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I think those studies are old, small, flawed, and don't stack up to larger, more curent data
What do you think about studies, which show that majority of people have replicated HCV many years after achieving SVR, detected by special high-sensitive techniques (for example, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC415836/ , http://cid.oxfordjournals.org/content/43/10/1277.long) ? If I correctly understand, "clearance from HCV" looks like some not well-studied question... We cannot be sure that HCV still alive after SVR in majority of patients. And, from the other side, we cannot be sure that HCV is killed after SVR in majority of patients. Thus, if I correctly understand, "total clearance from HCV after SVR in majoroty of people" is hypothesis (not proven fact) - and we may (or may not) believe in this hypothesis. We cannot exclude that, in future, new more sensitive equipment may be designed and majority of people with SVR (detected by current equipment) may become "hcv carriers", detected by that new very sensitive equipment. Best wishes, Serg.
So far, there isn't enough evidence showing the viability of HCV RNA in these rare, hidden infections. They tend to occur in people with complicated immune conditions. These remote possibilities aren't enough for me to worry about yet, and believe me, if I thought it worth worrying about, I'd be shouting it from the rooftop. People have been talking about this for nearly 20 years, and if it was really a big possibility, we'd likely have more evidence than a remote concern. There is a liver meeting in November - perhaps there will be more data then...
There have been recent studies of people who have cleared the virus through treatment but still have low levels of HCV in liver biopsy samples suggesting the virus doesn't leave the body completely.
Thanks for asking that question - I was concerned that my writing wasn't clear. I meant that if they already had cirrhosis when they underwent treatment.
I love this article. Very informative. Thank you so much.
Linda, if I understood your post correctly Hep C virus can be cured with the new DAA treatments available today in some cases. Whatever damage the virus has done to the liver may or may not be reversible. Will you please elaborate on the last paragraph regarding dormancy please. "The word dormant is confusing. News stories report that hep C lies dormant for years, and then suddenly people find themselves with cirrhosis. This isn't really what happens. The virus isn't dormant, it is just that the liver doesn't complain, while hep C is slowly causing fibrosis. The disease may appear to be dormant, but the actual virus is not." I'm not sure if I quite understand it. How would a person cured of hep C develop into cirrhosis of the liver if they did not have cirrhosis of the liver at time the of cure after DAA treatment?
Seymour Akshun
I've heard well supposedly well informed people still asking the question about what constitutes a cure. This annoys me a lot. It is often difficult for people who are cured after a lifetime with hep C to accept that that they no longer have the virus. We don't need to add to that difficulty by questioning the best advice of clinical experts that SVR means cured.
October 19, 2015