The definition of a Chronic HCV is infected 6 months or more. Acute is less than 6 months. So, generally, it would be in the range of 6 months or less.
As a veteran of the Army, where I got HEP-C 40 years ago, and a research junkie for the past 15 since being diagnosed, it is my understanding that you never really get rid of the virus. It may remain what is called "undetectable" which is under 50, but you will always carry the antibodies in your blood. I have met people who tried to resume a lifestyle that included alcohol intake and they weakened their liver enough for the virus to get started up again. By the way, what are your ALT, AST levels? If they are normal you should be fine.
If your virus never really became detectable, you may be one of the lucky ones who was able to fight it off on your own. I hope so because that would be very good new for you!
"a research junkie for the past 15 since being diagnosed, it is my understanding that you never really get rid of the virus"
Through your 15 years of research, obviously you collected study links, lord knows I have (lol), could you please post one that suggests one never rids themself of the virus after obtaining a sustained reponse?
I also would like to see a link to a research study suggesting alcohol or a weakend liver results in the "for the virus to get started up again".
Thanks in advance.
(who figure's most studies and results prior to ribavirin are far to outdated to be considered.)
PS: I didn't mean to sound so sarcastic in my previous post, I apologize.
by the by, there are now viral load tests to determine "undetectable" measuring down to 2 iu/ml
As far as I know, I will always test positive for the antibodies. As for the alt/ast levels, I'm not sure they did those tests because nothing came back on my report..Maybe I should ask the doc to run those tests. However, I think I'm probably just going to wait awhile and get another pcr to see if anything has gotten worse. I believe I got this in early summer of this year. So maybe I just need a little more time for accurate results. Thanks for the info
Hi Veteran - I would like to know the same thing that Proactive asks regarding the "drinking." I know that alcohol is not good for the liver but when I reach SVR I plan on having a glass of wine to celebrate.
Hi. I don't want to come across as a know it all, I am not that way. I believe very strongly in research and my 60 years on earth has taught me that a person is always learning. Below is a link that will give you a bit more info on drinking and hepatitis-c. I can provide you with a lot more similar information. Being a veteran of the Army and having end stage with severe cirrhosis, I can't get medical coverage from anyone else. Plus the VA has some really good specialists, especially as the incidence of Hep-C is five times higher in Vietnam era veterans, like me, than in the rest of the population. A lot of what I learn comes from the infectious disease specialists in the VA. Anyhow, here is the link showing the correlation between alcohol consumption and hep-c. If you would like more to read, just let me know.
Thanks for the article Veteran, although I fail to see it's relevance in regards to your statement of alcohol facilitating the virus to "start up again" I as well have read 100's of articles and studies, and have never seen anything suggesting alcohol as a cause of relapse after reaching svr.
Even the va has changed it's guidelines:Here is a link that quotes the va's hcv program director
" The doctor in charge of VA's program sees it as a matter of developing the right tools.
"Until recently, hepatitis C antiviral treatment was felt to be inadvisable in patients with psychiatric disorders and recent or ongoing substance abuse problems, including alcohol use," said Michael Rigsby, director of VA's National Hepatitis C program. "This was based on concerns that such treatment might not be safe for these patients and that the efficacy of antiviral therapy would be diminished.
"However, there has been a recent change, reflected in VA treatment recommendations and in the recent National Institute of Health (NIH) consensus statement, toward individualizing decisions about treating these patients. In general, such conditions, which are commonly encountered in patients with hepatitis C, are no longer felt to be absolute barriers to effective antiviral therapy."
PS: I'm sorry to hear about the condition of your liver, and wish you the very best possible outcome. As to the alcohol/hcv thing, I confess I really have never put much thought or done much research on the subject. I really practiced drinking alot when I was younger, but never learned how to do it right (g), hence had to it up some 17 years ago.--if I hadn't given it up, hcv would have been the least of my worries, I most likely would have been dead long before being diagnosed with hep c!!
Hi, Proactive. I appreciate your need to verify information. I'm the same way. I was a Senior Vice President with Bank of America for 15 years where I created a wholesale lending division. I also owned 3 mortgage companies, have written two books on mortgage lending and developed a continuing education course of study for Realtors. I've also created a non-profit organization for Veterans called Helping American Veterans Endure which is currently successfully functioning in San Francisco funding research into Post Traumatic Stress Disorder. I had to leave work two years ago due to the effects of Hep-C and have been going nuts with boredom ever since. I'm saying this to point out that in order to accomplish the above mentioned tasks, I had to do extensive research.
