Another good article on HCV

[mikesimon]

I found this presentation to be a concise and detailed description of many of the issues regarding HCV and treatment.

See: http://cme.medscape.com/viewprogram/17843?src=cmemp  To view the article requires membership at Medscape. It is free and easy to register and well worth the time..

Here is a look at the Title and the subjects addressed.

The HCV Council Investigations: Converging Evidence With Clinical Opinion


Contents of This CME Activity

1. Welcome/How and Why the HCV Council Was FormedAvailable As: Slides/Video | Slides/Transcript | Audio
  
2. Introduction/Topic 1: Endpoints of HCV Therapy-What Are Our Goals?Donald M. Jensen, MD, FACP, Moderator; David R. Nelson, MDAvailable As: Slides/Video | Slides/Transcript | Audio
  
3. Topic 2: Therapeutic Decision-Making Based on Viral KineticsMichael W. Fried, MDAvailable As: Slides/Video | Slides/Transcript | Audio
  
4. Topic 3: Overcoming Poor Response FactorsStephen A. Harrison, MD, LTC, MCAvailable As: Slides/Video | Slides/Transcript | Audio
  
5. Topic 4: Future Directions in Therapeutic OptionsDavid R. Nelson, MDAvailable As: Slides/Video | Slides/Transcript | Audio

[jmjm530]

MS: and I am clear today per my last Heptimax of one week ago.
---------------
Mike, given you been tested so often,  is it true that Quest labs is using your blood to calibrate their machines for the Heptimax test :)

-- Jim

[mikesimon]

I see my dentist every 3 months for cleaning and whatever else needs done. I've been SVR since 2004 and I am clear today per my last Heptimax of one week ago. Pick your health care personnel with care and caution and stay alert and you'll probably be OK.

[erv]

Serious, my family has allways used yogurt to deal with cold sores. Also hot water with flavored jello (make like tea) is excellent for nausea,sore throat,etc.

[erv]

I love that one. I had a young dentist go in a panic attack when i told him of my situation. he was soooo shakey. i thought hey, at least i know what i got . this young guy come from 8 years in the big city!!!!!i didn't go back..

[granitekonig]

...it takes just one nut to turn the tent into a circus

[Rockerforlife]

Not meaning to high jack...but it was mentioned about the sharping devices too...make sure they are cleaned too...i cancelled my dentist appoint today...LOL

[Rockerforlife]

BE SURE your dentist and hygenist use a sterile handset for each patient.

Excellent observation...thank you...we have to on our toes ..especially now if we are SVR....can you imagine if you were cured and caught it again from a dentist...dont know what i would do

[jdwithhcv]

I recall watching a documentary about bloodborne transmission of disease years ago.  They filmed sterile procedures at several dental clinics and interviewed patients and practitioners and what-not.  The thing I recall is this clinic where they demonstrated that they autoclave all the instruments, sterile procedure looked pretty impressive.  Then they asked if the clinic autoclaved the handsets before each patient and discovered, no, they autoclaved the instruments and placed them into the handsets that were not sterilized for each use.  The documentary demonstrated that the centrifugal force of the spinning drills, etc, drew small amounts of blood up into the handset.  When the next patient arrived they took clean instruments out of the autoclave and put them into the handset contaminated with minute amounts of blood.  Very scary because you SEE them using sterile instruments, right out of the autoclave so you feel safe!  BE SURE your dentist and hygenist use a sterile handset for each patient.

I had extensive dental surg eryin the days before universal precautions or awareness about bloodborne pathogens, this was one of my possible risks of exposure to Hep C.  So I wonder....

[Rockerforlife]

YOU SAID"
Also, don't you have hep c?

Yes i do...well im RVR...so yes and no,,

what im saying in a nut shell is..most people who have hep c,dont know they have it...millions....and they go to the denstist everyday...the odds that the guy before you that sat in the dentist chair had hep c and both him and doc dont even know....to me thats SCARY,,,

[granitekonig]

"It is worth reiterating that the majority of people infected with hepatitis C are unaware of their condition, therefore ensuring high levels of sterilization, disinfection and general hygiene is important....SCARY....

this means the tools used by dentists have been used before on patients with hep c...

im afraid to clean my teeth now "

That is not what it is saying. It is saying that the tools need to be kept clean because not everyone knows their medical condition. Also, don't you have hep c? Your post is the opposite of logical.

