Aa
treatments
are there any other treatments besides the interferon that anyone knows about?
That's all. IFN has be be in all the mixes at this time. A lot of snake oils out there but non proven.
No. There have been a few trials with non-IFN drugs but if that ever comes to pass, it will be a very long time away since the drugs are just in early testing. IFN side effects are frightening to read but a lot of people get out with no long-term damage. Plus the interferon leaves the patient with long-term hyperactivated immunity, which no other drug can provide.
"Plus the interferon leaves the patient with long-term hyperactivated immunity, which no other drug can provide"
huh?
huh?
You didn't know that? The effect of the interferon is to cause extra production of killer T-cells that kill infected cells. TX has to be long to insure that all infected cells are caught, long after blood clears. Your immune system is left that way after taking interferon. It's why people with 'occult hepatitis' (some Hep c genomic material or RNA left behind in liver cells - happens to a few, not all) don't activate the disease again. It's why you don't take steroids or other immunosuppressants in the months immediately following TX. You are also left unable to contract your genotype (but doesn't apply to others). It's not exactly 'immunity' to your geno, just won't happen.
I think I'm the only patient at the clinic who asks questions. My infectious disease researcher doc has shared some very cool info with me.
I think I'm the only patient at the clinic who asks questions. My infectious disease researcher doc has shared some very cool info with me.
Your immune system is left that way after taking interferon.
Actually, my understanding was the opposite. Ergo, the taper theory. But, I'm sure your doc knows best.
Actually, my understanding was the opposite. Ergo, the taper theory. But, I'm sure your doc knows best.
I'm happy to be left with an overactive immune system. My only flaw is that it's made me develop an allergy to a med I've taken a long time but hopefully won't need it anymore anyway after treating. I was super-immune most of the years I had hep c; rarely had colds or flu and cleared them quickly, just didn't have enough natural interferon to push the virus over the edge. Looking forward to high immunity again.
How do you know you have an overactive immune system after treatment? What kind of test is it? Or is it more of a hope and a belief?
Oh, you are asking for a serious lit review; don't know if I'm up for it today. The articles would likely be older, from earlier interferon research. I would guess, however, that the counts of the various WBC's might play into it. There is no assay for interferon levels, since it exists in the cells and does not circulate in the blood. I'll let you know after I get some actual work done (instead of playing on the forum) and get a chance to search.
Shaker, sorry to highjack your discussion.
Shaker, sorry to highjack your discussion.
Or is it more of a hope and a belief?
Sounds like a nice dream and a pleasant doctors hopes to me.
Actually, personally, two and a half years after SVR I can tell you it sure feels the opposite to me. While I didn't get sick once on treatment I sure do now........if anything I feel like my immune system was highjacked and taken away from me. It sure ain't no superduperpooperscooper to any bugs that's for sure.
Interferon.....nature's kraptrapper.
I don't know why I rarely got sick prior being diagnosed. I think maybe my immune system was in overdrive working on my virus, therefore regular bugs never had a chance. But that's just speculation on my part.
The article below makes it sound like if there are lingering immune system effects of interferon, it's not something done in moderation or to our benefit.
Gotta admit, I find this very interesting.
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ProduktNr=223829&Ausgabe=228300&ArtikelNr=57631&filename=57631.pdf
Interferon (IFN), a leukocyte-derived cytokine, has been used to treat several hematological malignancies. The most common adverse effects of IFN are flu-like symptoms. Autoimmune side effects are infrequent but may be hazardous and irreversible. These may occur in several ways: autoantibodies may either appear during the treatment or existing titers may rise, subclinical autoimmune phenomena may become clinically manifest or autoimmune diseases may appear de novo. The main categories of IFN immune-mediated side effects are: thyroid, hematological, connective tissue, renal and miscellaneous disorders. The most common ones are thyroid disorders, which manifest either as hypo- or hyperthyroidism. Patients with pre-existing autoantibodies are more susceptible to the exacerbation of thyroid autoimmunity, probably since IFN enhances the levels of autoimmunity. Hematological disorders include autoimmune anemia and thrombocytopenia and thrombotic thrombocytopenic purpura. The immunological derangement of autoimmune hemolytic anemia manifests as enhanced destruction of antibody-coated red blood cells and induction of autoreactive B cells secreting these antibodies. Although autoimmune thrombocytopenia is rare, a sharp reduction in the platelet counts, beyond that expected from the antiproliferative effects of IFN, should raise this possibility. Thrombotic thrombocytopenic purpura has recently been included among