Had Hep C for 5+ years and *MAY* have cleared it without treatment? Possible?

[GCheetah88]

Hey, everyone.  First time on this forum.  Not sure if this topic has ever been discussed before.  I admittedly didn't search because I didn't know what to search for without typing an entire sentence.  Google searches haven't turned anything up, either.

So I tested positive for the antibody back in late 2012, and I probably contracted the virus that same year (in rehab, of all places).  I have been using IV drugs on and off since well before then and have not been insured since that year, so doctor visits and health have been a "non-issue" for quite some time.

Now that I'm in recovery, I'm actually taking my health seriously.  I had my first appointment with digestive health a few weeks ago and had some more blood work done.  Back in October, my viral load was 12,400 iu/mL, log 4.09.  At last check, my viral load was so low they can't even genotype the virus to determine treatment!  "<1.50E+1 iu/mL, log <1.18.

What's more, my doctor called me as soon as the bloodwork came back and said that it looks like my body may be ridding itself of the virus on its own.  Now, I know this is not an uncommon occurrence--figures estimate anywhere from 10-30% of people clear it, depending on what study you're looking at.  But has anyone ever heard of it happening 5+ years after infection?  It generally happens within 6-18 months, and I can't find any actual data or experience about it occurring any later than that period.

I'm trying not to get my hopes up about this.  Any experience or knowledge would be much appreciated.  Thanks!

[Mugwump]

Most likely the specialists are just as unsure as we are when it comes to when and if some people will go on to clear the virus on their own. My guess would be if you have not reached a chronic infection stage where consistent viral loads are in the millions then your chances of clearing on your own are much better. Much is not know about the frequency of clearance and which genotypes clear more frequently naturally. The reasons for this are obvious, for one most who are recently infected are not caught early on during an infection the way you were. Also most who are diagnosed have been infected much longer and are at a chronic stage of infection even before the diagnosis is made.

All the best clearing this as soon as you can, but even if you do wind up not clearing the treatments are certainly light years ahead of what they were just a few years ago. I do believe that the treatment costs will drop because there is mounting pressure on governments to treat this disease early instead of waiting until there is liver damage. Many in the medical community are becoming vocal about how stupid not treating this disease as soon as it is diagnosed really is. So there is pressure to develop treatments for those who are not yet at a chronic level of infection.

The more of us that write to our respective political representatives stating the financial case for not waiting until this disease costs the economy even more, the better the chances are that they will wake up to the fact that not treating the disease immediately is going to be a huge burden upon the economy. We put men on the moon surely we can now eradicate HCV the same way we did polio if there is enough pressure put on politicians to make this an issue.

Eric

[Jorah]

I know of a person in your similar conditions that has also cleared it with no meds.

[GCheetah88]

UPDATE:

3 months later and the results are the same...so I haven't cleared the virus but it also can't even be treated because they can't fucking genotype it!  WTF?!  My fibroscan was rated 3 out of 4, more than enough to qualify for treatment. Can the virus still do damage at such low levels?

[Mugwump]

UPDATE:

3 months later and the results are the same...so I haven't cleared the virus but it also can't even be treated because they can't fucking genotype it!  WTF?!  My fibroscan was rated 3 out of 4, more than enough to qualify for treatment. Can the virus still do damage at such low levels?

The problem with fibroscans is that they are not accurate at determining pre-cirrhosis levels 1-3 but are fairly accurate if you have cirrhosis. All that might have happened is a stiffening of the liver if you ate something too soon prior to the exam. I am almost willing to bet that if you fasted for 2 days prior to another scan that your reading would be lower. The most important tests to do right now and every 6 months is the liver function tests, if your infection goes on to become chronic these tests will more accurately indicate that the virus is doing damage.

If you do eventually have a genotype test then most likely your level of infection will have become chronic. There are many who never reach a chronic infection stage with viral loads levels high enough to do serious damage.

This is the problem with HCV, for very many years a great many people donated blood with the blood banks having no way of knowing that the donated blood was infected, thus spreading the disease.

So essentially all it means is that you cannot donate blood, not that you will eventually develop cirrhosis or go on to become chronically infected.

It does change things for you in the sense that you now have the responsibility to inform your partners that you have an infection and to take sensible precautions against spreading the disease. For me it was telling my wife about my infection. She is not infected nor are my children. Although I have had to feel most of my adult like a pyrrhia and contend with the knowledge that I carry the disease, and that there was the possibility that my blood could infect others, to the best of my knowledge and my great fortune as well as emotional well being, this consequence of HCV infection never happened.

