RE: Is this possible: Virus is on the liver but PCR RNA test is negative

[Guest guest]

Yes, the virus can remain in small enough amounts that your PCR cannot detect it but its being held at bay by your immune system.. its not going to continue to damage your liver because as I said, your immune system is holding it at bay... NOT everyone has residual virus left but some do.. I always have my PCR done that tests down to 2-5 iu/ml which is the lowest test they have right now I believe and if that is negative,, its a good probability that its really gone.. That is why its so important for those who do reach SVR to still take good care of themselves and not start consuming alcohol or do anything that suppresses the immune system.. IF there are left over virus hiding in there and you suppress your immune system, you can have a relapse.. I hope that answers your question,, its kind of a yes and no answer.. but if its still undetectible virus wise, its not continuing to damage your liver..aylin.kantarci@...

wrote: Hello,I have heard something about HCV virus on the existence of people who haveobtained SVR.Have you ever heard that HCV virus can remain in the liver even if PCR RNAis negative for a patient with SVR? The virus does not give any sign, PCRRNA tests still give negative results and the virus continues to damagethe liver slowly without any sign? Can the virus live on the liver withoutpassing to the blood? For our patient, damage on the liver was negativeaccording to the biopsy results. For such a patient, if he has obtainedSVR, what is the likelihood of developing chirosis and liver cancer?Is there an academic paper on this issue. I have heard this info from onedoctor, who is a well known specialist on this issue. Therefore, Ibelieve, this issue is very important for the people with

SVR.RegardsIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- Hepatitis C/Happy Posting

[Guest guest]

The hepatitis c virus will remain on the subatomic level of the cells

indefinitely even if the patient has achieved SVR . I will try to find a

research paper that supports this but give me a day or two my mom is in town

visiting .

Is this possible: Virus is on the liver but

PCR RNA test is negative

> Hello,

>

> I have heard something about HCV virus on the existence of people who have

> obtained SVR.

> Have you ever heard that HCV virus can remain in the liver even if PCR RNA

> is negative for a patient with SVR? The virus does not give any sign, PCR

> RNA tests still give negative results and the virus continues to damage

> the liver slowly without any sign? Can the virus live on the liver without

> passing to the blood? For our patient, damage on the liver was negative

> according to the biopsy results. For such a patient, if he has obtained

> SVR, what is the likelihood of developing chirosis and liver cancer?

>

> Is there an academic paper on this issue. I have heard this info from one

> doctor, who is a well known specialist on this issue. Therefore, I

> believe, this issue is very important for the people with SVR.

>

> Regards

>

>

>

>

>

>

>

>

>

>

>

> It's a pleasure having you join in our conversations. We hope you have

> found the support you need with us.

>

> If you are using email for your posts, for easy access to our group, just

> click the link-- Hepatitis C/

>

> Happy Posting

>

[Guest guest]

No matter how long a person is svr there is still minute amounts of the virus in them .....forever Jackie ,lol

Re: Is this possible: Virus is on the liver but PCR RNA test is negative

Yes, the virus can remain in small enough amounts that your PCR cannot detect it but its being held at bay by your immune system.. its not going to continue to damage your liver because as I said, your immune system is holding it at bay... NOT everyone has residual virus left but some do.. I always have my PCR done that tests down to 2-5 iu/ml which is the lowest test they have right now I believe and if that is negative,, its a good probability that its really gone..

That is why its so important for those who do reach SVR to still take good care of themselves and not start consuming alcohol or do anything that suppresses the immune system.. IF there are left over virus hiding in there and you suppress your immune system, you can have a relapse..

