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Alcohol and HCV...an unanswered question.

Here is a curveball, along with an article regarding the highprevalance of HCV in alcoholics.  See link below.

http://www.nih.gov/news/pr/jun2003/niaaa-26.htm

This is an issue that I have discussed with several HCV doctors, with no clear answer to my questions.  The article, as well as several others I have reviewed lately, indicates the abnormally high number of heavy drinkers, alcoholics, etc. that are HCV positive.  Often this is within populations with no known risk factors, and no past IVDU history.  My big question, which I have wondered about for years, is WHY does this seem to be the case.  Why would heavy alcohol users seem prone to developing HCV???  Unless, of course, they are all lying, and happen to also have risk factors which they now deny.  I think there is much more to this mystery, which still baffles the medical community.

Along with my concerns about persistent HCV after SVR, is another concern which many of you have responded to in the past when I have posed this issue.  Could there be HCV transmission in the general population, on a much larger scale than suspected, that is not in the bloodstream or liver.  In effect, a 'latent' tissue, or glandular infection which remains latent or suppressed, until a major stimulus causes it to 'explode' into the bloodstream.  This theory would help explain the great numbers of HCV cases worldwide that have no known risk factors.
Could there be a somewhat 'dormant' viral infection in a large portion of our population, within organs like salivary system, sexual organs , membranes, CNS, etc.??? (cont. below)
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86075 tn?1238115091
Hi, as for my opinion (and I guess you can see I'm giving it freely this morning) I'd opt to have a little extra weight come treatment time. From all my reading and questioning, etc. I've come to the conclusion that people deal with stress and food in different ways. There are the people who eat even more when stressed, and the people who eat way less. I'm in the latter category, the minute I get depressed or stressed or upset, it's very hard for me to eat. I have a big feeling (though of course I'm trying not to program it) i'd be one of the ones who had a real hard time eating on treatment, which isn't rare. The stuff is supposed to effect your tastebuds, along with the fact that many people get nausea, and it's hard to eat when that's going on.

So I plan on packing on an extra 10 pounds at least before I start, and I've always been a good weight for my height... I don't like that anorexic starlet look, especially when middle aged. Tom Wolfe called them "X-Ray Women", not for me. It's not unusal for people to lose 20 pounds or more on treatment. I know several people who lost more than 40.

That's not to say that there aren't people who actually gain weight on treatment, perhaps they are way less active and the boredom makes them eat while on the stuff.

Packing on some 10 or 15 pounds before treatment is different than being obese before treatment. I have read the meds have a harder time getting through a lot of fat, (also the fatty liver issue) so it's a question of how much to me. Also, if youve been very overweight for a long time, your metabolism is probably different than if someone just packed on some extra weight before treating. All these issues should probaby be discussed with the professionals in charge of your treatment of course. Just my take.

Oh, and I don't have a flat head, for those concerned, it's nice and round like Charlie Brown, with Lucy hair.
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108191 tn?1199599905
Wow, this is a great thread.  Sounds like we have all had similar experiences.  A bunch of people caught in the same fabric of time.  I too shared a needle with others, even though it was only a couple of times....during the summer of '75 in Alaska.  Seems as though everyone was doing the 'coke' thing up there.  Well, I have finally had my biopsy and my results are grade 2, stage 2.  I am a 2b, vl 28,243 and my doctor says I should treat since there will not be much coming down the pike (for another 5 years).  She thinks it is a 'slam dunk' (her words), for me to treat.  I am thinking about starting treatment this march.  But first I want to lose about 25 pounds, before I treat.  Has anyone heard it is better to not be heavy before treatment?  I am not obese just overweight, BMI 28.
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86075 tn?1238115091
Hi, sounds like we went to some of the same parties. anywhoo, this whole thing about certain people advancing in liver damage and others not is so multi-factoral. Women "tend" to advance less quickly with hep c, according to some stidies...estrogen is supposedly a protective factor...that's why women will tend to progress at a higher rate once post menopausal, and HRT can help slow that down, again, according so some studies. Then there's the age you contracted it, your genetics, your lifestyle, so many things come into play. And for a real rabble-rouser of an argument, I think that using herbs and supplementation can slow down inflammation in some people, so there you go. Just my thoughts.
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86075 tn?1238115091
Hi, gotta qualify myself here a little, when I said that active alcoholics are probably one of the least likely populations to fess up the truth about any IV use, I meant (for these purposes) to the docs and/or any people asking in authority...who might need to know this kind of information for statistical analyses, etc. But yeah, they are not the only people likely to go into denial about these types of issues, at least to these authorities...many people do. Many of us here in No. America and Western Europe are still working out Calvinistic religious credos for the most part, and it's resulted in a lot of shame and guilt and blaming, I think...(let's not forget the catholics and a number of other religions)...which might be one of the reasons we are attracted to a lot of drugs and alcohol in the first place. The "downside" of religious teachings in my book.

