Welcome, Guest
Username: Password: Remember me

TOPIC: To treat or not to treat: Acute HCV mono-infection

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13431

  • Looking4Help
  • Looking4Help's Avatar
  • Offline
  • New Member
  • Posts: 2
  • Thank you received: 6
  • Karma: 0
Hi All,
Have been lurking on here for about two weeks and wanted to seek some advice or opinions from this great community.

First, let me start at the begining.

I fell ill on 15 Feb 2016. I was working in West Africa at the time and so at first I thought it was something I had eaten. My symptoms came on very strong: Body aches, lethargy, mild fever, anorexia, bloating and lower abdominal cramping, nausea and vomiting. Towards the end of that week, Friday the 19th, I was appearing noticeably jaundiced.
As it happened, I was due to wrap up my job there and travel to the US for a conference. I got on the plane on the 19th and promptly went to an ER in NYC and was admitted.
I was discharged on the 24th of Feb with a diagnosis of Acute Hepatitis C and after a few days returned to my home in South America.
Here is a table I put together to show the progression of my hepatic function. As it so happened, I had been tested for HCV on October 30th of 2015, and was negative, and so it is clear than I was exposed to the virus around December / January timeframe. My exposure came from a stupid (and obviously very regrettable) mistake in my sex life during a difficult period (PTSD sufferer). Fortunately, I was not infected with HIV or any other STIs.
Since returning home, I have had some ups and downs with symptoms, fine for a few days, and then headaches, abdominal pain and then feel better (I am currently battling a chest cold which doesn’t help!). I have been eating very cleanly and have not had a drop of alcohol (never was much of a drinker anyway).
With my Fibroscan and latest hepatic panel complete, I went to see my infectologist today. After reviewing my latest results, his advice was that I NOT pursue Tx at this time. He said given my results I may be heading for spontaneous clearing, as suggested by a number of factors: 1) The fact that I had such a pronounced and robust immune response 2) That my LTFs are dropping steadily 3) That this was a mono-infection (no HIV) and 4) Mv viral load of 5685 was, all things considered, relatively low. He also added that there are no studies that he was aware of for treating acute HCV mono-infection (noting that there are studies on treating acute HCV co-infection with HIV)
I was ready to enroll in one of the trials or otherwise seek access to generic Harvoni. His advice was to wait, and that the best option would be for me to spontaneously clear the virus. As he put it, don’t pull out the big guns (Harvoni) yet, until you need them. Your body is battling this virus on its own and let’s see if in fact reinforcements are needed. On the one hand, I totally agree with him. It would certainly save me money, and also save me having to take a daily pill for a few months that may not agree with my system. On the other hand, I like to deal with things as they come up, and aren’t I letting HCV wreak havoc on my liver (and my emotional state) with every day that passes? I have events coming up in the next few months where I would like to have an alcoholic drink or two.
This is where I would like the advice of the Experts here. I totally trust my doctor and am not going against his advice. He said he was optimistic about me spontaneous clearing, but I guess I am just interested to hear what other think. He wants to see me in a month to check LTF and Viral Load (at which point he said, if things look like they haven’t improved, or not significantly, we can talk about Tx) I guess I am mostly curious.
1. Are there any studies out there on treating acute HCV Gen1 mono-infection with Harvoni?
2. Is there any benefit from spontaneously clearing vs. clearing through treatment? (I understand that if you spontaneously clear Hep A and Hep B, you are essentially immune to future exposure, but that is not the case with HCV re-infection, even the same genotype?)
3. Aside from taking care of myself, eating well and sleeping well etc, is there anything that I can do to increase my chances of spontaneously clearing the virus?
4. ]Any other thoughts etc?


My thanks in advance to you all.

Last Edit: 2 years 8 months ago by Looking4Help. Reason: typo
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13432

  • Vororo
  • Vororo's Avatar
  • Offline
  • Platinum Member
  • Posts: 334
  • Thank you received: 1047
  • Karma: 15
Hi Looking4Help,

Thank you for posting! What a story! I have never seen ALT/AST numbers like those before. Are you still alive to read this? ;)

Nearly everyone on this site has chronique Hep-C, not acute Hep-C.

