Relapse Rates in Correlation to time after SVR

[drofi]

Hi,
I am looking for good links to scientific data about the correlation between relapse rate and time after SVR. I think someone has done a study to find out, how many of us stay "clean" after SVR. My sugestion is, if you are UND 6 month after last shot, you have a good chance to stay forever. But how big is the chance? It should be better after 12 month than after 6 and even better after 3 years than after one year, and so on.
Well, are there any data availabele on this time dependency somewhere?

Drofi

[Kalio1]

Both definitions seem to apply here.
I can see him all dolled up in makeup and heels typing feverishly away from his little troll cave.

So how's post tx? Seen any improvement? It seems the improvement isn't immediate, but I hope you are feeling good.
Im soo sick of this **** but I am encouraged by the results of the election.

[beamishboy]

REV- say it ain't so!!..puff,puff..pot "destroys liver" ??..puff,puff..~(-:/......skip gitmo and go directly to havana.....everything is cheaper & the music is much better
kalio- i thot flaming was  very 'out' behavior of certain persuasions..such as priscilla of the desert waltzing down the 'commons' path ,strutting herstuff.....out,proud & in your face.....isn't that a bettr image ?.....(-:

[Kalio1]

Welcome to the forum. Hope you can just ignore some of the more inappropriate comments and focus on the helpful ones.

Sorry to hear you are dealing with this, the only thing I could find on it said it is sometimes occurs in those with Diabetes or people with thyroid issues. Hav ou had our thyroid checked? Both HCV an treatment are known to affect your thyroid.

Hope you find a solution, that sounds hard to deal with.

[agathis]

good lord, you guys to love to hear yourselves talk. and the later in the evening it gets the more verbose you are.
this is my first time to the site, i had 24 weeks of peg/interferon in 2001, am a sustained responder - for now-
my question to you guys- have you heard of anyone having a skin condition known as granuloma annulare as a result of treatment?
i have had it for 3 yrs now, and it continues to spread.

[Kalio1]

"Flaming is the act of sending or posting messages that are deliberately hostile and insulting, usually in the social context of a discussion board on the Internet. Flaming is said by some to be one of a class of economic problems known as The Tragedy of the Commons, when a group holds a resource (in this case, communal attention), but each of the individual members has an incentive to overuse it. Flamers usually call their flames justified attacks.

Although the trading of insults is as old as human speech, flaming on the Internet, like many other online 'actions', started in the Usenet hierarchies. A flame may have elements of a normal message, but is distinguished by its intent. A flame is typically not intended to be constructive, to further clarify a discussion, or to persuade other people. The motive for flaming is often not dialectic, but rather social or psychological. Sometimes, flamers are attempting to assert their authority, or establish a position of superiority. Other times, the flamer is simply closed-minded or biased, and is simply shocked and appaled that anybody would dare to have an opinion that isn't the same as that of the flamer, so he/she personally attacks the "dissenter." Occasionally, flamers wish to upset and offend other members of the forum, in which case they are trolls."

[anise]

Thanks for trying to explain.  I still don't get it :)  However, you have a very poetic style to your writing.

[ladybug52]

POETIC?? I have to say that there is nothing poetic about arguing or putting others down. Rev I have to be honest- since this is your most obvious personality trait- you seem shallow, influenced by external beauty and self-righteous. Why do you think your biting sarcasm is welcome or appropriate? You  obviously are a miserable human being who does not make mistakes like us common folks and you really enjoy telling others how much they irritate you. I'm glad you have a forum to display your views--how lonely and miserable you would be without it.. Feel free to correct my spelling or judgement of you, I know this will add fuel to your out of control fire but I can't stand bullies.

