recent thoughts.

It is a wordy study, but was done with tremendous attention to detail, using a variety of very specific tests.  Basically what they conclude, is that people in CONTACT with those who are HCV Positive have a very high probability of developing ongoing cellular immune responses to HCV.  Their conclusions are interesting, and are framed as either/or type scenarios...one of which says the individuals were exposed to the virus, but fought it off and now retain the cellular immune responses in tissues and organs.  The other scenario is that they have an ongoing, low-level HCV infection in these tissues and cells, that stays under the antibody test and PCR testing radar.  In other words, they are infected, but are not detected on standard testing.

This is a potential reason for my feeling that I have observed 'HCV-like, extra- hepatic symptoms in many of my past close contacts and family members...even though they test negative on standard HCV antibody tests.  There may actually be a low level chronic, but undetectable infection!  OR, according to scenario #1, there may just be ongoing cellular immune responses, without any HCV present.  Maybe this also could provoke ongoing symptoms in  these close contacts.

Here is the study.  Please take the time to read it fully and patiently.  It is fodder for much thought.  And it confirms many of my long held concerns!!!

http://www.ajtmh.org/cgi/content/full/73/1/44

Comments????
24 Responses
Avatar universal
By the way, some of the symptoms I have observed in close contacts over the years include:

* increasing bouts of fatigue and sleepiness at inappropriate times

* abnormal forgetfulness or short term memory loss

*  arthritic and muscle related symptom development, especially neck, back, and hip related.

* development of dry eye, floaters, and dry skin. Eye problems, focus, etc.

* and ongoing 'allergic type condition' year round, characterized by sinus inflammation, throat clearing, irritated eyes, and a congested feeling.  This seems to be prevalent among all contacts!

*  mild balance issues, and gait disturbances when walking.  'Klutziness', dropping things, and bumping into things.

*  difficulty awakening in the morning, and non-refreshing sleep.

*  rashy outbreaks, sometimes on face, under eyes, or on trunk.

I am sure there are some I am leaving out, but if anyone else has observed any of these issues in loved ones, or family members, please do comment.  I have seen these symptoms develop in contacts of wide ranging ages, many under 40 years old, so I do not attribute any of this odd stuff to their natural aging.
Its all too similar!!!  Cellular Immunity to HCV????????

Comments?????

DoubleDose
Avatar universal
Those all seem like very common conditions that people in non Hep C households would get.

I don't know how you can make any connection.
Avatar universal
isn't this the Egyptian study we discussed a while back?  where the HR group included people that could have been infected by multiple use of the same syringe among family members?
how does this confirm your suspicions?  
This looks like the same discussion we had a while back, when this study was first linked.  
If members could have been exposed to hcv via syringe use, and some recovered and others did not, how does this confirm infection via common contact between family members? After all, the researchers are filling the blanks with whatever response the family wants to share and they might not be sharing or admitting to doing treatments that were banned.
Avatar universal
No, if you read the end of the study, the children they studied were born after the multiple syringe usage.  They discounted that whole line of potential infection.  AND, they are not talking about typical HCV blood infection, but a different form, based on cellular immune responses.  

Did you actually READ the study.  I am trying to make sense of this, not just shoot it down because it doesn't feel good to consider it.

Also, note the different test responses from those in the HCV positive families, vs. those in the non-infected families.  Close to 'zero'cellular immune responses, if there was no HCV positive person in the environment.  Not so, for the people in contact with an HCV positive individual.  A high rate was found!

Again, they DISCOUNT the use of syringes for causing this cellular response.  The study was done in children born after this practice was in use!!!  We have just not done these studies here in the US.

This same issue is the subject of an upcoming study by one of the nation's leading Hepatologists.  It is a serious issue, not one to be 'blown off', if you read the study.

Also, Hepatitis Researcher discussed this same issue several weeks ago, indicating an absolute possibility of 'cellular immune' responses within HCV contacts.  We just do not know the implications of this, or how widespread the phenomenon is!

AND NO, these are not all just common symptoms every household has.  Not by a long stretch!