I hope that answers your question,, its kind of a yes and no answer.. but if its still undetectible virus wise, its not continuing to damage your liver..aylin.kantarciege (DOT) edu.tr wrote:

Hello,I have heard something about HCV virus on the existence of people who haveobtained SVR.Have you ever heard that HCV virus can remain in the liver even if PCR RNAis negative for a patient with SVR? The virus does not give any sign, PCRRNA tests still give negative results and the virus continues to damagethe liver slowly without any sign? Can the virus live on the liver withoutpassing to the blood? For our patient, damage on the liver was negativeaccording to the biopsy results. For such a patient, if he has obtainedSVR, what is the likelihood of developing chirosis and liver cancer?Is there an academic paper on this issue. I have heard this info from onedoctor, who is a well known specialist on this issue. Therefore, Ibelieve, this issue is very important for the people with SVR.RegardsIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- Hepatitis C/Happy Posting

[Guest guest]

Here is a sample of some of the research out there ...

IS THE VIRUS GONE?

So you've gone through treatment and you still test negative 6 months later.

Is the virus really gone? Can you stop worrying? Researchers in this recent

study examined the blood of randomly chosen patients who once had hep C and

had either resolved it spontaneously (5 patients) or through treatment (11

patients).

They tested the peripheral blood mononuclear cells and in some cases, the

monocyte-derived dendritic cells, using a very sensitive test (RT-PCR-NAH)

and by real-time RT-PCR. Their results showed that HCV RNA was

carried in the convalescent-phase sera and/or PBMC in all 16 individuals

investigated. Also, HCV RNA negative strand were found in most of the blood

tested.

This suggests that the virus is multiplying, even in samples from patients

who tested negative 5 years after treatment. The results suggest that HCV

can remain in the blood and lymphoid cells at very low levels and an

intermediate replicative form of the virus can remain in the body many years

after the apparent resolution of the virus.

Source: Pham TN, et al, J Virol. 2004

Jun;78(11):5867-74. Hepatitis C virus persistence

after spontaneous or treatment-induced resolution

hepatitis C.

(courtesy of: Sept 2004 hepc.bull - Canada's Hepatitis C News Bulletin)

Hepatitis C Virus Persistence after Spontaneous or Treatment-Induced

Resolution of Hepatitis C

(the above cited trial, complete)

--------------------------------------------------------------------------------

Persistence of Virus Following Successful Therapy

Sustained viral response to hepatitis C therapy is defined as an

undetectable serum HCV-RNA 6 months after stopping treatment, regardless of

the therapy used. This definition has become the cornerstone of hepatitis C

treatment because its attainment has a significant impact upon both the

patient and the treating physician.

An important study was presented by Radkowski and colleagues[9] during these

meeting proceedings that places into question our definition of response.

They evaluated for the presence of hepatitis C viral RNA in either

stimulated lymphocytes, cultured macrophages, or posttreatment liver biopsy

samples from 17 sustained viral responders to combination interferon and

ribavirin therapy. HCV-RNA was detectable in the macrophages of 11 (65%)

patients and in the lymphocytes of 7 (41%) patients. Three patients had

HCV-RNA detectable in liver tissue. Overall, only 2 of the 17 (12%)

sustained viral responders were negative for the presence of HCV-RNA in all

analyzed specimens.

These findings are important because they bring into question the current

definition of sustained viral response. These findings need to be further

evaluated in larger series because the persistence of virus may have

significant implications on future disease progression, disease activation,

disease transmission, and the development or persistence of hepatic

fibrosis.

source: http://www.medscape.com/viewarticle/495211

( 9. Radkowski M, Jablonski J, Wilkinson J, et al. Persistence of hepatitis

C virus in patients successfully treated for chronic hepatitis C.

Hepatology. 2004;40:180A. [Abstract #41])

[Guest guest]

Here is an article on the issue:

Response to Hepatitis C Therapy Can Last for Years

SourceURL:http://www.reuters.com/

NEW YORK (Reuters Health) - A sustained response to successful treatment

with interferon for hepatitis C virus (HCV) infection can persist for up to

12 years, according to a report in the November issue of the Journal of

Medical Virology.

Previous studies have shown remission for up to 5 years after successful

treatment with interferon, the authors explain, but HCV eradication from the

liver has not been well validated in longer follow-up.

Dr. Natsuko Tsuda from Osaka National Hospital, Osaka, Japan and colleagues

monitored 38 patients who had a virological response to interferon therapy,

defined as clearance of HCV from the blood after 6 months.