I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus.
Below is an informative questions and answers bulletin put out by the Alaska Native Medical Center in Anchorage, Alaska, where there is a serious problem with hep-c relapse. If you read under the question, "How long will the effects last" you'll see the statement regarding relapse due to alcohol consumption. Also here is the website for the ANMC in Alaska: http://anmc.org/index.cfm
As I said in an earlier posting, I can provide you with a lot of documented evidence that alcohol can trigger relapse. Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too. Such a horrible waste!
What is hepatitis C?
Hepatitis C is a viral infection of the liver. The liver becomes inflamed. It may be tender and swollen.
How does it occur?
Hepatitis C is caused by the hepatitis C virus. The virus is spread mainly through contact with infected blood. Sometimes it is spread through sexual contact. You can get it from:
receiving infected blood, blood products, or transplanted organs
long-term kidney dialysis if you unknowingly shared supplies or equipment that had someone else's blood on them
contact with infected blood on the job if you are a health care worker, especially from accidental needlesticks
your mother if she had hepatitis C at the time she gave birth to you
intravenous (IV) drug abuse
sharing razors or toothbrushes with an infected person
getting a permanent tattoo with unsterile equipment
having unprotected sex with someone infected with hepatitis C.
Before 1990 one of the most common ways to get hepatitis C was blood transfusion. However, now blood donors can be screened for the virus.
The disease can be spread by people who do not have any symptoms and may not know they carry the virus. These people are called asymptomatic carriers.
What are the symptoms?
You may not have any symptoms of hepatitis until several weeks or months after you are infected with the virus. Or you may never have any obvious symptoms.
If you have symptoms, the illness usually begins with these flulike symptoms:
loss of appetite
Other early symptoms may include:
a loss of taste for cigarettes if you are a smoker.
After several days you may also have these symptoms:
nausea and vomiting
foul breath and bitter taste in the mouth
dark brown urine
yellowish skin and eyes (jaundice)
pain just below the ribs on your right side, especially if you press on that part of your abdomen
bowel movements that are whitish or light yellow and may be looser than normal.
Some people develop a chronic form of the disease without any obvious symptoms, even though damage to the liver may be occurring. The symptoms of chronic hepatitis may be persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.
How is it diagnosed?
Your health care provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse.
Your health care provider will examine your skin and eyes for signs of hepatitis. Your provider will check your abdomen to see if the liver is enlarged or tender. You may have blood tests to see if your liver is inflamed and if you are infected with the hepatitis C virus.
If your health care provider thinks you may have chronic hepatitis or serious liver damage, or if the diagnosis is uncertain, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests to check for damage to your liver.
How is it treated?
The usual treatment is rest, having a healthy diet, and avoiding alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.
You may be given shots of an antiviral drug, such as interferon.
Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
How long will the effects last?
Symptoms may last 1 to 6 weeks and usually go away completely. It is common, however, to have hepatitis again (relapse). Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection.
Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your health care provider may check your blood every few months for signs of chronic liver disease.
Infection with the hepatitis C virus increases your risk for liver cancer.
How can I take care of myself?
Follow your health care provider's instructions for taking medicine to relieve your symptoms. When the hepatitis C virus is active, you need to avoid taking certain medicines (for example, acetaminophen). Ask your health care provider which medicines you can safely take for your symptoms (such as itching and nausea).
Follow your health care provider's advice for how much rest you need and when you can return to your normal activities, including work or school. As your symptoms improve, you may gradually increase your level of activity. It is best to avoid too much physical exertion until your health care provider tells you it's OK.
Eat small, high-protein, high-calorie meals, even when you feel nauseated. Soft drinks, juices, and hard candy may help you feel less nauseated.
Do not drink alcohol until your health care provider says it is safe.
Ask your health care provider if you need shots to prevent hepatitis A and hepatitis B.
Contact your health care provider if:
Your appetite continues to decrease.
You have worsening fatigue.
You have vomiting, diarrhea, or abdominal pain.
You develop jaundice.
You have a new rash.
What can be done to help prevent the spread of hepatitis C?
There are no shots that protect against hepatitis C. If you have hepatitis C, you can help prevent its spread by following these guidelines:
Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
Do not share needles, razor blades, and toothbrushes with others.
Avoid high-risk sexual activity.