I am sure that Lynn and moderators here can chime in and say more about this, but again it is absolutely essential that you do not let HCV rule your every day and thus become a disease of the spirit as it can do for many who let it become more than just a viral infection.

All my best wishes
Eric

[KimInTheForest]

Hi GCheetah. Do your tests results also say on them somewhere: "HCV RNA detected"?

Mine said that when I reached your level (during treatment). They said, in Canadian units but the same as your reading:

"HCV RNA <15 IU/mL   HCV RNA detected"

Different labs report differently. If the lab has not come right out and said "HCV RNA detected" I am wondering if in fact there is no virus left and the "<1.5" is the way your lab says undetected? Especially after 3 months of the SAME reading. Because HCV is (theoretically) continuously replicating in the body if it is alive. It doesn't have an inactive state. So, theoretically, if there was even one live virion remaining 3 months ago, there would be many more now.

kim

[GCheetah88]

I'm just worried because I've read that a high viral load doesn't necessarily mean the virus is "fully" active, nor does a low load mean it's not causing damage.  I did have a *very small* amount of coffee the morning of the fibroscan, so that may well have played a part, but still...I've done a lot of damage to my liver through using drugs and alcohol, no telling what the virus has been able to do on top of that in 5-6 years.

And no, the results don't say specifically that it's detected, but it gives the "baseline" or "normal" reading for every test result next to your actual results, and if it were undetected it would specifically say "target undetected."

[Lynn K]

Yes agree with Kim what exactly does your viral test say? Are the words either "Detected" or "Not Detected" on the report? But yes if you do have a viral load then yes you are likely still infected. As far as I know the definition of chronic infection is being infected with hep c for more than 6 months that if you haven't fought it off within that time you will need treatment. So even though your immune system is putting up a hell of a fight looks like you will need to be treated to cure your infection.

There are a couple of the meds that are effective on multiple genotypes and the most common genotype in the US is genotype 1 so they could consider a pan genotype Ned or just assume you have GT 1 but that would be up to your hepatologist.

Seeing that your case is a bit unusual I hope you are seeing a specialist for the best possible advice.

As far as liver damage only about 20% of patients infected for 20 years time will develop cirrhosis. Hep c is a very slowly acting virus. And while hep c is not considered to be an STD by the CDC there is a small risk of transmission but primarily this is more likely for those with multiple sex partners, those who engage in rough sex practices, and in the presence of HIV. I can't recall anyone from these forums who had hep c and their long term partner had become infected from them. There are many who have been in long term monogamous relationships where one partner has hep c and the other does not. In fact, the US CDC does not recommend to such couples the need to use barrier protection.

This does not relieve you of the responsibility of having a frank discussion with your partner.

Fibroscan is less accurate in mid range results the gold standard of liver damage is needle biopsy. I would not worry too much about the Fibroscan results. In fact they could be helpful in qualifying more easily for treatment.

Wishing you the best

[GCheetah88]

Thanks for all the replies.  I'm probably just being paranoid, I'll hear back from my doc soon.  The lab results just came up online and he's out of town for a few more days.  I'm only 28, always had a great immune system, and now that I'm clean I live a relatively active and healthy lifestyle, despite junk food binges and a tendency to overeat.  So I should be good for quite some time until we can get this all figured out.

[Lynn K]

Hi I posted while you were posting so to respond to your additional comments.

The virus never sleeps it is never anything other than fully active. It is a very slowly acting virus taking decades for most to cause damage although drinking alcohol with hep c is said to be like throwing gasoline on a fire.

Viral load and liver enzyme test results do not relate to severity of liver damage.

People can have very high viral load and no damage or very low viral loads and possibly have damage.  Most people infected with hepatitis C will have only slightly elevated liver enzyme test results.

I was infected for 37 years before I was cured. Before I was cured I was diagnosed by liver biopsy with cirrhosis in Jan 2008 after being infected for 30 years. I wasn't a super heavy drinker but I did drink more than perhaps I should have over my many years of infection and it still took 30 years to become cirrhosis.

Even having cirrhosis is not a death sentence with cure of hep c and time many people have had improvement in liver function. I haven't had any improvement so far but I am still going strong even with having cirrhosis now for more than 9 years.

For people with less liver damage (below F2) after cure can go on living life as though they were never infected per the  American Association for the Study of Liver Diseases (AASLD)

Hang in there you will be cured

[Lynn K]

Ok I keep bumping heads with you posting while I am typing

best of luck let us know how it works out