the autoimmune disorders. Sporadic cases have been reported in association with IFN treatment. The clinical spectrum of IFN-induced connective tissue disorders ranges from typical systemic lupus erythematosus to seropositive or seronegative rheumatoid arthritis. Some authors also reported on the development of Behçet's disease in chronic myeloid leukemia patients treated with IFN. The underlying reason for the skin hyperreactivity in Behçet's disease and the effect of IFN treatment in these patients may be altered neutrophil activity in both disorders. Several series evaluated the incidence of Raynaud's phenomenon in patients treated with IFN for hematological disorders. Some of them reported on a rather high incidence of nailfold capillary microscopy abnormalities with or without Raynaud's phenomenon. Whether IFN-induced Raynaud's phenomenon is immune-mediated or directly caused vasospasm, is still unknown although the occurrence of several autoantibodies suggests an immune mechanism. Adverse effects of IFN therapy on the kidney include proteinuria and rarely nephrotic syndrome or acute and chronic renal failure. The mechanism of renal injury is unclear although an immune mechanism is suggested. Sporadic cases of other immune-mediated side effects have been published. These include dermatological adverse effects manifesting as psoriasis, pemphigus and vitiligo, and also rare cases of sarcoidosis, hepatitis, colitis or cryoglobulinemia. In conclusion, patients treated with IFN should be monitored for symptoms of autoimmunity. Patients with previous autoimmune phenomena should be treated, if possible, with alternative drugs since there is risk of exacerbation of these manifestations in these patients.
I don't know why I rarely got sick prior being diagnosed. I think maybe my immune system was in overdrive working on my virus, therefore regular bugs never had a chance. But that's just speculation on my part.
The article below makes it sound like if there are lingering immune system effects of interferon, it's not something done in moderation or to our benefit.
Gotta admit, I find this very interesting.
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ProduktNr=223829&Ausgabe=228300&ArtikelNr=57631&filename=57631.pdf
Interferon (IFN), a leukocyte-derived cytokine, has been used to treat several hematological malignancies. The most common adverse effects of IFN are flu-like symptoms. Autoimmune side effects are infrequent but may be hazardous and irreversible. These may occur in several ways: autoantibodies may either appear during the treatment or existing titers may rise, subclinical autoimmune phenomena may become clinically manifest or autoimmune diseases may appear de novo. The main categories of IFN immune-mediated side effects are: thyroid, hematological, connective tissue, renal and miscellaneous disorders. The most common ones are thyroid disorders, which manifest either as hypo- or hyperthyroidism. Patients with pre-existing autoantibodies are more susceptible to the exacerbation of thyroid autoimmunity, probably since IFN enhances the levels of autoimmunity. Hematological disorders include autoimmune anemia and thrombocytopenia and thrombotic thrombocytopenic purpura. The immunological derangement of autoimmune hemolytic anemia manifests as enhanced destruction of antibody-coated red blood cells and induction of autoreactive B cells secreting these antibodies. Although autoimmune thrombocytopenia is rare, a sharp reduction in the platelet counts, beyond that expected from the antiproliferative effects of IFN, should raise this possibility. Thrombotic thrombocytopenic purpura has recently been included among the autoimmune disorders. Sporadic cases have been reported in association with IFN treatment. The clinical spectrum of IFN-induced connective tissue disorders ranges from typical systemic lupus erythematosus to seropositive or seronegative rheumatoid arthritis. Some authors also reported on the development of Behçet's disease in chronic myeloid leukemia patients treated with IFN. The underlying reason for the skin hyperreactivity in Behçet's disease and the effect of IFN treatment in these patients may be altered neutrophil activity in both disorders. Several series evaluated the incidence of Raynaud's phenomenon in patients treated with IFN for hematological disorders. Some of them reported on a rather high incidence of nailfold capillary microscopy abnormalities with or without Raynaud's phenomenon. Whether IFN-induced Raynaud's phenomenon is immune-mediated or directly caused vasospasm, is still unknown although the occurrence of several autoantibodies suggests an immune mechanism. Adverse effects of IFN therapy on the kidney include proteinuria and rarely nephrotic syndrome or acute and chronic renal failure. The mechanism of renal injury is unclear although an immune mechanism is suggested. Sporadic cases of other immune-mediated side effects have been published. These include dermatological adverse effects manifesting as psoriasis, pemphigus and vitiligo, and also rare cases of sarcoidosis, hepatitis, colitis or cryoglobulinemia. In conclusion, patients treated with IFN should be monitored for symptoms of autoimmunity. Patients with previous autoimmune phenomena should be treated, if possible, with alternative drugs since there is risk of exacerbation of these manifestations in these patients.