Do not donate blood.
I have no idea who is answering the questions in the Alaska Q&A. Is it a doctor, a hepatologist, a gastro or a layperson?
From the Q&A
"Relapses can be triggered by drinking alcohol or not getting enough rest before you are fully recovered. They may be caused by another infection, such as a cold. Relapses are generally milder than the initial infection."
If by "before you are fully recovered" you mean before you are proven to be a SVR then, yes, the virus can become serum detectable again. I have no idea what the support is for stating that "Relapses are generally milder than the initial infection" but I do not believe that is true and I have never seen anything to support it. Neither have I seen colds or lack of rest as risks for relapse - relapse POST SVR, that is. Please provide support for that aside from the Q&A.
Merely because it appeared in a "question and answer session" in Alaska does not mean that it is accurate. I went to the Alaska site and I could find no mention of a hepatologist on staff. Perhaps there is one and perhaps they have a gastroenterology department as well but, there is no mention of it. Frankly, it doesn't appear to be an advanced medical center from looking at their site.
You say: "I know of several former or current users of alcohol who choose to disbelieve that alcohol can trigger relapses of Hep-C. They forget that the virus is never completely gone and that a liver weakened by alcohol use becomes considerably more susceptible to allowing regenerative growth of an existing virus."
Well, it is true that some people who are SVR have sustained liver damage and that alcohol can have a negative impact on their liver histology but that is independent of and irrespective of HCV relapse. The alcohol in and of itself can be harmful to the liver as I am sure you well know. That is what this looks like to me.
You also said: "Heck, I personally know of several people who've received liver transplants or had successful Interferon therapy and thought they could resume a normal life, began drinking, and the disease returned and destroyed the new liver, too."
How do you know that? Were they proven to be SVR - serum undetectable 6 months after discontinuing treatment per a sensitive PCR? Did you see the tests? Did you see serum tests after the 6 months which showed a detectable HCV in the serum?
First of all I am a liver transplant patient and I know a lot of liver transplant patients and I might know "several" patients who achieved SVR - documented SVR. The SVR rate for liver transplant patients range from 20% to 32% percent so there are not many who achieve SVR and a lot fewer who "began drinking".
I don't know of one SVR liver transplant patient or non-transplant SVR who drank and the disease returned. I have not heard from any of my HCV friend that they know of a documented case of relapse in an SVR. The only reported cases, and there are very few of those, are in the setting of initiating immune suppressive drugs and I also believe that cancer was involved in some, if not all, of the few I have seen. And, believe me, since I am immunosuppressed I look for this stuff all of the time.
I'm not saying that you are lying but I don't think you really know what you're talking about. The studies do not show that drinking is a risk for relapse. Of course, drinking can be harmful to a healthy liver and worse for a liver damaged by hepatitis but, that is not relapse. Furthermore let's assume that your patients really were SVR and let's also assume that they died from drinking. If they were not serum detectable at their death then the only way to detect HCV would be to perform a liver biopsy and do a PCR test on the liver tissue. I sincerely doubt that was the case with your "acquaintances", so once again: How do you know this?
From your writing I believe you are a highly intelligent man and that your motive is pure. I simply believe that you are mistaken and that, while believing your opinion on this issue wouldn't put anyone at risk, I believe strongly in accurate information. If alcohol was a risk for relapse it would be known and there would be professional articles discussing it. If there are, I have not seen them and, if you have, please provide them.
One point: I am not convinced that upon achieving SVR every trace of Hepatitis C has been eradicated. Some traces may, and probably do, exist post SVR. But, SVR has been shown to be durable over many years and relapse post SVR is very very low. I think it would be naive to think that some, if not more than just a few, SVRs don't consume alcohol post SVR. If drinking resulted in relapse we would certainly have heard about it by now. I believe a lot of the confusion and mistaken statements are the result of poor documentation and unreliable viral testing. People were thought to be SVR who weren't. And, of those who sere presumed to be SVR, how many were tested at 6 months with reliable and sensitive tests?
It sounds like someone was just typing out of a very, very old text book and hasn't done any research into the disease in a long time. Remember there are still doctors that test to <615 and believe that nobody with HepC is really 'cured' - which understanding the function of SVR and Interferon we know is ridiculous, let alone the concept that having a glass of wine is going to make it 'come back'.
And as everyone knows I've always been one the most vocally anti-alcohol people on this forum but it's just not true.