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Clearing the virus
Just wondering..does anyone know how quickly its possible to clear the virus? From what I can tell from my pcr results today, I cleared it on my own..but I thought I got it like 4 months ago..? I figured it might take awhile to a virus like this to just clear. Does anyone have any knowledge about this? Thank you!
I still believe that this information is very old - nobody has used mono-therapy in years not even for acute infection.
“Complete abstinence from alcohol is an extremely important behavioral modification, and has been shown to affect the likelihood of progression as well as the efficacy of therapy."
It sounds to me as if he is talking about during treatment here and not post treatment, SVR and also as Joey said above behavioral modification to me speaks to the chance of a. further liver damage and b. the chance of getting high on drugs while drinking.
By the way we will never be able to donate blood because we will always carry those antibodies and how could you prove that you were truly SVR rather than just coming in to the acute phase and recently infected under the vl radar?
“Complete abstinence from alcohol is an extremely important behavioral modification, and has been shown to affect the likelihood of progression as well as the efficacy of therapy."
It sounds to me as if he is talking about during treatment here and not post treatment, SVR and also as Joey said above behavioral modification to me speaks to the chance of a. further liver damage and b. the chance of getting high on drugs while drinking.
By the way we will never be able to donate blood because we will always carry those antibodies and how could you prove that you were truly SVR rather than just coming in to the acute phase and recently infected under the vl radar?
I have seen some articles which suggest that shortly after stopping treatment a patient may be more susceptible to relapse. These involved patients who were administered immune suppressive drugs.
".....We report two patients that relapsed when immune suppressive therapy was given within a few weeks of achieving SVR. Patient 1 received prednisone for bronchitis and patient 2 relapsed soon after immune suppression was started post renal transplantation. These data suggest that the early phase of SVR might be associated with incomplete protective immunity. They suggest that sterilizing immunity with complete elimination of virus is unlikely. The cases also caution against the use of immune suppressive therapy in the immediate aftermath of SVR. J. Med. Virol. 80:1720-1722, 2008. © 2008 Wiley-Liss, Inc."
So perhaps immediately post TX we may be at increased risk for relapse. That is why I have consistently limited my position to people who are true SVRs. I define that as undetectable per sensitive PCR 1 year after discontinuing HCV treatment.
I should make it clear that I am not advising SVRs to consume alcohol nor am I condoning the consumption of alcohol by SVRs. I am discussing the durability of SVR by exploring the evidence we have available to us. And, from all that I have seen, there is no evidence that alcohol consumption triggers or hastens or has any effect on SVR status. And SVR may have a damaged liver which deteriorates with alcohol consumption as will a healthy non HCV liver if enough alcohol is consumed. But alcohol has not been shown to cause relapse in any of the literature that I have seen.
You ask: "How come there are not huge warning flags everywhere from Dr's that advise alcohol can make the virus "come back from being gone"?"
The virus is not really gone for our practical purpose until a patient is undetectable at 1 year after treatment. Just because a PCR shows UND does not mean there will not be relapse. We see relapse post TX frequently and it doesn't take long to occur - within weeks most of the time. .
".....We report two patients that relapsed when immune suppressive therapy was given within a few weeks of achieving SVR. Patient 1 received prednisone for bronchitis and patient 2 relapsed soon after immune suppression was started post renal transplantation. These data suggest that the early phase of SVR might be associated with incomplete protective immunity. They suggest that sterilizing immunity with complete elimination of virus is unlikely. The cases also caution against the use of immune suppressive therapy in the immediate aftermath of SVR. J. Med. Virol. 80:1720-1722, 2008. © 2008 Wiley-Liss, Inc."
So perhaps immediately post TX we may be at increased risk for relapse. That is why I have consistently limited my position to people who are true SVRs. I define that as undetectable per sensitive PCR 1 year after discontinuing HCV treatment.
I should make it clear that I am not advising SVRs to consume alcohol nor am I condoning the consumption of alcohol by SVRs. I am discussing the durability of SVR by exploring the evidence we have available to us. And, from all that I have seen, there is no evidence that alcohol consumption triggers or hastens or has any effect on SVR status. And SVR may have a damaged liver which deteriorates with alcohol consumption as will a healthy non HCV liver if enough alcohol is consumed. But alcohol has not been shown to cause relapse in any of the literature that I have seen.
