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Hepatitis Researcher importance of TH1 response
I aked you before in a previous post what, if any, your thoughts were in regards to SVR and a vigorous TH1 favored immune response. I'm started to beleive that it is exactly this shift from the dominating Th2 response to a more 'viral hungry" TH1 response which determines svr at the end of treatment. In other words, people who acheive svr are also maintaining a strong Th1 response at the end of treatment which in turn may be keeping any viral remnants in check. People who fail to acheive svr maybe reverting back to the old virally favorable TH2 arm of the immune system when the drugs are removed from their systems. Do you think my hypothesis is credible?
HR said above regarding interferon use:
THESE CONSTANTS ARE PERMANENTLY CHANGED BY LONG TERM INTERFERON OR ANY LONG TERM EXPOSURE TO IMMUNOGENIC ANTIGENS/stimulation.
My comment:
This sums up what I have been trying to explain in a more verbose, less effective way, over many threads and posts. Similar to what two of my 'other' doctors have told me (not HCV related doctors), that interferon causes a PERMANENT change in the system, and many, many subsequent generations of cells that come into being will behave as if one is still on interferon.
This, I believe, is what is responsible for the 'milder colds', and unfortunately for the : joint pains, fatigue, sun sensitivity, brain fog, lack of motivation, gastric disturbances, etc., etc after tx. In other words, as my Rheumatologist put it, we are now living with a chronic autoimmune condition, without a name or label. Its not exactly Lupus, or RA, or MS, etc. But IT IS.
HR put it succinctly. This is also why I sometimes 'go off the deep end' when people constantly claim that our post-tx problems have nothing to do with all the interferon that we used. On the contrary, the problems are more likely completely due to the interferon. Interferon has a track record of changing the system, and its function. Many doctors are well aware of this. Oddly, most HCV doctors are not. (Psst, by the way, neither are the drug companies.) Go figure!
DoubleDose
THESE CONSTANTS ARE PERMANENTLY CHANGED BY LONG TERM INTERFERON OR ANY LONG TERM EXPOSURE TO IMMUNOGENIC ANTIGENS/stimulation.
My comment:
This sums up what I have been trying to explain in a more verbose, less effective way, over many threads and posts. Similar to what two of my 'other' doctors have told me (not HCV related doctors), that interferon causes a PERMANENT change in the system, and many, many subsequent generations of cells that come into being will behave as if one is still on interferon.
This, I believe, is what is responsible for the 'milder colds', and unfortunately for the : joint pains, fatigue, sun sensitivity, brain fog, lack of motivation, gastric disturbances, etc., etc after tx. In other words, as my Rheumatologist put it, we are now living with a chronic autoimmune condition, without a name or label. Its not exactly Lupus, or RA, or MS, etc. But IT IS.
HR put it succinctly. This is also why I sometimes 'go off the deep end' when people constantly claim that our post-tx problems have nothing to do with all the interferon that we used. On the contrary, the problems are more likely completely due to the interferon. Interferon has a track record of changing the system, and its function. Many doctors are well aware of this. Oddly, most HCV doctors are not. (Psst, by the way, neither are the drug companies.) Go figure!
DoubleDose
He also talks about te AMOUNT of interferon. You used twice the "normal" dose which could be the reason you have had the response you have had. You can't rule out taking twice the approved amount as the reason either.
He seems to be saying it can produce both positive immune response effects and negative ones, depending on how your individual system responds.
I believe the virus can cause MORE damage than the treatment particularly in those with moderate to severe liver damage. A continuing declining liver status is no walk in the park either and can be responsible for many "after effects" that are blamed on IFN. Also the fact that many have had the HCV virus for decades in their bodies can't be disregarded as a factor in post tx problems or as a factor in their "changed" immune response. The problem is all these factors have to be considered and studied before you can say "IFN did this to me" when in fact there are a host of additional factors involved.
A person with substantial liver damage prior to treating might find more dramatic responses from IFN. that have something to do with their damaged livers.
To say "it's all due to interferon" is far too simplistic, all te factors have to be considered including the AMOUNT of IFN taken, the CONDITION of your liver and overall immune system prior that existed and YOUR response to it. You took double the recommended amount of the drug and also took it for extended periods of time, much longer than the typical patient. As cuteus points out, her immune response has been enhanced in a good way. To my knowledge she did not double dose IFN.
I dont think you can discount taking double the recommended dosages as non significant to post tx situations.
He seems to be saying it can produce both positive immune response effects and negative ones, depending on how your individual system responds.
I believe the virus can cause MORE damage than the treatment particularly in those with moderate to severe liver damage. A continuing declining liver status is no walk in the park either and can be responsible for many "after effects" that are blamed on IFN. Also the fact that many have had the HCV virus for decades in their bodies can't be disregarded as a factor in post tx problems or as a factor in their "changed" immune response. The problem is all these factors have to be considered and studied before you can say "IFN did this to me" when in fact there are a host of additional factors involved.
