Hep C Discussion Forum

Hey Skewed,

We discussed this a few years back. There has been a lot of research into the possibility that the HCV virus could hide out in tissues not easily accessed by the treatment medications. Studies have proven that adequate perfusion and attention to the individual, as well as things like past treatment, cirrhosis, genotype, etc., are all considered to assure adequate exposure to these virus killing agents. Here’s an article from Lucinda Porter with additional information. You can also find our discussions here. Search “post mortem” using our search function. Mallani and Matt talked about it in length.

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”Unlike HIV, hepatitis C does not form a latent reservoir, so technically if hepatitis C is nondetectable, it should remain that way. One theory as to why it may act otherwise, is that hepatitis C hides out in the lymphatic system. However, a study by Formann and colleagues found that although hepatitis C might be present in certain cells of someone with an SVR, there is no evidence that hepatitis C infection will recur. 

Most of us have heard a story or two of someone who had an SVR, but hepatitis C returned. The likely explanations for this are lab mistakes and reinfection. However, viral load assays are much more sensitive now, so I rarely hear about anyone with an SVR later becoming viremic.“

Treatment and Undetected Viral Loads

I think an individual that fails to clear the virus (active, chronic infection) during treatment or relapses within the 12 week post treatment period of time, then consideration of this could be made. However, I haven’t seen any current evidence of it. If the barrier protected the virus from the (all) larger molecule medications passing through it, that would preclude any chance of ever defeating the virus in the first place. Right? I think it’s another one of those explanations that might apply if Tx failure occurred. Rare in this age of blockbuster DAA’s.