How often do I get follow up tests?

[Petals264]

About 8 years ago I was treated for Hep C.  The treatment was successful.  I tested every 6 months for one and half years after treatment without any more detection. My doc said I was SVR and released me as a patient.  Life continues and fortunately I recover from the treatment after a long couple of years.  I'm about 8 years from my first treatment.  Should I periodically get tested to make sure it doesn't come back?  If so, is there a prescribe rate?

[medic54]

I've read a lot of studies and only came across a few cases of conversion to detectible after 1 year SVR and most were questionable (previous IV drug users who had 'moderately distant genetic variations' IE- same genotype  but with further distant genetic markers than one would expect over the same time frame within the same individual...but not so different as to diagnose a new infection.  But if an IV drug user returned to the vise and the same circle of friends, well then that is probably what would be found.
Other than that, I came across 2 cases of long standing SVR's who tested positive after radiation therapy. But as my doc insists "old age, chemotherapy (IE- for cancer), and immunosuppressive therapy (IE- liver transplants in those cleared/SVR prior) do not relapse, so SVR is in for all practical purposes a cure".
Consider it like many viruses in that it is still present but the treatments have trained your immune system to contain it. So, you should obviously not give blood, but unless you have an incident of a possible re-infection or radiation therapy, I think continued testing seems only for peace of mind.

[hrsepwrguy]

LONG-TERM CLINICAL, BIOCHEMICAL AND VIROLOGICAL OUTCOMES AFTER SUCCESSFUL HCV-THERAPY
F. Morisco1*, T. Stroffolini2, R. Granata1, L. Donnarumma1, M. Guarino1, N. Caporaso1
1Gastroenterology, University of Naples ' Federico II', Naples, 2Infectious and Tropical Disease, University La Sapienza, Rome, Italy.



Background and aims: In patients with chronic hepatitis C, therapy is considered effective when the sustained virological response (SVR) (undetectable HCV-RNA in serum 6 months after the end of therapy) is achieved. Although the persistence of HCV eradication in short or medium-term period (3-5 years) is well- established, little is known about the long-term follow-up.
The aim of the study was to evaluate the long-term persistence of HCV eradication in patients with chronic hepatitis C(CHC) who obtained SVR. In particular, we wanted to assess the risk of long-term virological relapse and liver related-complications.
Methods: From January 1989 to April 2008, 150 consecutive subjects (M/F 100/50, median age 47.69 years, range 22-67) with CHC and SVR after interferon-based therapy, were enrolled in a long-term clinical follow-up study.
137 patients had pre-treatment diagnosis of CHC and 13 patients had cirrhosis.
All patients received interferon-based therapy (66 with conventional IFN-monotherapy, 25 with conventional IFN and ribavirin, and 59 with pegylated IFN and ribavirin). The patients were followed with clinical, biochemical, virological and ultrasonographic assessments every 6 months until the 3th year of follow-up and than every 12 months. HCV-RNA assessment in serum was determined by quantitative RT-PCR ( cut-off < 50 UI/ml).

Results:
The median follow-up was 8,6 years (range:2-19.8 years). Serum HCV-RNA remained undetectable in all patients, indicating no risk of HCV recurrence independently from the schedule of therapy used. During the observation period 3 liver-related complications (2 HCC, 1 bleeding) were observed. The incidence rate of complication was 0.23%/person/year. All 3 of the events occurred in patients with pre-treatment cirrhosis. Only 1 out of 150 patients deceased for liver-related causes (HCC) with a mortality rate of 0.08%/person/year.
Conclusions: In this large cohort of CHC patients with SVR, the eradication of the virus lasted up to 20 years after treatment. Overall, patients with CHC and SVR show an excellent prognosis with no risk of viral recurrence and a very low rate of mortality, so they can be considered healed. Patients with pre-treatment evidence of cirrhosis show a rate of liver complications that cannot be neglected.

http://www1.easl.eu/easl2011/program/Posters/Abstract263.htm

[dustbear]

Today, my hepatologist said to get tested once yearly for up to 5 years after a successful SVR.

[Petals264]

That gives me much "peace-of -mind". I honestly don't know if I could go through the treatment again.  The treatment was the worse part of it for me.

[can-do-man]

Nope no need, while you are offically cured at 6 months most doctors will still do a 1 year post, mainly for peace of mind...... Enjoy