Now I'm talking about organized religion for the most part, not sprituality. Please, this is just my opinion and if I've offended your religion, here's my pre-apology. I'm just tired of being shame-based in my attitudes, bought into that for too long...I'm presently trying to work that stuff out of my psyche cause it isn't doing me any good, I feel. I fully belive that I can adhere to personal moral prinicipals without a lot of shaming, but of course I'm only speaking for myself.

Back to my point and I do have one...I'd even venture that when and if they give some people those questionnaires dealing with how they "contracted" the disease...even if they are anonymously taken, that certain people lie on those too, it's such a hard thing for some people to admit.

I might add that this is not a criticism of people who feel that they must "pick and choose" who they admit these things do.  Sometimes you need to lie about these things in order to be able to negotiate situations more smoothly, to protect yourself and other people.

But yeah, I'm mostly honest about these things, these are personal decisions and sometimes it has to do with people that "need to know" or not. Small children might not be able to process this info very well, it's a case by case thing. It's been said and I agree with this, who cares how you got this except for researcers.  
That's old information, it's how we are dealing with it now that counts.

BTW, odd how many Californians are on this board, Californians who know who "The Dead Kennedys" were.
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Avatar universal
All your posts have touched me.  I too am guilty as charged.  Sex, drugs & rock & roll.  Late 70's, Seal Beach mostly.  Hubby & I lived right behind Clancy's Bar if anyone knows the area.  When the bar closed everyone would stumble over to our place and party.  Lots of white powder. Amazingly, we are still married!  The Dr. told me as well that those hundred dollar bills were big carriers, along with straws.  Course the needles may have come in to play as well.

The interesting thing is, I am not sure that is how I got it.  It certainly SHOULD be the reason but I have very little liver damage.  My hubby is 1b and has extensive damage.  I am 1a.  Does that make any sense to anyone?  It seems to me we should both be co-infected and have equal damage.  As stated in earlier posts, I also had a blood transfussion and cared for my father-in-law who had Hep C.

It's nice not to be alone on that island.  I wish everyone well.  We are the survivors!  We will beat this!
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Avatar universal
Just curious how many people out there -- if they're being truly honest with their physicians -- really have no risk factors and have no idea where they contracted HCV.  I've been told 40% of dx'd Heppers have no risk factors.

Being truly honest, my risk factors seem to be visiting the dentist (and probably not as often as I should have), having my ears pierced once or twice in my life, and once, in grade school, I poked a hole in my finger with another little girl, and we pressed them together so we could be blood sisters.  Stupid, I know. My drug use has been limited to occasional cannabis ingestion after starting tx.  Never tried anything else.  Alcohol intake was always social and sporadic.

I do wonder about the possibility of sexual transmission, but my husband, who I have checked annually now, is fine.  I had my ex checked.  He's fine.  I have a short list of lovers.

So the truly scary thing is (following DoubleDose's musings), for people who truly have none of the listed "risk factors" or incidents that they can point to as a possibility for contraction, where on earth did it come from?  And how many people are there out there that have no idea and would never be checked for it because of that?

I've read there's a possibility of contraction through a cat scratch, though it seems slim.  They seem to have ruled out the possibility of contraction through mosquito bites.  My husband's own theory is that I might have gotten it from maybe a restaurant worker, maybe a sushi restaurant, thinking that there's a greater possibility of a chef getting cut working in that type of food-handling.

Who knows?  The point is, I really, really hope there's no latent reservoir; that there's no way to somehow bring it upon yourself through alcohol alone; and I really hope that it is truly blood-borne.  There's just got to be an explanation.  If the numbers of clueless people are truly 40%, it just makes me worry that maybe there's another risk factor out there that no one really knows about.
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Avatar universal
Yes I am a rare 2a?  Have no clue how that happened as this is a very rare genotype.   I have friends who have hep c and also got it when i did.  I have no clue what genotype they are?
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Avatar universal
I have been in the Hep C closet for many years.  I am on week 20 of closet treatment.  Anyway, I am not sure what good it will do to tell your sons how you got this Hep C.  My adult daughter knows that I got this from IV drug use.   But that is because she has always been told of my past. Anyway, I would stick to the blood transfusion story.  Good luck

Treatment sucks!  Sorry... I need to remember that worst things can happen to someone.  It is not really that bad..

4 shots to go
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Avatar universal
this is a great thread...

This is what a support group is all about!!!!
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Avatar universal
I was there, Mabuhay was my favorite. Had a band called "Bad Habit" and 'GDMF", Bad Habit played Mabuhay more and with GDMF we hung at The Sound of Music in the TL more.
If you're female we could have even had sex at the Mabuhay, in that closed off room when you first walk in. When you were inside you could see Broadway from the window; but on the street it was mirrored , my guitarist and I used to have a contest.  lol. Looking back "how sick was that".      Peace
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Avatar universal

It seems in one way or the other we are all paying for the sins of our past.  The collaterol damage just might be the hardest thing about it all.

