trace amounts of virus found after SVR???

[katla]

"Trace amounts of HCV RNA of pretreatment sequence persisted and reappeared sporadically in the circulation within 8 years after recovery from hepatitis C"

http://www.ncbi.nlm.nih.gov/pubmed/21040725

Could someone please help clarify what this means? I couldn't access the entire article, just the abstract.

How are 'trace amounts' defined (quantified) and how are they distinguished from 'detectable virus'?
Is it possible that some people who cleared the virus, later tested positive for 'trace amounts'  and then they were retreated unnecessarily?

I'm most curious in understanding this. Thanks.

Kat

[katla]

I thank you all.

[HectorSF]

Your posts title "trace amounts of virus found after SVR???" as I stated above not correct. Trace amounts also appeared in one individual that never treated. Showing that it is the nature of the hepatitis C infection itself and has nothing to do with SVR after treatment.
The vast major of patients in the study were post treatment patients.
"98 following therapy and 19 spontaneously". A larger group of spontaneous cleared patients will need to be studied to clarify if the mechanisms are exactly the same in both populations.

Hector

[HectorSF]

To answer your questions....I hope this helps to clarify the issue.

“How are 'trace amounts' defined (quantified) and how are they distinguished from 'detectable virus'?”
* The testing used for this study used a unique protocol for testing for HCV RNA which is many times more sensitive than current HCV RNA tests.  So the standard HCV RNA tests showed the patients to be nonreactive. Therefore no infection was found.

“Is it possible that some people who cleared the virus, later tested positive for 'trace amounts’ and then they were retreated unnecessarily?”
* No. The standard HCV RNA tests don’t detect trace amounts of virus.
This study used a unique HCV RNA test that was designed to detect very small levels of virus in the blood and lymphoid cells.

Note:

* Only 4 out of 117 (15%) had trace amounts of virus. And 1 of the four, had spontaneously resolved the virus using their own immune system (antibody positive but no HCV RNA). So it is the nature of HCV that in a small number of patients, trace amounts of virus remain for a number of years until the T-cells mop up the remaining trace amounts. This is due to the nature of HCV, not something unique to post treatment HCV.

* All patients’ immune systems (T-cells) were able to destroy the remaining trace amounts of HCV virus as time went on. And after 8 years all HCV even the trace amounts in the 15% were gone.

Hector

[desrt]

After becoming undetectible in the bloodstream - whether on your own or with IFN - 85-90% of people will cotinue to show + & - strand HCV in other parts of their bodies, showing some form of ongoing replication. Even these remnants seem to disappear after about 8 years. If you feel you need this info, there are a series of blood tests you can take that indicate this without the need for spinal biopsy or some equally invasive procedure.

http://www.ncbi.nlm.nih.gov/pubmed/20648609

[willbb]

Possibly this article will help explain ...or confuse further.....:
Will

http://www.medscape.com/viewarticle/522760_4


In conclusion, no recurrence of HCV infection was seen in any patient with an SVR achieved by an IFN-based anti-viral therapy. Thus, long-term prognosis in chronic hepatitis C patients with an SVR to therapy with PEG-IFN/ribavirin is excellent. The clinical impact of small persistent quantities of virus is yet unclear and has to be investigated in further studies.