Aa
genotype change w/transplant
On the Clinical Care Options website 8/18/07 (clinicaloptions.com)
A retrospective analysis comparing 38 HCV+ TP patients receiving HCV+ donor livers to 76 HCV+ TP patients receiving HCV- donor livers showed little difference in outcome or progression between groups. Three individuals in the HCV+donor liver group did show a change in genotype - two from geno1 to geno3 and one from geno2 to geno1.
A retrospective analysis comparing 38 HCV+ TP patients receiving HCV+ donor livers to 76 HCV+ TP patients receiving HCV- donor livers showed little difference in outcome or progression between groups. Three individuals in the HCV+donor liver group did show a change in genotype - two from geno1 to geno3 and one from geno2 to geno1.
Thanks Meki. The truth is that I just did the same thing we all do - worked to get well and stay well. I have had some rough spots but haven't we all? Be well, Mike
CS --- I like your liver too...
Mike - Yanno - that's gotta be a helluva thing to have a transplanted liver and to have gone through so much. You've got a lot of my respect - cause it can't have been easy.
Meki
Mike - Yanno - that's gotta be a helluva thing to have a transplanted liver and to have gone through so much. You've got a lot of my respect - cause it can't have been easy.
Meki
I was very fortunate to get a liver and I would never denigrate my wondrous gift. Having said that I tell everyone to "keep their own parts if they possibly can" so I know where you're coming from and you got it right. Be well, Mike
Think I'd prefer to be a 2 as well. G3s have a habit of being both easy and a little difficult, might have something to do with steatosis grade. Definelately has something to do with RVR. G3 non RVR has pretty lousy SVR rates. G3 HVL has pretty high relapse rates.
I just wish they would stop merging us with G2s so we can both get a better picture.
I was kidding about giving you my liver.
I like it where it is, even if it is a little scared and somewhat fatty.
CS
I just wish they would stop merging us with G2s so we can both get a better picture.
I was kidding about giving you my liver.
I like it where it is, even if it is a little scared and somewhat fatty.
CS
Oh sheesh CS --- I didn't know you were 3a also.
Hey --- so like maybe --- somewhere along the way -- both of us has the blood from someone that started this whole thing...
Heck CS -- if ya think about it --- LMAO ---we're kind of related... LOL! Oooh ick -- there goes the whole idea of an affair out the window... Sigh.. Incest ya know... if we're related and all... LMAO (just kiddin' with you...)
Meki
Hey --- so like maybe --- somewhere along the way -- both of us has the blood from someone that started this whole thing...
Heck CS -- if ya think about it --- LMAO ---we're kind of related... LOL! Oooh ick -- there goes the whole idea of an affair out the window... Sigh.. Incest ya know... if we're related and all... LMAO (just kiddin' with you...)
Meki
I am fine with the liver I have now so I don't want anyone's liver, but thanks for asking. But, if I needed another and there were two available and I had to choose - a type 1 and type 2 and all other factors were equal - I wouldn't hesitate. I'd go with door number 2. I am sorry that you haven't been as fortunate as most with your genotype and when we're one of the ones who doesn't comply with the clear rate there is little consolation in having a "good" genotype. I wish you luck. Mike
I am G3a and not sure you would want my liver as i've had 2 goes at Tx and failed both times.
Never even got to be UND. Not sure it would be that much easier than staying a 1.
G1s dont have a monopoly on Tx failure Ya know.
Speaking of Tx failure wouldnt that get annoying, exchange livers for an easy to treat one and still fail.
Also raises the question of whether you can get to keep both Genos.
Seem to remember reading somewhere that there has never been a case of dual 1a/3a infection, which is probably just as well.
CS
Never even got to be UND. Not sure it would be that much easier than staying a 1.
G1s dont have a monopoly on Tx failure Ya know.
Speaking of Tx failure wouldnt that get annoying, exchange livers for an easy to treat one and still fail.
Also raises the question of whether you can get to keep both Genos.
Seem to remember reading somewhere that there has never been a case of dual 1a/3a infection, which is probably just as well.