Whether it be dancer telling her son (which just made me cry) or strator with his dad...even those of us who have no infection of our family have to deal with the collaterol damage of our disease on them as well.

Such a hard price to pay. But then it was ME using as much as often as I could and not them...so do I feel guilt yes.  I dont think it will ever really go away...

I am just glad that my children have forgiven me and knowing everything that I did - it helps them make WISER choices in the future (they both tested negative).

Maybe that is the good in all of this, I hope.

(Praying for your dad strator. I hate this disease it sucks)
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Avatar universal
Actually as a recovering 24/7 alchie- I certainly agree that when I was an active alchie I pretty much didn't separate lies from truth, but I'm not sure anyone in the general population - for instance someone who just had a short span of poor judgement in their youth- would be more likely to be forthcoming about it. After all if they've mostly led a decent life- it might be a little harder to admit to loved ones or anyone the mistakes once made. I know although I did every drug in the book from 1970 to 93 and then again for '00 and '01  I did only shoot once- yes with a shared needle. But particularly if you spent most of your adult life in the lifestyle like I did- you realize you're probably not suprising anyone by admitting IV use, they may even assume it, you've probably already admitted to things some consider worse....and IV use may very well not be what you consider one of your darkest secrets.(Don't ask) Just my theory.

As far as the relativity- yes alchoholics probably have more reasons for blood tests:toxicology after accidents and injuries through violence, hospital visits from poor health. I found out through 1 of the may trips to detox. There certainly seems to be a higher percentage of people I've met in AA that have hepC. A drug is a drug. Alcoholics are more likely to use high risk behaviour such as the boody straw for snorting. But the added stress on the liver - for may years at  140lbs I drank over a quart and a half a day of vodka outta the bottle (just to function and go to work, not on party days, lol). I should be dead. But my understanding is that the liver just can't handle both the hep and the toxins like booz. It's like tring to climb a ladder with a suit of armour. Hence (possibly) more rapid heptic related sx pre trearment. Then of course genetics come into play and who knows what else. My liver shoulda fallen apart years ago on it's own. I've met people who drank less, don't have hep, but developed more liver damage. I think the mix-with alcohol is just what my dr said - it's like giving the bad guy(the virus) a daily hit of meth so it can REALLY put some emnergy into ripping up your liver.
Now I'm trying to deal with whether my dad has it(11/27 Hepatitus C post) and he wasn't a drinker but may be 'collateral damage' from my past.
Don
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94007 tn?1224762736
My kids know because I am in a recovery program, though I do admit it has been easier for me to let others assume that the recovery is from alcohol alone.  I tried everything, in my veins, up my nose, etc. And had tattoos done at someone's house - I just cringe at the risks I took. I've had nothing in my system since 1983, the drugs were for a very short time in the late 70's but obviously thats all it took.
The most difficult "talk" I had was with my disabled son, who has mild mental retardation as well as physical disabilities. My heart broke when he said he thought it was weird that grandma didnt have hep C since we were born with it.  I explained to him that he was born with it it because he got it from me, and I wasnt born with it, I acquired it from using drugs.  He definitely gets it, he just hugged me and said he was so glad I wasnt using drugs now.
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Avatar universal

It's nice not to be alone huh?

I had four blood transfusions last year and use that cover with people like my PARENTS and CO-WORKERS (well they think I'm on chemo for blood cancer LOL).  I mean I tell who I want the truth and that is just FINE.  

Sad that we have to endure such a stigma - prices we pay for our mistakes of youth.  Like none of them ever did anything that was a bad idea...I am sure.

People need to realize it's not a WHERE we got it thing or HOW we got it - just how lucky we are that we found out that we had it so we can fight to cure it.  But of course..out here on Hepper Island it is a lonely old place sometimes.

This board has saved my life I am sure.
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Avatar universal
San Francisco 1969-72.  Haven't been back since.  I too am surprised I am not co-infected.   I am at 20 weeks and still in the closet.  Furthermore, if it becomes so obvious that I am "ill" and I must expose myself, I will hide under the blood transfusion I did have in 1977.  So much about being honest about IVDU.  It is not an easy thing to share with others.   I am grateful for this forum, because I find honesty much easier on my psyche.  Still, I am wrestling with telling my two boys who live in town.  I don't see them all that much, and they have no idea (about the hep c or treatment or IVDU).  How have others dealt with adult children who have no idea about your youth? (BTW - both adopted so not an issue for them to be tested)
friole
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Avatar universal
"Of course so many people shared $100 bills; why am I not multi-infected from that?"