You ask: "How come there are not huge warning flags everywhere from Dr's that advise alcohol can make the virus "come back from being gone"?"
The virus is not really gone for our practical purpose until a patient is undetectable at 1 year after treatment. Just because a PCR shows UND does not mean there will not be relapse. We see relapse post TX frequently and it doesn't take long to occur - within weeks most of the time. .
I don't understand the difference between drinking alcohol post tx and post svr. After tx the virus is gone or it's not,is that true or false? Time just has not verified it yet. If it's gone there is nothing for alcohol to trigger. If it's not gone it will be back anyway,is that true or false? The virus can't just come back,it was just never gone. How come there are not huge warning flags everywhere from Dr's that advise alcohol can make the virus "come back from being gone"?
Too bad we cant get a VL sensitivity test below the < 5 limit,if we had an absoulte zero VL number this would be great,maybe one day this will happen.
"We're often so blind. Our demand for the credentialed so colors our perception of believeability, that we wouldn't recognize God if he appeared within us."
"We're often so blind. Our demand for the credentialed so colors our perception of believeability, that we wouldn't recognize God if he appeared within us."
No evidence of occult hepatitis C virus (HCV) infection in serum of HCV antibody-positive HCV RNA-negative kidney-transplant patients.
Nicot F, Kamar N, Mariamé B, Rostaing L, Pasquier C, Izopet J.
INSERM, U563, Toulouse, France.
Persistence of hepatitis C virus (HCV) in patients who cleared HCV is still debated. Occult HCV infection is described as the presence of detectable HCV RNA in liver or peripheral blood mononuclear cells (PBMCs) of patients with undetectable plasma HCV-RNA by conventional PCR assays. We have assessed the persistence of HCV in 26 kidney-transplant patients, followed up for 10.5 years (range 2-16), after HCV elimination while on hemodialysis. If HCV really did persist, arising out of the loss of immune control caused by institution of the regimen of immunosuppressive drugs after kidney transplantation, HCV reactivation would have taken place. Their immunosuppression relied on calcineurin inhibitors (100%), and/or steroids (62%), and/or antimetabolites (94%). An induction therapy, given to 22 patients, relied on rabbit antithymocyte globulin (59%) or anti-IL2-receptor blockers (32%). All patients had undetectable HCV RNA as ascertained by several conventional tests. At the last follow-up, no residual HCV RNA was detected in the five liver biopsies, the 26 plasma, and in the 37 nonstimulated and 24 stimulated PBMCs tested with an ultrasensitive RT-PCR assay (detection limit, 2 IU/ml). No biochemical or virologic relapse was seen during follow-up. The absence of HCV relapse in formerly HCV-infected immunocompromised patients suggests the complete eradication of HCV after its elimination while on dialysis.
Nicot F, Kamar N, Mariamé B, Rostaing L, Pasquier C, Izopet J.
INSERM, U563, Toulouse, France.
Persistence of hepatitis C virus (HCV) in patients who cleared HCV is still debated. Occult HCV infection is described as the presence of detectable HCV RNA in liver or peripheral blood mononuclear cells (PBMCs) of patients with undetectable plasma HCV-RNA by conventional PCR assays. We have assessed the persistence of HCV in 26 kidney-transplant patients, followed up for 10.5 years (range 2-16), after HCV elimination while on hemodialysis. If HCV really did persist, arising out of the loss of immune control caused by institution of the regimen of immunosuppressive drugs after kidney transplantation, HCV reactivation would have taken place. Their immunosuppression relied on calcineurin inhibitors (100%), and/or steroids (62%), and/or antimetabolites (94%). An induction therapy, given to 22 patients, relied on rabbit antithymocyte globulin (59%) or anti-IL2-receptor blockers (32%). All patients had undetectable HCV RNA as ascertained by several conventional tests. At the last follow-up, no residual HCV RNA was detected in the five liver biopsies, the 26 plasma, and in the 37 nonstimulated and 24 stimulated PBMCs tested with an ultrasensitive RT-PCR assay (detection limit, 2 IU/ml). No biochemical or virologic relapse was seen during follow-up. The absence of HCV relapse in formerly HCV-infected immunocompromised patients suggests the complete eradication of HCV after its elimination while on dialysis.
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