Correction... Many of the people on this site USED TO HAVE chronique Hep-C. Now more and more are being cured with generic DAAs (Sof+Dac or Sof+Led), with very few side effects (me included - and absolutely no sides).

Before the days of DAAs, the usual advice was "wait and see". But this was mainly because the classic Interferon+ribavarin treatment was expensive, horrible for many, and had only a moderate success rate.

Maybe you will clear the virus naturally... But you will only know that in 6 to 9 months time. Why wait and suffer? My advice is find out what your genotype is, get a sympathetic Dr to write a prescription, and order your generic treatment right now. There is lots of advice on here on how to do it. Most people on this site report VL < 15 or even UND after around 4 weeks. You can do it all on-line for about $1000, more or less, from a reputable source (again, check out the various threads about this).

Cheers,
Diagnosed Jan 2015: GT3, A0+F0/F1. Fatigue + Brain-Fog.
Started Sof+Dac from fixHepC 10-Nov-2015. NO sides.
Pre-Tx: AST 82, ALT 133, Viral Load 1 900 000.
Week4: AST 47, ALT 58. VL < 15 (unquantifiable).
Week12 (EOT): AST 30, ALT 26, VL UND
Week16 (EOT+4): AST 32, ALT 28, GGT 24, VL UND
Week28 (EOT+16): AST 26, ALT 22, GGT 24, VL UND
Ever grateful to Dr James.

Relapsed somewhere after all that... Bummer!

Jan 2018: VL 63 000 (still GT3).
The administrator has disabled public write access.
The following user(s) said Thank You: Looking4Help

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13434

  • Gaj
  • Gaj's Avatar
  • Offline
  • Moderator
  • Optimist :-)
  • Posts: 1436
  • Thank you received: 3084
  • Karma: 31
I had read that ALT/AST could reach several thousand in acute infections but never seen an example previously. :blink: The good news is that your LFT now all seem to be tracking downwards and your VL is currently low. :)

Clearance of Hep C of any genotype by any means does not appear to confer immunity due to the HCV virus' ready ability to mutate allowing it to avoid your immune system.

Chronic HCV tends to be a slow acting and seemingly benign disease as seen by the number of us who did not become aware of infection until decades later. Having said that, it is causing damage the whole time you are infected so I would advise that earlier treatment of the chronic form is preferable to waiting but I'm not sure how well that translates to acute infection.

Below are the current AADSL/IDSA recommendations regarding Management of Acute HCV Infection.

www.hcvguidelines.org/full-report/manage...-acute-hcv-infection
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 2 years 8 months ago by Gaj.
The administrator has disabled public write access.
The following user(s) said Thank You: Looking4Help

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13436

  • DrJames
  • DrJames's Avatar
  • Offline
  • Platinum Member
  • Posts: 1691
  • Thank you received: 6328
  • Karma: 98
You have a 25% chance of clearing virus yourself in the next 6 months and you are past the worst.

With medication you have a 95%+ chance and you will be virus free within about 4 weeks and you only need 8 weeks treatment.

It's your choice. Waiting won't kill you but you can get better sooner and chances are you WILL have to treat.
YMMV
The administrator has disabled public write access.
The following user(s) said Thank You: Looking4Help

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13470

  • Price
  • Price's Avatar
  • Offline
  • Elite Member
  • Posts: 237
  • Thank you received: 343
  • Karma: -5
Looking4Help wrote:
3. Aside from taking care of myself, eating well and sleeping well etc, is there anything that I can do to increase my chances of spontaneously clearing the virus?
4. ]Any other thoughts etc?