My doctor told me in fact this is most likely exactly where I got it from.  All it takes is one micromicro of blood on that straw going up your nose into your blood.

Believe me...in the rock scene in the 80s I never, ever thought of that.  I just thought about doing as much as I could.  ;-)

PS I am multi-infected - 1A &1B
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Avatar universal
Maybe alcoholics - because their livers are compromised to start with to a degree are more susceptible to developing full blown HCV.

Or maybe more alcoholics have liver tests done than the regular population?

I'm an alcoholic/addict and I have HCV.  It's intersting to me that is for sure.
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Avatar universal
Ahem, & what bands would that have been?   Perhaps we shared a toothbrush in the bathroom of the Mabuhay?
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86075 tn?1238115091
Hi, your post really touched me. As for me, I'm done blaming that silly kid that I was, for the most part, cept when I fall off my stool. Kinda non-productive and I feel bad enough sometimes without adding my past to it the equation. I just didn't have many tools or coping mechanisms back then, that's for sure. I know I sound like I'm giving us all a big giant "Pass Go" ticket, but I do think that back then...they just didn't know what they know now about some of the drugs we were experimenting with. Well heroin maybe, but I didn't like that stuff - hated throwing up.

Not that the extra knowledge would of stopped "baby me", but it sure might of slowed me down a bit, specially the hep c.  Do you remember when so many people were saying that coke was the "super achiever" drug? The drug of champions? Fast forward to crawling around a carpet looking for specs. Oh well, past is history, future is fantasy, no time like the present. I hope you get some answers youre looking for, and that you feel better soon.
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Avatar universal
I have to say I'm a product of the seventies too. Sex, drugs, rock, and roll. But I have to say I knew when I had viral hep. I had had Hep A when I was 12 so it wasn't hard to see or feel the same signs. What's is bad is that I was told non-A-non B and inactive after everything was over with. So 6 yrs after that turned up with kidney disease. Never once have I been told until now that Hep C causes the kind of kidney disease I have, so 30 yrs later need a kidney. And there's only out of about 1 of so many thousands that develop kidney disease, what's so bad these drs knew I had did drugs my arms and veins were destroyed but no one every mentioned checking for the Hep again, till started testing for transplant. Then got shock of my life. They told me I would be better off on dialysis for 15 yrs, then transplanted for 5, which are the odds they give with hep c transplants. I know I'm rambling but sometimes especially when I'm reading the other posts I feel so bad, who could have known what could come of all that, we were young and immortal. So now I'm fighting with everything I've got and it sounds like alot of others are fighting too. Hope we all do good. Just having small pity party. Take care Linda
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Avatar universal
Got the virus somewhere in the early 70
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92903 tn?1309904711
In 1980, San Francisco; I was diag. with non-A/non-B hep, I thought I was cured.

Me too pal!

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Avatar universal
What blows my mind as to transmission is why more regular IVDU's aren't multi-genotype/subtype/quasispecies-infected.  Honest to god I had one single iv stick w/ two users, so I guess my viral pool was their viral pool. (Venice Beach, '80-82, 2b, f 48y/o 1/1 13/24)

Of course so many people shared $100 bills; why am I not multi-infected from that?

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Avatar universal
Responses very much appreciated!!  I enjoy the input, and opinions.  Again, my comments were very speculative, and by no means presented as a firm belief...only a suspiscion...and an explanation of an odd set of statistics.  Bear in mind, I was not saying HCV transmits to the blood by sexual contact, or other tissue contact....only that it might remain in compartmentalized tissues, as a latent infection.  Only in extreme cases (the heavy alcoholic) would it then cross the blood barrier.  This was my speculative theory...and I am not at all claiming that this must be happening.  Only a potential, possible answer to the puzzling fact that many alcoholics seem to be HCV+.

Of course, they may have become infected through typical blood to blood contact, and might have a tendency to be less than truthful about IVDU issues, etc.  I agree with all the above comments, but the answers to this question are not at all clear, as the article points out.  There are lots of things relating to this virus that still seem to baffle the researchers, and the HCV medical community.  One by one, we will want to find the 'exact' answers to all of them.  I remain an optomist...but still have lots of questions and concerns...based on my own experiences, and observations of others out there...along with what I am reading in the past few years.

I am really hoping that research proves that HCV is 'gone', eradicated entirely from our bodies after we get a solid SVR, and that the odd findings that have been cropping up in research studies, are all explained by some 'viral remnant' or 'viral memory' type reasoning.  Maybe there is no cause for concern at all.  But the jury is still out.

And on some questions (such as tissue to tissue transmission) the jury is not even in the courtroom.  There are no real questions being raised around this issue at all, so maybe it is not really an issue.....at all.  Let's hope.

DoubleDose
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