A person with substantial liver damage prior to treating might find more dramatic responses from IFN. that have something to do with their damaged livers.
To say "it's all due to interferon" is far too simplistic, all te factors have to be considered including the AMOUNT of IFN taken, the CONDITION of your liver and overall immune system prior that existed and YOUR response to it. You took double the recommended amount of the drug and also took it for extended periods of time, much longer than the typical patient. As cuteus points out, her immune response has been enhanced in a good way. To my knowledge she did not double dose IFN.
I dont think you can discount taking double the recommended dosages as non significant to post tx situations.
No real arguments here other than being an optomist by nature, I believe that the immune system will eventually "settle down" in many/most of us, albeit at a different pace. I mentioned TCM earlier as one means to hasten that process, as well as more natural methods such as exercise, diet, etc.
But along this line of thinking, don't you think this post tx immune response argues for a more cautious approach regarding extended treatment, for example, which you often appear to advocate?
Personally, I think extending tx or "bumping up" the tx drugs only makes sense in those with significant liver damage, regardless of whatever incremental increase in the odds of SVR that a more agressive tx might bring. Again, weighing the risks of extended treatment against the reward of an incrementally better chance of SVR.
Be well,
-- Jim
But along this line of thinking, don't you think this post tx immune response argues for a more cautious approach regarding extended treatment, for example, which you often appear to advocate?
Personally, I think extending tx or "bumping up" the tx drugs only makes sense in those with significant liver damage, regardless of whatever incremental increase in the odds of SVR that a more agressive tx might bring. Again, weighing the risks of extended treatment against the reward of an incrementally better chance of SVR.
Be well,
-- Jim
Kalio: I believe the virus can cause MORE damage than the treatment particularly in those with moderate to severe liver damage.
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Don't mean to be cute here, but are you acknowledging then that treatment can cause more damage than the virus in those with little or no liver damage?
Just not sure what your position has been on this or if any changes. My position has always been that the risks of treatment for those with little or no liver damage probably outweigh the rewards. That said, the decision to treat or not to treat has so many other variable factors that in the end the right decision is the decision someone makes -- assuming they make an educated decision by taking a little time to study the issues.
-- Jim
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Don't mean to be cute here, but are you acknowledging then that treatment can cause more damage than the virus in those with little or no liver damage?
Just not sure what your position has been on this or if any changes. My position has always been that the risks of treatment for those with little or no liver damage probably outweigh the rewards. That said, the decision to treat or not to treat has so many other variable factors that in the end the right decision is the decision someone makes -- assuming they make an educated decision by taking a little time to study the issues.
-- Jim
I haven't had any colds, flu or anything of the sort, even though I've been around plenty of people who have, in close quarters. I used to get a flu maybe, every few years, and about a cold a winter, nothing much, but now nothing. For the three years since I've been symptomatic...course I'm not complaining, but it is strange...haven't taken the meds yet either...
wait! since you are around for a bit, let me run a scenario by you and you can guess what might be at work.
You have been reading extensive reports by some members here about post tx conditions that they are attributing to a "changed" immune system, caused by the medications and the length of tx, possibly.
I have been posting that perhaps in some folks the changes are not of the negative type, like the ones we have been reading about. That some of us, have been left with an immune system with 'superpowers' if you wish. My contention is based on the fact that for almost 4 yrs, I have not experienced the common cold or influenza, whereas before it took hold of me and would make me quite ill with chest congestion and severe coughing. What I have been noticing is that the throat will get sore, but not an extreme soreness where you can't swallow, but a milder form that will last 3 days or so, and then go away without developing into a runny nose, congestion, cough, the works. No fevers, flu aches, nada. Recently it went as far as a bit sore in the chest, and a soft cough once or twice. That's it. This has been puzzling to me, a positive post tx "side effect". Any thoughts? I am not the only one who has mentioned the same thing, but the others are not regular pests around here. Is this an immunology oddity? or common occurrence?
You have been reading extensive reports by some members here about post tx conditions that they are attributing to a "changed" immune system, caused by the medications and the length of tx, possibly.
I have been posting that perhaps in some folks the changes are not of the negative type, like the ones we have been reading about. That some of us, have been left with an immune system with 'superpowers' if you wish. My contention is based on the fact that for almost 4 yrs, I have not experienced the common cold or influenza, whereas before it took hold of me and would make me quite ill with chest congestion and severe coughing. What I have been noticing is that the throat will get sore, but not an extreme soreness where you can't swallow, but a milder form that will last 3 days or so, and then go away without developing into a runny nose, congestion, cough, the works. No fevers, flu aches, nada. Recently it went as far as a bit sore in the chest, and a soft cough once or twice. That's it. This has been puzzling to me, a positive post tx "side effect". Any thoughts? I am not the only one who has mentioned the same thing, but the others are not regular pests around here. Is this an immunology oddity? or common occurrence?
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