[drofi]

where did you read that? Why are you sure the virus is trapped? To share opinions about these important points without a minimum of evidence does not have more value than an advertising in a newspaper of north korea.
I am not looking for more opinions, I have several opinions and can go to MacDonalds to collect some more, I am looking for good data or links and citations.
Drofi

[desrt]

Most of what I've read about finding HCV RNA after sustained response speaks of RNA fragments in specialized (compartmentalized) systems - i.e. cerebrospinal, lymph, etc. - suggesting whatever change the virus had to make to get into these systems has it trapped. As for the studies that found HCV RNA in the livers of SVRs, that's another matter.

[drofi]

Your citation (Foremann) is confusing. They did not find any HCV, but was the test sensitive, they used the Cobas amplicor? What if the patients would be re-tested with a better test, see below?

Drofi

Here are some lines from a fromer link of this thread. Could someone help me to understand the difference?

"Consequently we tested sera of 50 patients with chronic hepatitis C  infection after treatment with PEG-IFNa + Ribavirin between 2001 and 2004.
All patients had a Sustained Virological Response (HCV-RNA negative by Cobas amplicorTM six months after therapy end). Sera at least 6 months after the end of treatment, stored at -20

[anise]

I really enjoyed this email discussion.  Many of the points raised have been on my mind.  BTW (somewhat off topic), many women are now beating breast cancer, as are other cancer patients, using chemicals.  I can  only hope that using chemicals, (which I never believed in the first place), will have a positive effect on Hep C in the long run.

revenire, I have to ask why you have this love/hate relationship with Kalio.  Is there something on your mind you might want to discuss?  You seem to be a very intelligent person, and I haven't seen you 'rail' against anyone else this intensely. Just curious why.

[DoubleDose]

I am enjoying the questions being raised on this thread, and enjoying the fact that I am not the one raising the questions.  At this point, I won't repeat my opinions, but merely state that there is much more to understand about this virus, and as time goes on we are going to find out many new things....both about the virus, its modes of infection, and the treatment, its impact and after-effects, etc.  The medical community often makes the mistake of trying to simplify something that is very complex.
As time goes by, the complexities unravel, overshadowing all the earlier simplistic thinking.  HCV may just be one of the bigger cases of this phenomenon.

I am taking the approach of not worrying about these issues for awhile, even though I know that many of the answers that will ultimately emerge will be pretty disturbing.   If that makes any sense.

I hope all of you are doing well!!!  

DoubleDose

[jmjm530]

Sorry. Should have mentioned that free registration is required for site. You should be able to register here:
http://www.clinicaloptions.com

---------------
Regarding studies you posted. You also might be interested in this in regard to "persistent" virus after SVR. The abstract references another study AASLD presentation LB9, the conclusion of which follows former abstract.

From: http://tinyurl.com/ydpcvu

"...The meaning of the detection of low viral load in patients after antiviral therapy for chronic hepatitis C with the new highly sensitive methods is controversial. It may be associated with a mild course of liver inflammation in single cases, but in most patients it does not show to have a clinical implication. Bigger and longer-term studies of patient cohorts after treatment should evaluate the meaning of low persisting viraemia.
Our data are in line with the abstract presented by Maylin et al (LB9, AASDL 2006) showing that SVR is associated with HCV eradication..."

From abstract LB9

CONCLUSION In our 345 patients with chronic hepatitis C and SVR, evaluated up to 18 years after treatment cessation, none demonstrated late relapse. In the 213 in whom liver tissues and/or PBMCs were available, 3 (1%) patients were detected HCV-RNA positive, by a very sensitive assay [TMA), in PBMCs (1 patient) or in the liver (2 patients). These results demonstrate a durable response to antiviral therapy with a marked improvement in liver fibrosis and indicate that SVR is associated with HCV eradication.

