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Spontaneous Clearance of Chronic Hepatitis C

I was surprised when I came across these two studies recently. That's because the studies talk about spontaneous clearance in *chronic* cases, not acute cases where  the concept is more familiar.

Keep in mind they are only two studies and while interesting on a number of levels, I don't think it prudent for anyone to use them to guide any treatment decision as the per cent of those with spontaneous clearance is simply too small to factor into the decision as I see it.

That said, it may explain a number of things including the occasional person who claims they were "cured" by this or that without SOC. If these studies are correct, it may turn out that they would have been cured anyway, just by a small statistical chance.


http://tinyurl.com/2hddnu
http://www.journals.uchicago.edu/CID/journal/issues/v42n7/38040/38040.html
61 Responses
Avatar universal
Haven't read it yet, but will... and what I'm wondering may very well be answered there... Were they followed for a long period, having documented labs... showing a chronic state; what were their bx results, did it go beyond 0-1 or so... That's what I'd be interested in knowing.  I'd think if virus had not taken hold and moved in a slower rate, not causing as much damage to liver and other organs ... if anyone was to have spontaneous clearance it would be in these patients, given their bodies had maintain very well having the virus. Looking forward to reading article, Jim... this is very interesting.  And if this is the case, its very well conceivable that given the estimated numbers of those having hep C, unaware they do in fact have it... there's a possibility in those cases/group, that there are chronic cases that also have had spontaneous clearance... hmmmmm...thanks for that
Avatar universal
...not that I don't want to jump on reading ..but taking a breaking and using an office computer but have to go back outside... will look forward to this, this afternoon, very interesting!!  be well....
Avatar universal
Espirit,

Some of your hunches are correct. Please read the study, but from memory some of the characteristics that favored spontaneous clearance were low viral load, low enzymes, being female, being infected at a younger age, and IV drug use as opposed to transfusions. The latter probably because with a transfusion more infected blood was shared.

I flagged "TallBlonde" although she probably isn't following the board closely but maybe someone in contact with her will email her the thread. I thought about her because I believe she fits some of the parameters discussed and in fact somewhat recently visited a world renowned liver specialist in Boston, who if memory serves me thought that maybe one or two shots of Peg might cure her given her extremely low viral load and normal enzymes. Hope I got that right but maybe she will show up and clarify.

-- Jim

Avatar universal
In the second article, there is a link to editorial commentary by "Lauer and Kim" which I found quite interesting. In part it reads:

"...One of the puzzling features of infection with hepatitis C virus (HCV) is that, even among healthy and fully immunocompetent individuals, up to 80% of individuals with HCV infection develop persistent viremia, with the potential consequences of liver cirrhosis, liver failure, and hepatocellular carcinoma [1]. On the other hand, one could argue that the glass is at least partially full, because a significant proportion of persons with HCV infection are able to gain control of their infection and most likely experience spontaneous eradication of the virus. This observation indicates that defeat of HCV infection can be achieved by means of weapons from the host's own arsenal; however, employing these weapons for future therapies will require better identification of the mechanisms by which viremia is controlled in these circumstances. HCV-specific cellular immunity has been shown to play a critical role in the spontaneous resolution of HCV infection [2, 3], but it remains unclear what exactly distinguishes a successful from an unsuccessful cellular immune response and how critical a role other parts of the immune system have in HCV control.

     Because almost all persons who experience clearance of HCV infection spontaneously do so within the first 6 months after onset of infection, it is often overlooked that patients sometimes experience clearance of HCV many years after chronic HCV infection has been established. Most of these reports describe spontaneous clearance of HCV together with other significant clinical events, which are typically associated with extraordinary changes in host immunity, such as immune reconstitution following receipt of HAART [4], termination of immunosuppressive therapy [5], pregnancy, or onset of other acute viral infections [6]..."
Avatar universal
It  boils down to is what we already know.  Each person deals with this differently and even some can clear after chronic conditions exist.  Explains to me why some people can deal with the infection all their lives and others have serious problems.  I still say its in the Genes.

                                                                                                    Ron            
179856 tn?1333550962
Agreed.  It's one of those things we'll never understand.  We all wish it had happened to us though!  :)

Maybe someday science will figure this disease out and maybe not.  Just lucky lucky for the people born with the good genes ;)
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