[Myown]

So far I only watched Dr. Harrisons presentation and it was good and what I hit me was when he mentioned that if people are going to hold off on txing due to minimal damage, they should get an IR test because with IR they have found fibrosis progression can happen quicker than without having IR...not his exact words, but the jist (brain fog)..

But anyhow maybe others have heard of that before, but I don't remember it being mentioned on forum that if you are going to "watch and wait," that their doctor first wants to check IR before making the decision to watch and wait. So maybe its something people should mention to their docs if they are waiting for new drugs and if they are IR maybe they can deal with that now while they wait - if thats possible.

Thanks for posting this,
MO

[susan400]

Good article.  Dr. Nelson, who was one of the speakers, was my doctor on the last clinical trial that I did.  It's an interesting concept of treatment w/o interferon, but, I don't know that I can wait 5-10 years to see that come into practice.  I might however, be able to treat with both a polymerase inhibitor, protease inhibitor, interferon & Riba, should the poly and prot. become available to me.  Anyhow....

Susan400

[willing]

good, uptodate summary - thanks for posting!

[Rockerforlife]

It is worth reiterating that the majority of people infected with hepatitis C are unaware of their condition, therefore ensuring high levels of sterilization, disinfection and general hygiene is important....SCARY....

this means the tools used by dentists have been used before on patients with hep c...

im afraid to clean my teeth now

[Rockerforlife]

Considerations for dentists
The risk of contracting hepatitis C through general dental practice is low. Patients are not obliged to inform dentists that they have contracted the virus because adherence to the Universal Precautions System, where every dentist-patient encounter is considered to have the potential for cross-infection, should minimise the risk of new cases of hepatitis C occurring

http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/Chiefdentalofficersbulletin/Browsable/DH_5099622

[smaug48]

Posting the entire article could be a copyright violation.  See MedHelp's Terms of Use:

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smaug

[mikesimon]

First allow me to say that iatrogenic transmission of HCV isn't a significant concern of mine.
Having said that we know that it is a possibility. When we visit our dentist or undergo a medical procedure at a hospital we are at risk. I chose my medical people and institutions pretty carefully and I don't think about the risk of being infected. I had a bad motorcycle wreck a year after I stopped TX and HCV was the last thing on my mind. And fortunately I am still SVR.
My opinion is that if we stay alert and use some caution the risk isn't significant in this country. I would probably not feel as comfortable about the risk if I was being treated in some other parts of the world though. But, you're right - there is a risk here too.
Mike

[jmjm530]

thanks for posting there are some good names attached to this presentation. I reiterate what Michael says about taking the time to register (it's free) at Medscape. Lots of valuable stuff over there.

[portann]

Thanks, Mike. This looks like good stuff. It's so easy and fool-proof to register and an invaluable membership to have.

Sorry if I'm off-topic but I have an out-of-the-blue concern that popped into my head recently and would like to hear from you in particular, given your wisdom and level-headedness.

Now that I'm in week 36 of 48, I inexplicably started to look up iatrogenic transmission of HCV. I sure want to avoid being re-infected. Do you think this is a common worry or am I becoming a nervous Nellie?

When I put in a google search, I wanted to get zero hits for iatrogenic transmission/HCV/ 2008 but instead got quite a few, for example:

http://www3.interscience.wiley.com/journal/121585470/abstract?CRETRY=1&SRETRY=0

One 2006 study said HCV transmission is still happening in hospitals and in often minor procedures. (Will find that link.)

I know we can't live in glass bubbles but it gets me down a bit to think of this. After all this tx effort, I just don't want some minor future surgery to blow it all. It's out of my control but dang.

Thanks, Mike, and sorry if this is unacceptably tangential.

Port

[granitekonig]

It would be better if you pasted the contents of the article here so that no body had to register.