Hep C carrier???

[jt57]

I have a friend that has been diagnosed with hep c.  as you all know, I am going thru my second round of tx.  She is being told she is a "carrier".  Can someone help me with that?  Either you have hep c, or you don't.  but a carrier?  Has anyone else heard of this?  i would like to advise my friend that I think she is getting misinformation, but I would like the opinions of you folks on this issue.

Thanks all!

Jean

[Trinity4]

Jean,

You're exactly right.  Either a person has the active RNA virus or they don't.  You can't just 'carry' the virus without it doing damage to the liver.  A person can test positive for antibodies but negative for RNA.  Technically speaking they will carry the HCV antibodies all their life but it posses no health problems and they can't transmit the virus because there is no active virus to transmit.  

I sure hope your friend didn't get that information from her doctor.  

Trin

[GFRY]

some websites consider people that are SVR as carriers, i would ask her about her pcr test

[jt57]

I don't get that.  If you are svr, how could you be a carrier?  I am und right now, at 38 wks into tx, and have been since wk 4.  I was told that as long as I am und, no one can contract the virus from me.  Any other opinions?

[FlGuy]

There are two "undetectables".  While on treatment you may have a PCR which tells you that you are undetectable, below the lower limit of the test's sensitivity.  But you can still have virus floating around below those quantities.  Then there's the real undetectable, or SVR, which is the lack of virus 6 months after the end of treatment.  So, one of those is undetectable and the other is UNDETECTABLE.  Around here, we like the second.

[Trinity4]

It's semantics Jean.  Many websites use incorrect terminology when referring to HCV and SVR.  Some say the virus is dormant.   The bottom line is you can't transmit HCV without active RNA.  Using a fairly sensitive PCR with negative results means no virus.  Simple as that.

[nygirl7]

I agree this makes no sense unless the doctor meant  that she had the antibodies but not the virus.  But she really needs to find out.  If you have the virus you have the virus and you have hepc, you are right.

I guess I am considered a carrier I did see it on one of my doctors reports but I am SVR so I believe the terminology was used to show that I dont have the dsiease but did and do carry the antibodies.

[fretboard]

It's called a "healthy chronic carrier" years ago it was thought that ppl who fell in this category were safer than the rest of the HepC population.   I don't know who ever started that idea b/c it doesn't make much sense.  If you look at the book by Dr Melissa Palmer she goes over it in page 161 of "Hepatitis & Liver Disease" What you need to Know.  The book was written in 2000.  Basically she says that when someone falls within this category, then they don't have to tx.  All they have to do is get a liver biopsy once every 5yrs or something sililar.  It's a category that was given to ppl who always have normal LFT's.  The book is on google somewhere.  Oh, incidently when she wrote her newer book  a couple of years later, she never touched on this idea again.   good luck

[jt57]

my test was a very sensitive test.  measured to a level of 2.  and I was und at 4 wks.  what do you think?

[Trinity4]

I think that is the best possible news a gal can get, especially since you relapsed first go round.

To me, that UND means no virus in the body to transmit at this point or in the future because I think you've got SVR in the bag this time.  

Way to go!
Trin

[jt57]

Thanks Trin!

[nygirl7]

I think UND <2 at week 4 is as promising news as anyone can ever expect to get.  I believe it puts you in like the 90% success rate. See...good thing you decided to do the SOC and not wait like some other folks. Wait and progress or try now and succeed...hum...easy answer to me!  :D

[willbb]

Good on you!! Gives us that decided to start TX. hope. !

To nygirl:

See...good thing you decided to do the SOC and not wait like some other folks. Wait and progress or try now and succeed...hum...easy answer to me!  :D     Right On !!!

[nygirl7]

See I looked my medical history up on line. In the diagnosis code section it says:

Diagnosis: HEPATITIS C CARRIE : V02.62

But he has written: 72 weeks of Interferon.  Now undetectable.  Seen by GI in NYC and Westchester

So I guess diagnostically since we carry the antibodies still we are considered carriers - which doesn't seem correct to me at all since we can't give it to anybody.  Archaic terminology.

[eureka254]

Medical terminology doesn't always evolve appropriately, and lots of docs will still use older, antiquated terms which further confuses patients.  Hopefully as understanding of hep c grows there will be more precise usage of language, but oftentimes doctors refer to positive antibodies for hcv as someone being a carrier.  Nygirl is right, it's archaic.

In the purest scientific term, being a 'carrier' doesn't mean you pass on disease, though; rather, it simply points to some apparent detectable 'trait' that demonstrates some aspect of the disease in the individual -- in this case, the presence of antibodies.  Because there are rare cases of relapse post long-term clearance, 'carrier' is not as yet deemed 'wrong' to use from a medical standpoint.  So bottom line is, anyone who has hcv antibodies could be labelled a hep c "carrier", but that term does not address whether one has detectable viral load or not.

Congratulations on continued undetectable virus in your treatment!  Your stats are looking real good for SVR! Wishing you continued success. ~eureka

[fretboard]

She is being told she is a "carrier".  Can someone help me with that?  Either you have hep c, or you don't.  but a carrier?
_________________________________________________________________
Ok, In answer to your question I tried to google the book but only the newest book would come up so I have the book I'm talking about and I'll write what the book says.  Page 161 of Dr Melissa Palmer's book Hepatitis & Liver Disease.  