FLguy,
I did start a search but have not had the opportunity to translate any of the language into human english (laymen's terms). I'll keep at it.
What I did find may not refer to a continuation of hyped interferon, like many of us had before TX. It referred to things like the ability of interferon to switch on a gene that the virus has switched off, a gene that controls apoptosis (destruction of infected cells). It also makes the virus infected cells more recognizeable by the killer T-cells that the interferon causes to increase. So, unless I find something else, the long-term increased immunity may just refer to being unable to contract your genotype again. I'll keep digging.
I did start a search but have not had the opportunity to translate any of the language into human english (laymen's terms). I'll keep at it.
What I did find may not refer to a continuation of hyped interferon, like many of us had before TX. It referred to things like the ability of interferon to switch on a gene that the virus has switched off, a gene that controls apoptosis (destruction of infected cells). It also makes the virus infected cells more recognizeable by the killer T-cells that the interferon causes to increase. So, unless I find something else, the long-term increased immunity may just refer to being unable to contract your genotype again. I'll keep digging.
"So, unless I find something else, the long-term increased immunity may just refer to being unable to contract your genotype again."
No I do not think so - there is no reason we cannot get our same genotype again. That doesn't even make sense in a million years. To think I could go out and start shooting Geno 1A and 1B infected blood and not get infected is really a marvelous pipe dream but it's a VIRUS. Some people are so worried they change tooth brushes every single day in fear.
I just do not believe that anybody who's gotten to SVR has any reason to think they are less likely to catch it than anybody else. Which is probably how I ended up with already two kinds of A in a way. You can be infected over and over and over again if you are exposed.
No I do not think so - there is no reason we cannot get our same genotype again. That doesn't even make sense in a million years. To think I could go out and start shooting Geno 1A and 1B infected blood and not get infected is really a marvelous pipe dream but it's a VIRUS. Some people are so worried they change tooth brushes every single day in fear.
I just do not believe that anybody who's gotten to SVR has any reason to think they are less likely to catch it than anybody else. Which is probably how I ended up with already two kinds of A in a way. You can be infected over and over and over again if you are exposed.
I have never seen any evidence that we have any immunity as a result of getting to SVR. I would ne interested to see the information that is the basis for that statement. I do not require translation into "layman's terms" as I have been reading and comprehending English successfully for some time now.
"I did start a search but have not had the opportunity to translate any of the language into human english (laymen's terms)."
Holy Mother Superiority Batman! How are we mere mortals to plod on if ever left to our own wits and devices?
"Plus interferon leaves the patient with long-term hyperactivated immunity, which no other drug can provide."
Sounds like you view an artificially over-revved autoimune system as a positive? I'm not much for chicks with hairy armpits, but for most other things - I'll take the human body the way Darwin intended it, thank you very much..... OK, I'll concede that silicone and botox have their places too.....
Holy Mother Superiority Batman! How are we mere mortals to plod on if ever left to our own wits and devices?
"Plus interferon leaves the patient with long-term hyperactivated immunity, which no other drug can provide."
Sounds like you view an artificially over-revved autoimune system as a positive? I'm not much for chicks with hairy armpits, but for most other things - I'll take the human body the way Darwin intended it, thank you very much..... OK, I'll concede that silicone and botox have their places too.....
I was also under the impression that tx will in no way be able to give you immunity to any genotype. I thought that the virus keeps mutating, so one would never able to get the exact same cocktail again, thus making it impossible to obtain immunity.
I do have a life beyond the forum and now that I feel better, I'm busy! I do the forum in my rest periods. The studies are not the hepatologist studies most of us are normally exposed to, they're more virology & biochem. Sorry if I was insulting. Let me get you started with one:
http://jvi.asm.org/cgi/reprint/82/20/10017.pdf Warning, it's a very slow slog.
This one is readable:
http://www.roche.com/pages/facets/10/pegasyse.htm
I trust my doc. I'm not afraid of ever contracting 1b again because interferon has set up my system to stop it (don't know how I'd get exposed to it anyway). There are probably even subsets to the subsets of the genos. After looking up the interferon immunity thing, though, I am not looking forward to getting all the colds and flus that my former high interferon levels made me immune to. Without the hep c goosing my interferon levels, I may catch every baby cold and snotty nose. The post TX immunity looks very specific to hep c and is related to changes in the immune system, not continuing high interferon levels.