Thirty-seven patients who had a biochemical response were also monitored.

These patients were defined as having normal liver function test results

after 6 months of therapy, but detectable levels of virus in the blood.

The subjects were followed for 4.4 years to 12 years after interferon

therapy.

All sustained virological responders remained persistently negative for HCV

in the blood during the entire follow-up period, the authors report. The

biochemical responders continued to have HCV detected in the blood and

nearly half (46 percent) experienced flared ups.

Four sustained virological responders (but no biochemical responders)

developed liver cancer (between 6 months and 5.5 years after treatment), the

report indicates. However, all four patients had advanced liver disease

before treatment.

HCV was not detected in biopsy samples from 15 sustained virological

responders taken 5.9 to 12.5 years after pretreatment biopsies, the

researchers note. However, all but one of the 15 biochemical responders who

had repeat biopsies had HCV detected in the liver.

In evaluations of liver tissue samples, all measures improved significantly

in the sustained virological responders, whereas only partial improvements

were observed the biochemical responders. In both groups, evidence of at

least mild inflammation remained in the biopsy tissue samples after

treatment.

The results suggest that clearance of HCV by 6 months after interferon

therapy indicates a " virological cure, " the authors conclude. " Although

further studies with a larger number of patients are necessary, control of

biochemical disease activity to near-normal levels may also confer favorable

long-term...outcomes, " they add.

SOURCE: Journal of Medical Virology, November 2004

Re: Is this possible: Virus is on the liver

but PCR RNA test is negative

Here is a sample of some of the research out there ...

IS THE VIRUS GONE?

So you've gone through treatment and you still test negative 6 months later.

Is the virus really gone? Can you stop worrying? Researchers in this recent

study examined the blood of randomly chosen patients who once had hep C and

had either resolved it spontaneously (5 patients) or through treatment (11

patients).

They tested the peripheral blood mononuclear cells and in some cases, the

monocyte-derived dendritic cells, using a very sensitive test (RT-PCR-NAH)

and by real-time RT-PCR. Their results showed that HCV RNA was

carried in the convalescent-phase sera and/or PBMC in all 16 individuals

investigated. Also, HCV RNA negative strand were found in most of the blood

tested.

This suggests that the virus is multiplying, even in samples from patients

who tested negative 5 years after treatment. The results suggest that HCV

can remain in the blood and lymphoid cells at very low levels and an

intermediate replicative form of the virus can remain in the body many years

after the apparent resolution of the virus.

Source: Pham TN, et al, J Virol. 2004

Jun;78(11):5867-74. Hepatitis C virus persistence

after spontaneous or treatment-induced resolution

hepatitis C.

(courtesy of: Sept 2004 hepc.bull - Canada's Hepatitis C News Bulletin)

Hepatitis C Virus Persistence after Spontaneous or Treatment-Induced

Resolution of Hepatitis C

(the above cited trial, complete)

----------------------------------------------------------------------------

----

Persistence of Virus Following Successful Therapy

Sustained viral response to hepatitis C therapy is defined as an

undetectable serum HCV-RNA 6 months after stopping treatment, regardless of

the therapy used. This definition has become the cornerstone of hepatitis C

treatment because its attainment has a significant impact upon both the

patient and the treating physician.

An important study was presented by Radkowski and colleagues[9] during these

meeting proceedings that places into question our definition of response.

They evaluated for the presence of hepatitis C viral RNA in either

stimulated lymphocytes, cultured macrophages, or posttreatment liver biopsy

samples from 17 sustained viral responders to combination interferon and

ribavirin therapy. HCV-RNA was detectable in the macrophages of 11 (65%)

patients and in the lymphocytes of 7 (41%) patients. Three patients had

HCV-RNA detectable in liver tissue. Overall, only 2 of the 17 (12%)

sustained viral responders were negative for the presence of HCV-RNA in all

analyzed specimens.