[amicraxy]

As I am sitting here watching private ryan and crying over, weel you'd really have to be in my head instead of me trying to explain. Mind altering.  I have been alter with these drugs. For me that is very hard. I mean I can understand it and except it, but to really belive that I have not been able to nor do I seem to be able to put it aside, is harder.
I have been drug free in evry form for 18 yrs. and this is the first time I have been altered un naturaly.
I have said maybe 1000 times on tx  "What is wrong with me" or "What is happening to me"  intelectually knowing the answer but unable to realy belive it.  Maybe thats another sx of tx, an un easiness that creats denial

[merlino]

Please excuse me while I vent. I have had a morning from He&& trying to understand all this Hep c meds, resuce drugs, stay sane and so on and people actually come here and make believe they have Hep C!! Dear God, why????

[amicraxy]

I don't think there's any understanding during tx. Just know your not alone

[willing]

Here's yet another recent study supporting the durability of SVR <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16441471&query_hl=5&itool=pubmed_DocSum">Formann'06</a>.

As best I can tell, the following two observations are currently uncontradicted in peer-reviewed publications :

1) If you look for HCV RNA in serum via conventional commercial tests (eg COBAS Amplicor,Bayer/TMA etc) and don't find it 3 months post-tx chances are very good (high 90%s) you won't find it again.

2) if you go looking *inside* cells (pbmcs, liver) and use more sensitive detection protocols you do find it, often but not always and regardless of SVR status.

If anyone knows of published data contradicting either of the above please post!

[Oreos]

Cuteous!  Long time no see.  Thanks for the sane post. I hope you are well!

Drofi,
I'm 2 years post tx (1A 48/48 Peg/Copeg) and still undetectable.  Were the lingering effects of the meds worth it?  You bet.  Are there conflicting studies out there?  Of course.  You can drive yourself nuts worrying about relapse percentages. Definitely read the links from Cuteous...

[drofi]

I think exactly the sanme as you do!!!! There are indeed good arguments that this tiny RNA in some cells has nothing to do with clnical outcome: The best evidnce is, that there are examples of people with SVR who had to get a strong medical suppression of the immune system and did not relapse, the just stayed Hepc free.
So, why I want those papers and good scientific links is just as a helping argument exactly for this opinion.
Sorry, I am not a native speaker, but hope you could understand what I mean.

Drofi

jmjm83: Your first link was nice, the second did not work, perhaps I could not search the side well, because of language problems. Could you help nme again, are the more facts similar to your first link?

[Kalio1]

The way I understand it, "occult" virus does not contain replicating particles, so it isn't causing any harm even if they can find it.  It does not affect your SVR if you attain that status. It isn't like someone who  relapses who is undetectable on tx but when tx stops they still have replicating virus.

Like you say, you'd have to be reinfected to have the virus "come back" once you are SVR from tx for 6 months.
There is a less than 1% chance of it coming back.

[jmjm530]

OCCULT refers to individuals with non-detectible HCV RNA virus and showing no HCV antibodies who show virus in other compartments such as liver tissue. These individuals have NOT been treated. This has nothing to do with SVR.

PERSISTENT is similar but refers to individuals who HAVE been treated and achieved SVR. They have non-detectible virus but unlike with occult, they have antibodies.

[drofi]

Thank you, I agree with your comments about differences between occult and persistency, but that is an academic discussion abou wording only. What is important is the question, will there be any viral copies somewhere in the body after SVR (as it is called today)and will these copies be able to harm liver and life. This is what the spanish group suggests.
Thank you for the new link, very good additional argument against the spanish suggestion!

Drofi

[jmjm530]

Yes, an academic distinction, but as long as people are using these terms they mine as well be used correctly, especially since an "occult" study may not apply to SVRs.

You said: Will there be any viral copies somewhere in the body after SVR (as it is called today)and will these copies be able to harm liver and life.

As stated, that's controversial, especiall the latter part "will these copies be able to harm liver and life." Didn't read the Spanish study yet but all the studies I read suggest that the clinical signifiance isn't known, i.e. no statments that persistent virus will"be able to harm liver and life".

[cuteus]

http://www.natap.org/2005/HCV/010505_02.htm

while we are at the durability of SVR subject yet again.