Aa
Reservoirs, SVR, Relapse, Barriers, etc.
Thanbey does raise quite a few questions, but very few answers.
There is little scientific proof at this point that SVR status means one is still carrying the virus in 'reservoirs'. I have discussed this issue with several leading virologists, and hepatologists. All seemed to agree unequivocally that the virus is not in hiding anywhere else in the body after a TRUE SVR is achieved.
The question one must ask is this: If the HCV virus initially is introduced into the body via the bloodstream, and infects the blood and liver, at minimum, and then if migrates to the brain, spinal cord, lymphatic system, etc. Then WHY does the reverse not seem to happen after SVR is achieved in blood and liver???
WHY, when SVR is achieved, does the virus NOT seem to travel back through those same routes, FROM the brain, spinal tissue, lymphatic system, etc. to REINFECT the blood and liver????
You would think that IF THERE WERE reservoirs of virus remaining in the body, that it would not take very long for it to pass back into the blood, and become detected again by PCR. Also, the liver would become affected and would generally be demonstrated by LFT abnormalities.
THIS is the logic that the reservoir theory proponents DO NOT address. Will it now take , let's say, 50 years for the reverse to take place? 80 years???? Because it does not seem to be happening in SVR's after 2, 3, 5, or 10 year periods.
Thanbey, believe me I have wrestled with this issue for a long time, and have asked many pointed questions to docs in all fields. So far, logic and research points to real SVR.
There is little scientific proof at this point that SVR status means one is still carrying the virus in 'reservoirs'. I have discussed this issue with several leading virologists, and hepatologists. All seemed to agree unequivocally that the virus is not in hiding anywhere else in the body after a TRUE SVR is achieved.
The question one must ask is this: If the HCV virus initially is introduced into the body via the bloodstream, and infects the blood and liver, at minimum, and then if migrates to the brain, spinal cord, lymphatic system, etc. Then WHY does the reverse not seem to happen after SVR is achieved in blood and liver???
WHY, when SVR is achieved, does the virus NOT seem to travel back through those same routes, FROM the brain, spinal tissue, lymphatic system, etc. to REINFECT the blood and liver????
You would think that IF THERE WERE reservoirs of virus remaining in the body, that it would not take very long for it to pass back into the blood, and become detected again by PCR. Also, the liver would become affected and would generally be demonstrated by LFT abnormalities.
THIS is the logic that the reservoir theory proponents DO NOT address. Will it now take , let's say, 50 years for the reverse to take place? 80 years???? Because it does not seem to be happening in SVR's after 2, 3, 5, or 10 year periods.
Thanbey, believe me I have wrestled with this issue for a long time, and have asked many pointed questions to docs in all fields. So far, logic and research points to real SVR.
It is important because, while the viral infection may not show up in the blood tests, it may still be acting on the very part of the body that makes us all human.
If there is continued infection in the brain, or any other part of the body, we need to look for a better way to treat it than we have now. There are studies that have found virus in the liver beyond an SVR. There are studies that have found that there isn't. So, the possibility of that happening is there, at least.
And, finally, there may be better ways right now for people to feel better. Interferon impacts only about 10% of the population infected with hepatitis C at this time.
It is important do that people whose infection and symtoms do not resolve are not simply sent home and told it is all in their heads, when in fact, it well may be and there may be startegies found to improve their quality of life in a way that interferon is not able to do.
That's why I think it is important. But this is, in fact, just my opinion and I'm not a doctor.
thanbey
for articles, www.hcop.org
If there is continued infection in the brain, or any other part of the body, we need to look for a better way to treat it than we have now. There are studies that have found virus in the liver beyond an SVR. There are studies that have found that there isn't. So, the possibility of that happening is there, at least.
And, finally, there may be better ways right now for people to feel better. Interferon impacts only about 10% of the population infected with hepatitis C at this time.
It is important do that people whose infection and symtoms do not resolve are not simply sent home and told it is all in their heads, when in fact, it well may be and there may be startegies found to improve their quality of life in a way that interferon is not able to do.
That's why I think it is important. But this is, in fact, just my opinion and I'm not a doctor.
thanbey
for articles, www.hcop.org
The statement: Interferon impacts 10% of the infected population, needs a little clarification. Is not sarcasm but true confusion. Is it 10% of Known infections or 10% of the estimated 4 million infected of which the majority don't know of this infection, or 10% of the few that know they are infected and chose to treat or does it include the ones that did not choose to treat? Ok, now my head is spinning...
Clinical trials only hand select certain patients for inclusion. So, those resulting numbers apply only to the same population of people reflected in those criteria.
That limits response rates for all-comers in a community setting.
For those who would not meet the inclusion criteria due to a multiplicity of reasons, for whom interferon is not a safe option, who choose not to treat, for those who cannot afford it or have not insurance, for those who are too young, too old, African American, homeless, incarcerated, those who have co-morbidities, autoimmune complications, heart patients, and those who do not realize an SVR.