CS
"Meki, I think you may have misunderstood me. Honestly, I have no idea what I said that left you with that impression. I really don't even know what you are saying and I am not being mean or sarcastic when I say that. I said recently that I think some centers do not treat HCV if the graft is functioning well - that they may be concerned with graft survival so much that they do not address the HCV - it's working well so we don't need to worry about it. Is that what you are referring to?"
I think so...
"mikiesmom - advised that they give such hard core drugs to keep the transplanted livers "
What I was talking about was the high amount of rejection meds. (meaning that the liver is given extra anchors to keep it... even though it may be a different genotype)
The rest was my own theory - I should have separated that better...
I may also have "read into" what you wrote ---
But I think more of what I was trying to say is that the Liver is needed by the HCV to survive --- so if one liver is one type (1a) and the new liver is another type (3a) then the virus (1a) must/might mutate to the liver type (3a) in order to survive... (In hypothetical logic) --- AND/OR it must/might change the liver to the type that it is in order to keep thriving... (Again hypothetically --- or shoot is that theoretically? I'm thinking linear logic --- not proof, stats, documented logic)
You guys are the expert --- I'm just a wild guesser.
But I think a LOT of things are wild guesses - even the best scientists or doctors must guess at some point. There are so many loose ends and unknowns about this disease... You'd think with 20 + years to get more info on it --- that they'd know more... That they'd at least know how to make a vaccination --- even if they have to do genotype vaccinations - for each new gentotype or mutation.
But I want you to know - never thought you were being sarcastic - you're a freaking doll. You keep us all in tune with medical information.
Thanks for all you do on the board --- if no one else has thanked you --- I do.
Meki
I think so...
"mikiesmom - advised that they give such hard core drugs to keep the transplanted livers "
What I was talking about was the high amount of rejection meds. (meaning that the liver is given extra anchors to keep it... even though it may be a different genotype)
The rest was my own theory - I should have separated that better...
I may also have "read into" what you wrote ---
But I think more of what I was trying to say is that the Liver is needed by the HCV to survive --- so if one liver is one type (1a) and the new liver is another type (3a) then the virus (1a) must/might mutate to the liver type (3a) in order to survive... (In hypothetical logic) --- AND/OR it must/might change the liver to the type that it is in order to keep thriving... (Again hypothetically --- or shoot is that theoretically? I'm thinking linear logic --- not proof, stats, documented logic)
You guys are the expert --- I'm just a wild guesser.
But I think a LOT of things are wild guesses - even the best scientists or doctors must guess at some point. There are so many loose ends and unknowns about this disease... You'd think with 20 + years to get more info on it --- that they'd know more... That they'd at least know how to make a vaccination --- even if they have to do genotype vaccinations - for each new gentotype or mutation.
But I want you to know - never thought you were being sarcastic - you're a freaking doll. You keep us all in tune with medical information.
Thanks for all you do on the board --- if no one else has thanked you --- I do.
Meki
The idea about genotype switching is very interesting, and perhaps has some future research possiblities in a non-transplant setting. For example, if they found a way to introduce a genotype 2 virus into someone with genotype 1 (my preference would be 'high-risk sex' with voluptious vixen :) )-- and if the genotype 2 had a reasonable chance of becoming dominant, then in effect the person would be left with more curable strain. You never know.
-- Jim
-- Jim
Meki, I think you may have misunderstood me. Honestly, I have no idea what I said that left you with that impression. I really don't even know what you are saying and I am not being mean or sarcastic when I say that. I said recently that I think some centers do not treat HCV if the graft is functioning well - that they may be concerned with graft survival so much that they do not address the HCV - it's working well so we don't need to worry about it. Is that what you are referring to?
CockSparrow, it might make a difference if type 2/3 got a type 1 liver in terms of post treatment. I personally know someone on the list who is trying to decide which way to go vis a vis an HCV infected liver. It could be good and it might be bad.
From Clinical Care
"A change in HCV genotype may have important implications, both positive and negative, for subsequent treatment following transplantation with an infected liver and should be considered when evaluating such patients in the posttransplantation setting. In my opinion, patients who receive an HCV-infected liver should undergo repeat HCV genotype testing posttransplantation in situations of recipient-donor HCV genotype discordance as this may have implications for the effectiveness of HCV therapy."
