American Association For The Study of Liver Disease

[mikesimon]

<A HREF="http://www.medscape.com/viewarticle/495211/">ARTICLE</A>
Many subjects are addressed including 1)duration of treatment 2)marijuana and liver disease 3)persistance of virus after treatment. It's at www.medscape.com so you must be registered to view. Registration is free and well worth the time. Mike

[DoubleDose]

Here is my $24 Million Dollar Question for the week:

IF HCV turns out to be a virus that not only infects serum and liver cells, but also possibly brain, lymphatic, maybe even salivary, mucosal, (there have been recent articles by the  Gastro. Asso. that HCV is found in gastric mucosa as well!), sexual tissues, etc then:

1:  What would keep it from replicating in the organs of casual contacts, partners, close family members from things like kissing, sexual contact, etc??  That is, not infecting the blood per se, but setting up a low level, sub-clinical infection in various tissues/ organ systems of our close contacts.  This might be characterized in the same way that SVR's now seem to carry replicating virus in other compartments, BUT NOT in the blood or liver.  That creates an entire new paradigm for the virus!  Do we know for sure that things like CFS, Fibromyalgia, vague autoimmune disease, might not stem from something like HCV infecting perpheral organs, causing autoimmune reactions...arthritis, fatigue, tinnitus, brain fog, etc.  

2:  IF infection can potentially transmit into peripheral organs in other people, would they necessarily have an HCV pos. response to standard serum HCV antibody tests???  Maybe there are many people infected, in non serum/liver organs, who test negative on blood testing!  
(Why do the HCV antibodies NOT go away in SVR's???)  Is the body still detecting HCV??

3:  ARE we yet totally sure that HCV is purely and only a blood transmitted virus????  Recent research is starting to shake my confidence.  Read what Oral Surgeons say about finding HCV in salivary cells, etc.  Why Couldn't it transmit in those tissues?  Or sexual mucosa???? Or mucous membranes..eyes..etc?
THESE are still unanswered questions.  The virologists need to really go to work on these issues. We need ANSWERS, AND treatments.

Food for thought and discussion.  Regards to all of our members.

DoubleDose

[jonihs]

I just want to ditto what everyone else has said welcoming you both back. You were greatly missed and in my prayers often. Your research and knowledge helped enormously while I was going through tx. and the long months I had to wait to start. God bless you both.   Joni

[willing]

thanks for the kind word. I'm a bit conflicted about the benefits of pursuing hcv research. On one hand it's endlessly fascinating to learn more about such an intimate enemy. On the other other hand it really doesn't help get on with living the rest of one's life. After discovering that, by and large, contemporary medicine understands little and can do less, you're back to attitude and adaptation, regardless of how the ifn/riba lottery treated you. And these are much harder topics to talk about (at least for me) ...so back to Marek and his bad news. It's hard for me to see this as anything but evidence that in most people the virus replicates, in the liver and elsewhere, long after SVR. Negative strand RNA is a short-lived intermediate created during replication and thus presumably harder to detect than plus strand RNA properly ensconced in its protein coat.  
With RNAases constantly chewing up and recycling whatever they run into, the detected RNA would have to be of recent vintage. Purists who want assurance that they've eliminated every last virion probably need to wait until they stop making hcv antibodies and/or show no RNA after taking immunosuppressants. For most people however, "cured" means a working liver and that's not inconsisted with an immune response that keeps viral replication at a low-level (for years and years as confirmed by many studies). Since damage to our liver is not done directly by the virus but by the immune response to its presence, even low-level warfare is not great news, but it's probably good enough to get through one lifetime. Since we're just starting to quantify the impact of infection outside the liver during full-blown chronic infection it seems that any discussion about the impact of residual, low-level, post-SVR infection outside the liver will have to be guesswork for a long time yet. Still, it means that even SVRs may have a reason to be interested in the new meds that directly target the HCV replication cycle.

[Tallblonde]

When I found this site a year ago, I began cutting and pasting and printing virtually everything posted by Willing, TnHepGuy and Doubledose. I actually have a file folder full of their stuff.  My own knowledge base was, in large part, developed by learning from them.

Anyone out there who has been recently diagnosed with HCV should pay close attention to their postings (in case you haven't figured that out already).  While this board, unfortunately, can often be filled with nonsense, you can always count on these guys to come through with useful information.

My hat is off to them.

Susan

[Tallblonde]

Boy, can I ever relate to that.  My GI tells me to "quit obsessing" about the disease" and "quit reading so much."  He acts irritated if I ask any questions.  The answers he does throw out as crumbs to appease me, are often ridiculous....."I won't be surprise if you clear the virus, but I also won't be surprised if you don't." (Wow!  That sure covers all the bases, doesn't it?).  

It's absolutely maddening and insulting to have to try so hard to tap into their knowledge base.  Wait a minute...maybe their knowledge base isn't as formidable as we think.

Susan

[TnHepGuy_]

<u>mikesimon</u> - congratulations on continuing down the path of SVR. That recent study (though small and limited) showing 100% correlation between 3-month and 6-month PCR/SVR results - if fully born out - is good news for anyone who cares not to wait so long. I've decided to go with a 3-month'er myself. But since my LFT's were elevated prior to tx, I can keep any eye on them and hopefully gain some knowedge via those results prior to the 3-month date.

<u>chevygal55</u> - wonderful news to hear of your SVR. Congratulations and hopefully you can take some solice from that 3-month study (mentioned above) as you go into your 6-month'er.

<u>doubledose</u> - good to see you, as well. This virus truly is a riddle wrapped in a mystery inside an enigma.

<u>honey15637</u> - thank you for the welcome. How are you and hubby holding up here near the end? I'm still hanging on by a thread or thereabouts. I finish all my meds on January 8th.

<u>layla</u> - very good to see you again, too. I hope things are going well for you and your family - especially as you head into the holidays. I'm doing as good as these lousy meds will let me be - and counting the days from here. My guitar playing has been suffering as of late - which of course means that my wife's ears haven't ... ahahahaha. Glad to hear that you're decided to go forward with lessons. You'll be playing like James Taylor in no time flat.


TnHepGuy