Those With Normal ALT Levels
Approximately one-third of all people with chronic hepatitis C have persistently normal ALT levels, despite having elevated viral loads (HCV RNA).  The exact significance of this finding is not known and may, in fact, vary from person to person.  Some experts believe that these people may never have serious liver disease, and thus, have been referred to as " healthy chronic carriers".

Skipping a couple of paragraphs, this is part of the last part on page 161.

So, should people with persistently normal ALT levels be treated?  Well the National
Institutes of Health (NIH) consensus statement in 1997 regarding the management  of hepatitis c recommended that people with persistently normal ALT levels refrain from treatment,

Well there it is in a nutshell.  That said, the book was published in 2000 and her new book does not mention the above sentiment at all.  I'm not surprised as it's full of incorrect information.  

Hey I think I just found the link and it looks like this doctor still says the same stuff on page 128 of the new book.   Here it is if you want to check it out!  

http://books.google.com/books?id=Pf5j8RgzkRMC&pg=PA128&lpg=PA128&dq=and+thus,+have+been+referred+to+as+%22+healthy+chronic+carriers%22.&source=bl&ots=Jsi879bwy8&sig=4mk45s48fWZyijin-dcBQXJiMqA&hl=en&ei=fJnkTIL-EI_4sAPa7OzhCA&sa=X&oi=book_result&ct=result&resnum=1&sqi=2&ved=0CBMQ6AEwAA#v=onepage&q=and%20thus%2C%20have%20been%20referred%20to%20as%20%22%20healthy%20chronic%20carriers%22.&f=false
  

[Frreebird]

Would having a rare blood type say yiu have heo c. My uncle had same he drank I can give blood but i can get blood 26 yrs ago i was have me first child my doc saud i had a the mos rarest blood type

[Frreebird]

He ever sine like a+du-

[Diane12855]

I had persistently normal ALTs for years, yet my viral load was 6,000,000 and I was Stage 2 Grade 2 when I got my biopsy.... so that opinion is obviously not correct.

Diane

[Diane12855]

Here is Wikipedia's definition .... kinda:

Asymptomatic carrier, a person or organism infected with an infectious disease agent, but displaying no symptoms.

Once we are SVR we aren't infected with an infectious disease agent, so we can't be carriers. Since antibodies aren't infectious, that can't be what they are talking about.

Jean: What kind of doctor told your friend she was a carrier?

Diane

[eureka254]

Most of us are 'asymptomatic carriers' of chicken pox but we're not actively infected.
All people with hep c were 'infected' at one point or another, regardless of current status, which actually still fits the less than sufficient wiki interpretation given above.

Another way of thinking about it is being an asymptomatic 'carrier' of a genetic disease as opposed to an infectious disease, lets say.  You have the presence of something in your blood that shows a marker for an environmental or genetic exposure or condition, but you cannot cause disease all by yourself (or infect another).  

It's not the best terminology, but it's not wrong either.

[IAmTheWalrus]

Carrier is a little antiquated and really not appropriate for someone who is SVR. However, my hepatologist says that, even someone who is SVR, should be ruled out as an organ doner except in cases where they would use an organ for an already infected recipient. Also, a formerly infected patient is not allowed to donate blood. There are still some questions as to what tissues in the body of an SVR patient may still have remnants of the virus, if not active replicating virus.

Does this mean you are a carrier in the sense that you could infect someone else? I think not. Just don't donate blood or share needles.

[fretboard]

I had persistently normal ALTs for years, yet my viral load was 6,000,000 and I was Stage 2 Grade 2 when I got my biopsy.... so that opinion is obviously not correct.
_______________________________________________________________________
It's not my opinion, it's what's in the lady doctors book, Dr Melissa Palmer.  In the newer book it's on page 128 and in the older book it's on page 161.  The book is on google for free if anyone wants to check it out and it specifically talks about "healthy chronic carrier".  I have the older book but there's not an easy way to share it and I've forgotten how to use the tinyurl.  If the OP is interested then read my posts as they are all true and not my opinion at all.

[fretboard]

If you just google what I have below the new book will come up, around the 4th link when I tried it.  Not everything she says in her book is right but I think the way she uses the term "healthy chronic carrier" is important nonetheless.  


Doctor Melissa Palmer's guide to hepatitis and liver disease

[James10500]

I didn't know Dr. Palmer's book was on line for free.  I ve seen some videos on YouTube of hers, but was unaware of the book.  Knowledge is key, I tend to have to print articles and studies to educate people about Hep. C.   Before I got hep c, I never knew there were so many experts on the subject in ordinary like.......lol.  It's a battle and now I have another bullet.

Thanks !

[Diane12855]

I understand that you weren't stating your opinion. Since hep c has only been discovered in the past 25 years, lots of the things doctors learned about it in med school are already obsolete. I guess we have to look for doctors who are keeping up with the latest discoveries on a regular basis.

Diane

[fretboard]

Since hep c has only been discovered in the past 25 years, lots of the things doctors learned about it in med school are already obsolete.
______________________________________________________________________
I absolutely agree.  Isn't it something that even in her new book published in 2004 she is still talking about this "healthy chronic carrier"?  The rest of the book is fine but to talk about this in an informational manner is totally irresponsible, jmo.  At least she has minimized what she said in the first book.  Maybe it's an East Coast thing. lol  Incidentally I have only heard one other doctor use that term and he is a complete idiot. go figure