Mike
CockSparrow, it might make a difference if type 2/3 got a type 1 liver in terms of post treatment. I personally know someone on the list who is trying to decide which way to go vis a vis an HCV infected liver. It could be good and it might be bad.
From Clinical Care
"A change in HCV genotype may have important implications, both positive and negative, for subsequent treatment following transplantation with an infected liver and should be considered when evaluating such patients in the posttransplantation setting. In my opinion, patients who receive an HCV-infected liver should undergo repeat HCV genotype testing posttransplantation in situations of recipient-donor HCV genotype discordance as this may have implications for the effectiveness of HCV therapy."
Mike
Upbeat - Why would they transplant a liver already infected?
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A non HCV infected liver will become infected if transplanted into anyone HCV+
So it make no difference. Changing Genos is a bit interesting though.
CS
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A non HCV infected liver will become infected if transplanted into anyone HCV+
So it make no difference. Changing Genos is a bit interesting though.
CS
No - not just speculation - that's good information. Thank you for sharing.
You know - the more you know - the more you know that you don't know.
LOL!
Meki
You know - the more you know - the more you know that you don't know.
LOL!
Meki
There are some reasons I may not fit the pattern.
Infected at a young age (17) has been suggested to be a factor in slow progression.
Presented as acute. My body fought back with a vengence.
Prior infection with Hep A and B - my body was 'primed' to fight back. (This is speculation on my part.)
Infected at a young age (17) has been suggested to be a factor in slow progression.
Presented as acute. My body fought back with a vengence.
Prior infection with Hep A and B - my body was 'primed' to fight back. (This is speculation on my part.)
I probably don't fit the G3 rapid progression pattern niceguy has laid out. I probably had genotype 3e for close to 30 years with only mild fibrosis and no overt symptoms.
LOL me too desrt -- can I ask you a question?
How long did you think you had HCV before symptoms got too bad to ignore? (just curious based on one person saying that 'maybe' the genotypes have something to do with the speed of damage --- just a wild thought out there --- but it was interesting... I was/am a 3a)
How long did you think you had HCV before symptoms got too bad to ignore? (just curious based on one person saying that 'maybe' the genotypes have something to do with the speed of damage --- just a wild thought out there --- but it was interesting... I was/am a 3a)
Don't ask for a four. Same length of tx and rate of SVR as a one. Maybe I should fill out an organ donor card - an (ex)geno 3 liver might be something someone could use.
LMAO cigaso - no doubt.
That's hilarious... Order 2 for me please...
No - but in a strange way - that makes sense. If I understood correctly - mikiesmom - advised that they give such hard core drugs to keep the transplanted livers - that the current infected liver might override the housed HCV - because obviously the HCV needs LIVER to function --- and it would have to adapt to the new liver. Right??
Hmmmmmmmmmmm....
I'm gonna think about this --- that's interesting.
That's hilarious... Order 2 for me please...
No - but in a strange way - that makes sense. If I understood correctly - mikiesmom - advised that they give such hard core drugs to keep the transplanted livers - that the current infected liver might override the housed HCV - because obviously the HCV needs LIVER to function --- and it would have to adapt to the new liver. Right??
Hmmmmmmmmmmm....
I'm gonna think about this --- that's interesting.
I think I'll ask my dr this question next time I see him.
Say Doc, can I trade my geno 1B liver for a 2 or 4 geno liver to be named later?
Say Doc, can I trade my geno 1B liver for a 2 or 4 geno liver to be named later?
"Why would they transplant a liver already infected?"
For lack of anything better, I would guess. And as the above report seems to show, it doesn't seem to make any difference in the rate of recurrence. Plus, as the report seems to show, you have a chance of changing your genotype to something that has a better response rate - or not.
For lack of anything better, I would guess. And as the above report seems to show, it doesn't seem to make any difference in the rate of recurrence. Plus, as the report seems to show, you have a chance of changing your genotype to something that has a better response rate - or not.
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