DoubleDose
Avatar universal
I agree, the symptoms are far too common and can be attributible to any number common causes. Household dust or other environmental allergens or pollutants for instance.
Avatar universal
what were they referring to when this was stated:
"Other common exposures (e.g., injections given to multiple members of the household using the same needles and syringes) could certainly be a risk. "
That statement came AFTER the one about the intravenous therapy.
Avatar universal
If this was Nazi Germany it would be interesting to see if these children who have CMI to HCV are actually 'vaccinated' against HCV infection (like the article refers to the HIV cases) by intentionally infecting them.

If they are vaccinated then it seems possible to create one.
Avatar universal
I still have problem understanding how from this article you can make the leap to hepatic illnesses. The article in no way suggests that (in fact it talks about the full blown disease being asympotmatic).

Avatar universal
Most of my friends and family have at least some of the symptoms you mention. I think these are very common symptoms, symptoms which those of us living in human bodies are familiar. Perfect health and well being are not so common, although I feel I'm approaching perfection now that I've achieved SVR. I feel fine and so does my family. My dog is the healthiest and happiest member of our family, but she is obsessed with chasing squirrels.

Bob
Avatar universal
Moniker: Most of my friends and family have at least some of the symptoms you mention. I think these are very common symptoms, symptoms which those of us living in human bodies are familiar.
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Ditto. And congratulations again (unless I missed it the first time :) on your SVR!
Avatar universal
A comment from the study in the conclusions section:

None of the subjects with HCV-specific CMI responses had a history of hepatitis or symptoms compatible with hepatic disease. The majority of HCV infections are asymptomatic, even during the acute phase.2 Therefore, we speculate that our CMI-positive seronegative subjects had a transient very mild infection, possibly associated with low-dose exposure to the virus, which was cleared. Infection is supported by most of the immune responses being to non-structural epitopes of HCV, an indication of replicating virus. A less likely, in our opinion, alternative is the CMI positive individuals have a healthy carrier state with the virus being present in some body compartment (i.e., in the liver) and not in the blood or it is replicating at levels below the sensitivity of our PCR assay (100 copies/mL).



Although our data does not elucidate on how these exposures to HCV occurred, the results suggest they are underestimated in endemic areas using anti-HCV. They could be caused by a common exposure infecting multiple members of the household or they may be between the HCV-infected and non-infected within the household. A common exposure during intravenous therapy of schistosomiasis as occurred in the past11 is not a factor, as all but one of those having CMI in the absence of HCV antibodies were children born after treatment with tartar emetic was discontinued.

We speculate they are often low-dose exposures stimulating HCV-specific CMI that aborted, or rapidly cleared, the viremia. These exposures might be from shared toothbrushes or other toilet items. Could they be from exposures to and from cuts, nicks, skin abrasions, and ulcerations that children often have?
Avatar universal
I agree, that they do not directly implicate the cellular immune responses in causing any symptoms, or actual disease, but they do leave the door open to it causing a possible chronic infection, below the limits of detection.  This is the second of their two possible scenarios.  If so, it could be similar to what the SVR's experience, with residual HCV that is under the limits of detection, remaining in tissues and compartments after SVR.  

The systoms issue is one that I take lightly....when they say that HCV has no symptoms....we all know that the medical community has said this for years.  Doctors that I have met with have said this to my face.  I lived with HCV for decades, and I know that there are a multitude of symptoms.  I think the symptoms are often subtle, blamed on other conditions, and ignored by many doctors.  How many people with HCV have you known that did NOT have any symptoms.  I think it just becomes a 'catch phrase' that doctors use in describing HCV.

In this case I hope that I am totally wrong in my suspicions.  I am not at all happy about the prospect of the disease being able to transmit in 'atypical' ways, if it does, and would love to see this line of study proven incorrect.  I still have to wonder why it is currently the subject of a large study , and what some of these researchers actually suspect is happening.

I would love to hear feedback from others on the forum regarding whether they have seen any curious symptoms in their family members over the years.  Please do convince me that I am on the wrong track!  

DoubleDose
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