These findings are important because they bring into question the current

definition of sustained viral response. These findings need to be further

evaluated in larger series because the persistence of virus may have

significant implications on future disease progression, disease activation,

disease transmission, and the development or persistence of hepatic

fibrosis.

source: http://www.medscape.com/viewarticle/495211

( 9. Radkowski M, Jablonski J, Wilkinson J, et al. Persistence of hepatitis

C virus in patients successfully treated for chronic hepatitis C.

Hepatology. 2004;40:180A. [Abstract #41])

It's a pleasure having you join in our conversations. We hope you have found

the support you need with us.

If you are using email for your posts, for easy access to our group, just

click the link-- Hepatitis C/

Happy Posting

[Guest guest]

Is HCV Curable?

Reported by Jules Levin

Over 90% of HCV mono-infected patients who have negative HCV viral load

(undetectable) 6 months after stopping therapy remain undetectable. Small

studies of perhaps 200 hundred patients in total have followed patients for

3-11 years and find over 90% of these patients continue to have undetectable

HCV in the blood. Small studies have shown that these patients do not have

HCV in the liver either. The study discussed below found that 98% of

patients achieving a sustained viral response (undetectable HCV viral load)

did not have HCV in the liver. This of course is good news. Most doctors

feel that a patient who achieves and sustains undetectable viral load is

likely to remain healthy. Many patients who achieve a sustained viral

response (SVR) are able to improve the condition of the liver (fibrosis and

inflammation). Studies have also found that a percentage of patients who are

not able to achieve an SVR are still able to slow disease progression

(inflammation and fibrosis). However, we still need long-term studies which

follow large numbers of patients for many years to evaluate long-term

clinical outcomes: the development of cirrhosis and other severe

complications of HCV, and longevity.

This past year HCV researchers (Poynard, McHutchison, et al)

reported on the effect of HCV therapy on fibrosis and inflammation. They

followed patients who received various regimens including interferon and

Pegylated interferon, and they evaluated the outcomes in terms of improved

fibrosis and inflammation. They found that inflammation and fibrosis

improves in many patients whether or not they achieve an SVR, but of course

achieving an SVR results in greater likelihood of improving the liver. They

also found that 49% of the 150 patients with cirrhosis in this study were

able to " reverse " cirrhosis.

Here is link to full article: http://www.natap.org/2002/may/050902_2.htm

When doctors refer to HCV being " curable " it is often said that this is

analagous the situation with cancer. In cancer if they can't find cancer for

a certain number of years after therapy has been finished they call the

person cured. Does cancer ever re-emerge? We need long-term studies in HCV

to evaluate the outcomes of patients who sustain undetectable HCV viral load

in order to confirm this.

In summary, if a patient can sustain an undetectable viral load for 6 months

to 1 year after stopping HCV therapy this gives them the best opportunity to

remain healthy. It's important to bear in mind that these study results

apply to patients with HCV mono-infection. We are not certain if these

findings apply precisely to HCV/HIV coinfected patients. Studies in

coinfected patients are ongoing and soon we will have additional information

on them. There is much research going on now into new drugs for treating

HCV. For patients who do not achieve a sustained viral response with the

current therapy, they may want to consider maintenance therapy if they have

advanced liver disease. Maintenance therapy consists of continuing

interferon at a half-dose. Studies have found that this slows disease

progression. The first study data on a new HCV drug that appears promising

was presented recently at the large annual liver conference (AASLD). They

studies and reported for the first time results from patients with HCV who

received an HCV protease inhibitor (BILN 1061). Patients received this new

drug for 2 days and achieved potent reductions in viral of 2-3 logs. There

were no apparent safety concerns. Phase II studies are expected to begin in

early 2003.

[Guest guest]

my last liver biopsy showed no ongoing hep damage in my liver after being SVR for over 3 years nowAylin KANTARCI <aylin.kantarci@...> wrote: Is HCV Curable? Reported by Jules Levin Over 90% of HCV mono-infected patients who have negative HCV viral load(undetectable) 6 months after stopping therapy remain undetectable. Smallstudies of perhaps 200 hundred patients in total have followed patients for3-11 years and find over 90% of these patients continue to have undetectableHCV in the blood.