Why is this important? Because those patients matter, too. And they represent the vast majority of those affected by and infected by hepatitis C. As an individual patient you can afford to disregard those patients, but if you are an educator or a researcher, or a compassionate human being, I don't think you can.
The fact is we have a treatment that applies to a narrow minority of patients infected with hepatitis C and that poses a public health, humanitarian, and clinical problem. Can we afford to think that it isn't an important problem?
<a href="http://www.hcop.org/hcvinfo/articles/index.cfm?articleid=97">SURPRISINGLY LOW IMPACT OF INTERFERON ON HEPATITIS C PATIENTS IN A METROPOLITAN HOSPITAL LIVER CLINIC SETTING</a>
thanbey
That limits response rates for all-comers in a community setting.
For those who would not meet the inclusion criteria due to a multiplicity of reasons, for whom interferon is not a safe option, who choose not to treat, for those who cannot afford it or have not insurance, for those who are too young, too old, African American, homeless, incarcerated, those who have co-morbidities, autoimmune complications, heart patients, and those who do not realize an SVR.
Why is this important? Because those patients matter, too. And they represent the vast majority of those affected by and infected by hepatitis C. As an individual patient you can afford to disregard those patients, but if you are an educator or a researcher, or a compassionate human being, I don't think you can.
The fact is we have a treatment that applies to a narrow minority of patients infected with hepatitis C and that poses a public health, humanitarian, and clinical problem. Can we afford to think that it isn't an important problem?
<a href="http://www.hcop.org/hcvinfo/articles/index.cfm?articleid=97">SURPRISINGLY LOW IMPACT OF INTERFERON ON HEPATITIS C PATIENTS IN A METROPOLITAN HOSPITAL LIVER CLINIC SETTING</a>
thanbey
I don't think it is better to use metaphors of liver cooking dragons, dragon slayers, death and the holy grail of an SVR or any other superstitions to scare people into a treatment or to stay on a treatment they may not need and may do more harm that good. It is not a balanced view of the situation and it oversimplifies the issues and diminishes the serious nature of what is being considered.
Better that people make personal decisions having had the opportunity for decisionmaking based on facts and data. At least having the informaiton on what is and is not known about the treatment they are considering.
That is my point of view.
Taking comments out of the context in which they are written is a desperate attempt to bolster a weak case. Why bother? It is what it is and people are adults and can research for themselves, discuss with their physicians, and do whatever fact finding they feel personally comfortable with. I cheer on those who undertake the treatment and and those who do not, equally.
At the end of the day, it is the patient and the knowledgeable physician who are the best combination therapy and we are but voices on an internet board. Nothing I do or say is intended as a substitute for a person's own good judgement and that of their provider.
best thoughts,
thanbey
Better that people make personal decisions having had the opportunity for decisionmaking based on facts and data. At least having the informaiton on what is and is not known about the treatment they are considering.
That is my point of view.
Taking comments out of the context in which they are written is a desperate attempt to bolster a weak case. Why bother? It is what it is and people are adults and can research for themselves, discuss with their physicians, and do whatever fact finding they feel personally comfortable with. I cheer on those who undertake the treatment and and those who do not, equally.
At the end of the day, it is the patient and the knowledgeable physician who are the best combination therapy and we are but voices on an internet board. Nothing I do or say is intended as a substitute for a person's own good judgement and that of their provider.
best thoughts,
thanbey
Ok I got that the 10% minority comes from the data from clinical trials? There are scores of us under tx not in that data and will not be, how can anyone then conclude that the majority or at least, a larger minority than 10% of the infected population is not impacted by interferon Tx? That the actual benefit vs risk is not higher?
How many stats like me, on Tx, not included thus making that estimation quite inaccurate. The only thing I am learning from stats recently is that they reflect a lot of inaccuracies. whew!
How many stats like me, on Tx, not included thus making that estimation quite inaccurate. The only thing I am learning from stats recently is that they reflect a lot of inaccuracies. whew!
I know that alot of people do believe here that if they are in fact on the treatment and don't come out of it....The big holy word "SVR". That in fact this disease will put them in their grave. I'm sorry...I don't feel that way at all in fact my dr when I first went to him and was crying...He said this is not a death sentence and I do truly believe that. I'm not so naive as to believe that it does not have the potential in some cases to kill. I have done lots and lots of research on this and know each and everyone of you do also and there is not that many cases of death. I know that alot of deaths are probably due to liver failure and noone even knew they had hep c. However, we all in this forum are fully aware that we have it which is a godsend on our part. We can be evaluated yearly and so on. If you are in fact a SVR...Congratulations but....Please remember that alot of us are either still in process of working on it or didn't make it and we don't need the doom and gloom comments of non--SVR's.
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