Why do they know all this pertinant stuff and not have a way to communicate it to us? It's a pity.
http://jvi.asm.org/cgi/reprint/82/20/10017.pdf Warning, it's a very slow slog.
This one is readable:
http://www.roche.com/pages/facets/10/pegasyse.htm
I trust my doc. I'm not afraid of ever contracting 1b again because interferon has set up my system to stop it (don't know how I'd get exposed to it anyway). There are probably even subsets to the subsets of the genos. After looking up the interferon immunity thing, though, I am not looking forward to getting all the colds and flus that my former high interferon levels made me immune to. Without the hep c goosing my interferon levels, I may catch every baby cold and snotty nose. The post TX immunity looks very specific to hep c and is related to changes in the immune system, not continuing high interferon levels.
Why do they know all this pertinant stuff and not have a way to communicate it to us? It's a pity.
" I'm not afraid of ever contracting 1b again because interferon has set up my system to stop it (don't know how I'd get exposed to it anyway). " newleaf
"I thought that the virus keeps mutating, so one would never able to get the exact same cocktail again, thus making it impossible to obtain immunity. "Marcia
Agree 100% with Marcia on this one.
Sorry but if you do develop an immunity of some sort it would ONLY be to your specific virus and not to ALL of the 1b in the entire world. I don't think it's responsible to be telling people that they can't get it again no matter what - there are lots of people in the world who that could effect cause they would say "oh John is a 1b like me I'll just do some drugs with him cause I can't catch it".........but it wouldn't be the same strain or mutation and of course they would get it again.
I was a geno 1A and 1B do you really mean to tell me I can't EVER get ANY type of geno1 in the rest of my life? I don't believe that for one second and wouldn't even figure it was worth chancing on a good day. I've had the flu more than once and it's the same concept in a way isn't it?
Plus I don't see my immune system over-reved up at all in fact I've noticed I get much sicker much more easily now than I did prior to treatment when I was never really sick in my life. I just don't think it's the responsible thing to be saying at all since you aren't absolutely sure and nobody on earth is.
UNLESS you take a whole bunch of your blood, then clear the virus and then start injecting yourself again with the contaminated blood after SVR - and I can't imagine anybody is that desperate to find out if they could indeed get it or not that would be the only way to really do that study to find out.
"I thought that the virus keeps mutating, so one would never able to get the exact same cocktail again, thus making it impossible to obtain immunity. "Marcia
Agree 100% with Marcia on this one.
Sorry but if you do develop an immunity of some sort it would ONLY be to your specific virus and not to ALL of the 1b in the entire world. I don't think it's responsible to be telling people that they can't get it again no matter what - there are lots of people in the world who that could effect cause they would say "oh John is a 1b like me I'll just do some drugs with him cause I can't catch it".........but it wouldn't be the same strain or mutation and of course they would get it again.
I was a geno 1A and 1B do you really mean to tell me I can't EVER get ANY type of geno1 in the rest of my life? I don't believe that for one second and wouldn't even figure it was worth chancing on a good day. I've had the flu more than once and it's the same concept in a way isn't it?
Plus I don't see my immune system over-reved up at all in fact I've noticed I get much sicker much more easily now than I did prior to treatment when I was never really sick in my life. I just don't think it's the responsible thing to be saying at all since you aren't absolutely sure and nobody on earth is.
UNLESS you take a whole bunch of your blood, then clear the virus and then start injecting yourself again with the contaminated blood after SVR - and I can't imagine anybody is that desperate to find out if they could indeed get it or not that would be the only way to really do that study to find out.
I never knew how I was exposed to it in the first place, so I guess I'll never feel completely secure about a new infection. What happened once can surely happen twice.
It also makes the virus infected cells more recognizeable by the killer T-cells that the interferon causes to increase. So, unless I find something else, the long-term increased immunity may just refer to being unable to contract your genotype again."
Theory not fact.
Respectfully I did read your post and I do not agree with the idea of posting it - let alone the content. As you never really know how someone might take something out here in cyberland I always feel unless you know something is scientific hard core fact 100% it's better not to post it. You know how many addicts might misconstrue the idea that they "can't catch their own geno again" as an open invitation to start doing drugs again? And someone like me who had both a and b - am I to believe my immune system is so hyped up that if I started having someone inject me several times a day with geno1 blood I would still not catch it because I'll have super duper killer T cell response? Many people WILL believe the ideal that they can't catch it again if the idea is posted because they WANT to believe it and oftentimes what is the easier way is the road people will take just because it is easy.
