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Hep C Discussion Forum -> On Treatment -> Svr = cure?
Post Info TOPIC: Svr = cure?
mallani


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RE: Svr = cure?
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Hi Kelly,

You can't donate blood. Some organ transplants are being considered.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
KMMM


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In 1988, my husband was 18 years old and received a blood transfusion following a horrible ski accident.  In 1995, 1 month after we were married we received a phone call from his former surgeon saying there had been a blood "trace back" and stated my husband needed to be tested for Hep C.  At the time there was no "hep C"...it was Hepatitis non A/nonB.  The test was inconclusive.    In 1998 we were called to "be re-tested" as the test for hep C was more specific.  One month before our second son was born we found out he was hep C positive and scheduled for a liver biospy.

If someone has  had hep C, received treatement and no longer has "detectable" virus I would still say...DO NOT DONATE BLOOD.

I do not have hep C and was checked regularly over the years.  I would never even consider donating blood as a partner of someone infected with hep C.  The world will survive without Rob and I being blood donaters.  Even though I am hep C negative, why would I ever donate blood.  I can't even fathom putting another person at risk and do to another what happened to us.

Rob would certainly never consider donating blood even if he is "cured" at the end of treatment.

The consequences to our lives living with Hep C all of these years has been enormous due to that blood transfusion.  Not to mention that treatment has been extremely hard for him and this  year of treatment is one I would never wish on anyone.

Back in 1988, there was testing for Hep C with donated blood but the Canadian government decided to not spend the money to do the testing because the risk was considered too small to justify the expense.

Seriously, even if the risk to transmitting Hep C is minimal following treatment, why would someone ever donate and take the risk in giving it to someone via a blood transfusion.

Ronna



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DJ


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Kellyw wrote:

Hmmm I'm pretty sure my nurses said I could donate blood . That I was not able to pass on hep c and that I did not need to inform anyone of this prior infection for health reasons etc

 

Are you in the United States?  We can't donate blood here ever once we have Hep C.  I am just hoping one day my husband can donate again because he has been doing it all of his adult life and he has never had Hep C and I think he should be allowed to, but they may not let him.



__________________

Genotype 3.  Treatment started on 1/11/2013 with Ribavirin and Pegatron.  Week 4 UND.  Week 12 UND.  Ended treatment on 6/28/2013.  Six months post treatment 12/04/2013 SVR.
Kellyw


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Hmmm I'm pretty sure my nurses said I could donate blood . That I was not able to pass on hep c and that I did not need to inform anyone of this prior infection for health reasons etc

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Kelly 2b dx 8/11. Tx begun 12/30/11. Apparently had it for decades.
mallani


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 Hi jrc,

I agree some of the links are a few years old. I subscribe to several on-line journals, and there is a perfect article called 'The prolonged farewell to Interferon' in 'Virology ', which I can't publish yet due to copyright.

Most of the new papers are on RAV's (Resistant Mutations). RAV's have only been around since Rx with Victrelis and Incivek started. There are specific RAV's for each DAA, and these vary depending on Genotype. The Geno 1a's have the most potent, persistent RAV's and these are the mutations that probably cause relapse after Rx or SVR. Sofosbuvir is such a potent DAA that there is widespread concern it is being used without any other DAA, and without the safety net of Interferon (even in Trials). I imagine Gilead would not want a reservoir of sofosbuvir- resistant mutations out there , before the drug is even approved.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
JIme


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I'm anxious to see if any people who have acheived SVR on the new triple tx and 7977 will relapse. I hope not. I hope they have to rewrite the record books.

 



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jim

GT1a, St2 Lv2 last biopsy 2002, VL  11.4m,  start triple tx 9/30/11

VL 470 @4wks.....VL 22,000 @8wks  stopped tx

Round 2-  Started 3/16/12   PSI-7977, BMS-790052, Riba Undetectable day 14

Did 24 weeks Still UND 12 weeks post tx, SVR24!!!!!!! 2/14/13

 

 

 

 

 
jrc


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mallani wrote:

Sorry to be a party pooper, but SVR does NOT mean your body is virus free. It means you have no DETECTABLE circulating virus in the blood. If all SVR's were virus free, they would be 'cured'.

This is why you cannot donate blood, and why a small number (~1-2%) suffer from relapse after SVR. There have been many studies confirming this and the following links are to a few:

http://hepatitis.about.com/od/treatment/f/SVR.htm

http://www.ncbi.nlm.nih.gov/pubmed/15619235/

 Some pretty old links there :)



__________________

Geno 1 A Started Tx w/ Victrelis  8-3-11, Viral Load  21.2 Million,  Und Weeks 4 Through 28 ,End Of Tx 2-15-2012 !SVR
libgirl07


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Are we still contagious then

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Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
mallani


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Sorry to be a party pooper, but SVR does NOT mean your body is virus free. It means you have no DETECTABLE circulating virus in the blood. If all SVR's were virus free, they would be 'cured'.

This is why you cannot donate blood, and why a small number (~1-2%) suffer from relapse after SVR. There have been many studies confirming this and the following links are to a few:

http://hepatitis.about.com/od/treatment/f/SVR.htm

http://www.ncbi.nlm.nih.gov/pubmed/15619235/



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
mallani


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Hi Nicole,

The answer lies between possibly and probably. Otherwise blood could be donated and the usual precautions would be lifted. It's a complex issue. I'm sure many SVR's are completely virus free, but as yet we have no way of proving it. Unfortunately I don't see how this can change.