Small studies have shown that these patients do not haveHCV in the liver either. The study discussed below found that 98% ofpatients achieving a sustained viral response (undetectable HCV viral load)did not have HCV in the liver. This of course is good news. Most doctorsfeel that a patient who achieves and sustains undetectable viral load islikely to remain healthy. Many patients who achieve a sustained viralresponse (SVR) are able to improve the condition of the liver (fibrosis andinflammation). Studies have also found that a percentage of patients who arenot able to achieve an SVR are still able to slow disease progression(inflammation and fibrosis). However, we still need long-term studies whichfollow large numbers of patients for many years to evaluate long-termclinical outcomes: the development of cirrhosis and other severecomplications of HCV, and longevity. This past year HCV researchers (Poynard,

McHutchison, et al)reported on the effect of HCV therapy on fibrosis and inflammation. Theyfollowed patients who received various regimens including interferon andPegylated interferon, and they evaluated the outcomes in terms of improvedfibrosis and inflammation. They found that inflammation and fibrosisimproves in many patients whether or not they achieve an SVR, but of courseachieving an SVR results in greater likelihood of improving the liver. Theyalso found that 49% of the 150 patients with cirrhosis in this study wereable to "reverse" cirrhosis. Here is link to full article: http://www.natap.org/2002/may/050902_2.htmWhen doctors refer to HCV being "curable" it is often said that this isanalagous the situation with cancer. In cancer if they can't find cancer fora certain number of years after therapy has been finished they call

theperson cured. Does cancer ever re-emerge? We need long-term studies in HCVto evaluate the outcomes of patients who sustain undetectable HCV viral loadin order to confirm this. In summary, if a patient can sustain an undetectable viral load for 6 monthsto 1 year after stopping HCV therapy this gives them the best opportunity toremain healthy. It's important to bear in mind that these study resultsapply to patients with HCV mono-infection. We are not certain if thesefindings apply precisely to HCV/HIV coinfected patients. Studies incoinfected patients are ongoing and soon we will have additional informationon them. There is much research going on now into new drugs for treatingHCV. For patients who do not achieve a sustained viral response with thecurrent therapy, they may want to consider maintenance therapy if they haveadvanced liver disease. Maintenance therapy consists of continuinginterferon at a half-dose.

Studies have found that this slows diseaseprogression. The first study data on a new HCV drug that appears promisingwas presented recently at the large annual liver conference (AASLD). Theystudies and reported for the first time results from patients with HCV whoreceived an HCV protease inhibitor (BILN 1061). Patients received this newdrug for 2 days and achieved potent reductions in viral of 2-3 logs. Therewere no apparent safety concerns. Phase II studies are expected to begin inearly 2003. Jackie

[Guest guest]

THATS what I thought too Liz,, thanks for re-enforcing that,, so how are you?elizabethnv1 <elizabethnv1@...> wrote: No matter how long a person is svr there is still minute amounts of the virus in them .....forever Jackie ,lol Re: Is this possible: Virus is on the liver but PCR RNA test is negative Yes, the virus can remain in small enough amounts that your PCR cannot detect it but its being held at bay by your immune system.. its not going to continue to damage your liver because as I said, your immune system is holding it at bay... NOT everyone has residual virus left but some do.. I always have my PCR done that tests down to 2-5 iu/ml which is the lowest test they have right now I believe and if that is negative,, its a good

probability that its really gone.. That is why its so important for those who do reach SVR to still take good care of themselves and not start consuming alcohol or do anything that suppresses the immune system.. IF there are left over virus hiding in there and you suppress your immune system, you can have a relapse.. I hope that answers your question,, its kind of a yes and no answer.. but if its still undetectible virus wise, its not continuing to damage your liver..aylin.kantarciege (DOT) edu.tr wrote: Hello,I have heard something about HCV virus on the existence of people who haveobtained SVR.Have you ever heard that HCV virus can remain in the liver even if PCR RNAis negative for a patient with SVR? The virus does not give any sign, PCRRNA tests still give negative results and the virus continues to damagethe liver slowly

without any sign? Can the virus live on the liver withoutpassing to the blood? For our patient, damage on the liver was negativeaccording to the biopsy results. For such a patient, if he has obtainedSVR, what is the likelihood of developing chirosis and liver cancer?Is there an academic paper on this issue. I have heard this info from onedoctor, who is a well known specialist on this issue. Therefore, Ibelieve, this issue is very important for the people with SVR.RegardsIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- Hepatitis C/Happy Posting

[Guest guest]

Crappy of course but trying to get online at least 4 times a week . So my emails are slow it's gonna take time to catch up ..