I've never heard one doctor in this universe that said to any patient that if they do treatment they can't catch their geno again. it might be a novel concept that our immune systems are so over hyped that it would make it impossible however I believe my system was more ramped up BEFORE tx which is why I had such a low VL and why it was therefore so hard for me to get to UND in the first place.
I just ask that if you aren't 100% sure of something as fact that you don't publish it where people might take advantage of the information and said "Oh yes I read that you absolutely cannot catch your own genotype again" - I have never heard that as a fact before and while it's an interesting hunch I think that is all it really is. As a hunch it's ok but as a fact that might be incorrect - it's dangerous.
Theory not fact.
Respectfully I did read your post and I do not agree with the idea of posting it - let alone the content. As you never really know how someone might take something out here in cyberland I always feel unless you know something is scientific hard core fact 100% it's better not to post it. You know how many addicts might misconstrue the idea that they "can't catch their own geno again" as an open invitation to start doing drugs again? And someone like me who had both a and b - am I to believe my immune system is so hyped up that if I started having someone inject me several times a day with geno1 blood I would still not catch it because I'll have super duper killer T cell response? Many people WILL believe the ideal that they can't catch it again if the idea is posted because they WANT to believe it and oftentimes what is the easier way is the road people will take just because it is easy.
I've never heard one doctor in this universe that said to any patient that if they do treatment they can't catch their geno again. it might be a novel concept that our immune systems are so over hyped that it would make it impossible however I believe my system was more ramped up BEFORE tx which is why I had such a low VL and why it was therefore so hard for me to get to UND in the first place.
I just ask that if you aren't 100% sure of something as fact that you don't publish it where people might take advantage of the information and said "Oh yes I read that you absolutely cannot catch your own genotype again" - I have never heard that as a fact before and while it's an interesting hunch I think that is all it really is. As a hunch it's ok but as a fact that might be incorrect - it's dangerous.
This is a gift. In the future, please look up your own references for things that you disagree with.
From the Journal of Virology, this will get you started:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=321392
Also try journals for immunology, microbiology, infectious disease. Many articles will be related to the search for an anti-hcv vaccine.
From the Journal of Virology, this will get you started:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=321392
Also try journals for immunology, microbiology, infectious disease. Many articles will be related to the search for an anti-hcv vaccine.
Thank you so much for your delightful gift. It has truly made my day to know that chimpanzee's everywhere are nice and safe after they've been purposefully reinfected. Well some of them anyway. A few. Not all.
"Despite the fact that the inocula contained very high levels of virus (>4 logs more than the average chimpanzee infectious dose), in each case, viremia during the rechallenge infection was markedly reduced in magnitude and duration in comparison to the primary infection in the same animal (Fig. 1)."
Doesn't this mean that those poor chimpanzees were indeed reinfected but they had a less virulent strain for most of them and not all the chimps cleared and were not reinfected?
I don't mean to snipe here but for every study you find you can find 100 more to go completely against it. We've all seen this time and time again. One chimp was not reinfected with G1 - but that is a chimp and we are humans who don't live in the Planet of the Apes.
In response to the chimp study:
PARTIAL PROTECTIVE IMMUNITY AGAINST HEPATITIS C VIRUS REINFECTION IN HUMANS
Conclusions: These findings describe a heterogeneous natural history of HCV superinfection and reinfection, consistent with chimpanzee studies. Protection from viral persistence upon reinfection can occur, but is not universal.
http://www.pulsus.com/cddw2009/abs/008.htm
"Despite the fact that the inocula contained very high levels of virus (>4 logs more than the average chimpanzee infectious dose), in each case, viremia during the rechallenge infection was markedly reduced in magnitude and duration in comparison to the primary infection in the same animal (Fig. 1)."
Doesn't this mean that those poor chimpanzees were indeed reinfected but they had a less virulent strain for most of them and not all the chimps cleared and were not reinfected?
I don't mean to snipe here but for every study you find you can find 100 more to go completely against it. We've all seen this time and time again. One chimp was not reinfected with G1 - but that is a chimp and we are humans who don't live in the Planet of the Apes.
In response to the chimp study:
PARTIAL PROTECTIVE IMMUNITY AGAINST HEPATITIS C VIRUS REINFECTION IN HUMANS
Conclusions: These findings describe a heterogeneous natural history of HCV superinfection and reinfection, consistent with chimpanzee studies. Protection from viral persistence upon reinfection can occur, but is not universal.
http://www.pulsus.com/cddw2009/abs/008.htm
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