Being "truly SVR" is defined by being undetected in the bloodstream. Recent studies seem to show that as many as 80%-90% of us who have been SVR for many years still show detectable HCV RNA in our specialized/compartmentalized systems (spinal fluid, lymphatic system, etc.) - and our livers.
Which is fine - as long as I can't pass it on to someone and disease progression is halted, it works for me.
What is worriesome is that corticosteroids may allow it break free of these systems and back into our blood. This is not a matter of a not sensitive enough test.
It should be emphasized that a lot of this is speculation at this point and our current definition of SVR is still workable.
Respectfully
I also respect Dieterich's opinions a lot -- not only because he has been there, done that as a doctor and researcher with hundreds and hundreds of patients -- but because he successfully treated himself for Hepatitis C.
Don't know if you caught my earlier post on Dieterich's web cast. Very informative for anyone interested in newer treatment protocols. http://tinyurl.com/lsv3o
-- Jim
cortisone shots or epidurals will not bring the virus back if you are truly SVR.. When we get these stories about people getting hcv back after taking prednisone, we get very limited information and the possibility of unfounded fears. The only documented case was of a woman who was undetected by not so sensitive PCR, showed positive for HCV after prednisone, and went back to negative after stopping it. To me, this person has a very low vl, and is not truly SVR. What is keeping the load so low is anybody's guess.
I have had the epidural for pain, and will have the shot for the carpal tunnel, and so far, no HCV. I am pretty sure the same is true for most.
In case you missed my earlier answer below:
Never took it but here's what Dr. Dieterich had to say:
http://www.thebody.com/Forums/AIDS/Hepatitis/Archive/HepCtreat/Q171746.html
Of course check with your GI.
Good luck!
-- Jim
I had horrible itching after I got off tx. I had been off for 2 mos and giant whelps started coming up me. My family doc gave me a shot of cortisone and I ended up in the hospital in shock. Not only did I still itch, it was worse. It took two huge shots of Benedryl to get me out of that and the itching was still there after the Benedryl wore off.
The best you can do is keep busy, if you can. I know that it drives you insane, but scratching makes it worse. Yes, I know you know that, but take oatmeal baths and things like that.
Hope you get better! I have been post-tx for 2 years and no critters so far.
It is worht it!
So weird... around thursday I started to get a sour stomach. It peaked around Sunday. Really bad cramps and stuff. Then Monday I woke up with incredible itching. I took a benadryl and it went away for a while then came back with a vengence.
I am not even on treatment yet, but jeeesh, if itchy skin is a symptom of Ribavirin then I am in for a long haul, because I am a whimp when it comes to body itches. Driving me crazy!
I take it with Riba-itch you cant just take a benadryl to subdue it??
Poor you! Bad enough to be treating for hep c but to get poison oak that bad too is awful. Although they work against one another, be careful and work with the docs ad dot just stop the steroids, poison oak can get very severe especially on tx. You have to be carful with stopping it so you dont get a "rebound reaction" of poison oak which can happen if you stop the steroids too fast..the steroids hit the poison oak but it moves to your nerve endings and can sometimes reoccur a few weeks later, usually on your palms and soles of your feet where the nerve endings are. You might have to complete the course of steroids first to reduce yur poison reaction and second so you dont have further problems. I only know this because it happened to me. The doctor wil know how to stop the steroids so that doesnt happen. I hope it is taking care of that poison oak. It is such a drag and can be dangerous for some. My Father was highly allergic and ended up in the hospital for a week with it.
I know I have been told repeatedly on this board not to take steriods. They cut the effectiveness of the inf. I take dexosome for bone pain once a month. My oncl/Hemo said to take as few pills as I could, b/c it does interfer with the interferon. For me I took four pills the first time and then 2 the next. I couldn't stand the pain! I am going to ask for neup instead of neulasta and see if the bone pain/headaches etc. are less. I hope so!
I know how bad poison oak is. I used to get it so bad, I would be home for weeks from school. Now I stay away from it! Good luck! Don't scratch!
Thanks for the tip. I will call the GI tomorrow.
Better safe then sorry. It has finially stopped or slowed the itching. GOsh I will stay away from all vines from now on. I never knew you could itch so bad. Heck they could grind this up and put it in a bomb and have it go over Iraq. Heck they would stop killing one another and just itch.
I know a lady who cleared the virus and also had lupus. Sometime later she took prednisone for the lupus and AND THE HEP. C came back. Now she's going through tx again. It's so sad. I would not take it. NO WAY.
My doc had me on prednisone to help my skin ()lots of scabs and rash stuff). He figured it was from the interferon putting the immune system into overdrive and the prednisone would calm it down. Doesn't sound like it would be the best thing on tx but a short course (even the 5 days I did) didn't make a big change in things, just helped along when I was done.
There are reports that prednisone and cortisone may cause relapse even in people who are many years SVR. So far it's just anecdotal and one small European study on 1b supporting this, but it's enough that I'm going in to get a 3.5 yr post-tx PCR next month. My family doc has been treating my post-tx RA in my hands with cortisone shots.