Yet another link:

http://www.med.mun.ca/Medicine/CommunicationsNews/NewsMedicine/May-2009/Hepatitis-C-patients-likely-still-contagious-after.aspx



-- Edited by mallani on Sunday 3rd of February 2013 11:27:04 AM

__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
kiwi


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libgirl07 wrote:

So will I still be contagious if there are still tiny amounts of virus in my blood? If I svr do I need to tell people I had HCV. How does this work.


if you are SVR there are no amounts detected. in fact during treatment while i was undetected i asked the same question, and NO i could not pass it on coz there is no virus to pass on....

SO, you will always show up positive, coz you will have antibodies, but NO you will not have the virus...



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kiwi. genotype 1. started pegasus and riba on 10 nov. VL 17.6 million. (4 weeks VL 1368)  week 15 UNDETECTED... :)
libgirl07


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So will I still be contagious if there are still tiny amounts of virus in my blood? If I svr do I need to tell people I had HCV. How does this work.

__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
mallani


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Hi Nicole,

SVR means no detectable circulating virus 24 weeks after end of treatment. It is as close as we can get to being 'cured'.

Several studies have looked at recurrent viraemia(relapse) after SVR. This is fairly consistent at 1-2%. Invariably this is the same Genotype indicating renewed replication of persistent virus. Obviously reinfection ( often with a different Genotype) can occur in parients who resume unsafe activities.

The source of the recurrent virus after SVR, is still hotly disputed. In cirrhotics, there is universal agreement that residual virus comes from poorly perfused regenerative nodules or septae.  In non-cirrhotics, there may still be a small amount of virus remaining in the blood  (despite being called Undetected).  However the most popular theory is that virus can lie dormant in blood monocytes, T-cell lymphocytes, lymphoid tissue or gastric mucosa.  Patients who achieve SVR and do not suffer relapse, can obviously deal with this small viral presence using their own autoimmune system. Using the latest detection techniques, tiny amounts of virus have been detected 5 years later in SVR patients who have not relapsed.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Shaun


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Medically achieving SVR is considered cured.  The reason they do not use the word, "Cure" is because in order to be called a cure, a treatment has to be effective in100% of patients.

When you reach SVR you do not have any virus left in your system, they are totally eraticated.  There is a very tiny percent of people who relapse between 6 months and a year, but this is extremely rare. 

My nurse practitioner told me that people who relapse after 1 year have been reinfected by outside sources, aka IV drug use or other means.



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JoAnneh


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Biggy! Love the way you put it! Straight forward and exact:)

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JoAnne

Genotype 1a, Triple therapy w/Invicek started May 19, 2012

DET 4 wk. UND 2,6,12,24 48 treatment. Achieved SVR 2013!
libgirl07


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Biggyb. Thanks. I love that.

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Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
JoAnneh


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My husband was exposed in College, 30 years ago and he Is in the 10-15 percent that has natural Antibody and he has zero VL! Which makes sense he can't donate blood, But I don't understand the concept w Your husband. Perhaps once you are SVR He can donate again.

__________________

JoAnne

Genotype 1a, Triple therapy w/Invicek started May 19, 2012

DET 4 wk. UND 2,6,12,24 48 treatment. Achieved SVR 2013!
DJ


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Well I don't think we can ever donate blood. What I wonder....will my husband ever be able to donate again? He had donated for 30 years now. I have had two blood transfusions and so I have either had this for 32 years or 19 years...either way he has been donating all of that time. I found out I have Hep C this summer when I went with him to donate for the first time. NOW they won't let him donate even though he doesn't have it.

So if I clear the virus....will he be allowed to donate again in the future?



__________________

Genotype 3.  Treatment started on 1/11/2013 with Ribavirin and Pegatron.  Week 4 UND.  Week 12 UND.  Ended treatment on 6/28/2013.  Six months post treatment 12/04/2013 SVR.
Biggyb


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We can live with labels, we can't live without a liver.  



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58 yo..Relapsed in 99 and again in 2004. Started triple therapy with Victrelis July 22,2012.  genotype 1a. week 8,12,16,24 VL Undetectable..E.O.T -- 6-22-2013,,,EOT + 24., UND. 

SVR !!!

 

~Bob~
libgirl07


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At my job they test all the women for hcv antibodies and if they are positive it doesn't specify usually whether or not they have a viral load. So as cynical as it sounds are we ever really "cured" will we always be labeled regardless of all the **** we go through w tx.

__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
libgirl07


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Posts: 165
Date:
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Thank you!

__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
Cinnamon Girl


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Hi Nicole, the vast majority of people who attain SVR, which means the virus is still undetectable 6 months after they`ve finished tx, are then considered `cured`.   It is possible to have a `late relapse` after the 6 month period has ended but that only happens to a very small percentage of people.  So yes, as it stands at present we consider that SVR = cure.

It is still possible to become reinfected, of course, if people are exposed to infected blood at any time after SVR

Hope that helps.  ~ Jill



__________________

Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
libgirl07


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Can someone tell me the most recent info on this? I've read that it's just dormant until something happens to suppress your immune system.

__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
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