Re: Is this possible: Virus is on the liver but PCR RNA test is negative

Yes, the virus can remain in small enough amounts that your PCR cannot detect it but its being held at bay by your immune system.. its not going to continue to damage your liver because as I said, your immune system is holding it at bay... NOT everyone has residual virus left but some do.. I always have my PCR done that tests down to 2-5 iu/ml which is the lowest test they have right now I believe and if that is negative,, its a good probability that its really gone..

That is why its so important for those who do reach SVR to still take good care of themselves and not start consuming alcohol or do anything that suppresses the immune system.. IF there are left over virus hiding in there and you suppress your immune system, you can have a relapse..

I hope that answers your question,, its kind of a yes and no answer.. but if its still undetectible virus wise, its not continuing to damage your liver..aylin.kantarciege (DOT) edu.tr wrote:

Hello,I have heard something about HCV virus on the existence of people who haveobtained SVR.Have you ever heard that HCV virus can remain in the liver even if PCR RNAis negative for a patient with SVR? The virus does not give any sign, PCRRNA tests still give negative results and the virus continues to damagethe liver slowly without any sign? Can the virus live on the liver withoutpassing to the blood? For our patient, damage on the liver was negativeaccording to the biopsy results. For such a patient, if he has obtainedSVR, what is the likelihood of developing chirosis and liver cancer?Is there an academic paper on this issue. I have heard this info from onedoctor, who is a well known specialist on this issue. Therefore, Ibelieve, this issue is very important for the people with SVR.RegardsIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- Hepatitis C/Happy Posting

[Guest guest]

Im sorry hon,, Im here if you need me,, ok? I hope you start feeling better soon! Our kitchen is working now,, finally! Ill post some pics when I get them downloaded.. its looking great,, only have the floors left to do and just some odds and ends to finish,, love you and miss chatting with you hon,, meelizabethnv1 <elizabethnv1@...> wrote: Crappy of course but trying to get online at least 4 times a week . So my emails are slow

it's gonna take time to catch up .. Re:

Is this possible: Virus is on the liver but PCR RNA test is negative Yes, the virus can remain in small enough amounts that your PCR cannot detect it but its being held at bay by your immune system.. its not going to continue to damage your liver because as I said, your immune system is holding it at bay... NOT everyone has residual virus left but some do.. I always have my PCR done that tests down to 2-5 iu/ml which is the lowest test they have right now I believe and if that is negative,, its a good probability that its really gone.. That is why its so important for those who do reach SVR to still take good care of themselves and not start consuming alcohol or do anything that suppresses the immune system.. IF there are left over virus hiding in there and you suppress your immune system, you can have a relapse.. I hope that answers your question,, its kind of a

yes and no answer.. but if its still undetectible virus wise, its not continuing to damage your liver..aylin.kantarciege (DOT) edu.tr wrote: Hello,I have heard something about HCV virus on the existence of people who haveobtained SVR.Have you ever heard that HCV virus can remain in the liver even if PCR RNAis negative for a patient with SVR? The virus does not give any sign, PCRRNA tests still give negative results and the virus continues to damagethe liver slowly without any sign? Can the virus live on the liver withoutpassing to the blood? For our patient, damage on the liver was negativeaccording to the biopsy results. For such a patient, if he has obtainedSVR, what is the likelihood of developing chirosis and liver cancer?Is there an academic paper on this issue. I have heard this info from onedoctor, who is a well known

specialist on this issue. Therefore, Ibelieve, this issue is very important for the people with SVR.RegardsIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- Hepatitis C/Happy Posting