Since sustained hyperresponsiveness of dendritic cells is associated with spontaneous resolution of acute hepatitis C, then I'm going to say a good option would be pre/probiotics.

www.ncbi.nlm.nih.gov/pubmed/?term=Sustai...of+Acute+Hepatitis+C

Since HCV core protein is a pro-inflammatory TLR2 ligand; (this allows the immune system to recognise the virus and respond appropriately.) Chronic infection means that the virus has managed to subvert these responses. So supplying TLR2 ligands may be a way of switching back on the responses the virus has managed to subvert. So I'm going to say...spirulina. 4 out of 30 patients cleared the virus with spirulina in this trial

www.biomedcentral.com/1471-230X/12/32

And since hep c is glucose dependent, a low carb diet can also help.

P.
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13483

  • A.L.
  • A.L.'s Avatar
  • Offline
  • Senior Member
  • Posts: 67
  • Thank you received: 29
  • Karma: -13
Price wrote:
Looking4Help wrote:
3. Aside from taking care of myself, eating well and sleeping well etc, is there anything that I can do to increase my chances of spontaneously clearing the virus?
4. ]Any other thoughts etc?

Since sustained hyperresponsiveness of dendritic cells is associated with spontaneous resolution of acute hepatitis C, then I'm going to say a good option would be pre/probiotics.

www.ncbi.nlm.nih.gov/pubmed/?term=Sustai...of+Acute+Hepatitis+C

Since HCV core protein is a pro-inflammatory TLR2 ligand; (this allows the immune system to recognise the virus and respond appropriately.) Chronic infection means that the virus has managed to subvert these responses. So supplying TLR2 ligands may be a way of switching back on the responses the virus has managed to subvert. So I'm going to say...spirulina. 4 out of 30 patients cleared the virus with spirulina in this trial

www.biomedcentral.com/1471-230X/12/32

And since hep c is glucose dependent, a low carb diet can also help.

P.

Price, You clearly don't have a clue of what you are talking about – no informed person would quote such specific details from isolated papers chosen out of context and use that information to give treatment advice.

Your behaviour is ignorant and deceptive. Fortunately in this case, your directions are essentially harmless (apart from the spurious low-carb recommendation), but I sincerely recommend staying away from playing the expert on medical topics of which you know less than nothing.

You could hurt someone one day.
G4, F4, cirrhosis.

Thank you to Gilead, Michael Sofia, and the terrific folk at FixHepC for making this adventure possible.

YEAR..... ALT..... AST..... GGT... FERRITIN........................................
2009....... 210..... 215..... 953..... 1400........... (Bad health, stupidity)
2015....... 60....... 45....... 150..... 360............. (Improved diet and health, FixHepC treatment)
2016....... 20....... 24....... 25....... 156............. (SVR 12)
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13485

  • Price
  • Price's Avatar
  • Offline
  • Elite Member
  • Posts: 237
  • Thank you received: 343
  • Karma: -5
Actually Al, Dr Robert Gish, one of the top hepatologists in the US thinks it's a great answer and so do the docs at Research Gate where we had the same discussion and since I spent 2 years studying this subject as well as pre/probiotics, I can quote papers until the cows come home. It's not my fault you only understand Kincaid 8.

If you want to challenge what I say you may try quoting a few papers yourself because your answers are always the same and they are BORING nonsense. It's going to take more than one little troll to prove me wrong, I can tell you that.

"The potential use of Toll-like receptor agonists to restore the dysfunctional immunity induced by hepatitis C virus"

www.sciencedirect.com/science/article/pii/S000887491000064X

Price
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13615

  • sabrecat
  • sabrecat's Avatar
  • Offline
  • Elite Member
  • Posts: 255
  • Thank you received: 719
  • Karma: 9
Hi Price,

"And since hep c is glucose dependent, a low carb diet can also help".

I am into 5 months of Sof/Dac: at EOT, is it worth steering clear of too much sugar in my (occasional) coffee?

Just saw a post on a relapse an starting again yesterday and want to give my my body the best chance of getting rid of any stragglers that are left post treatment.

J.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
Last Edit: 2 years 8 months ago by sabrecat. Reason: editing
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13747

  • Price
  • Price's Avatar
  • Offline
  • Elite Member
  • Posts: 237
  • Thank you received: 343
  • Karma: -5
Sure but it also depends on what else you're eating.
The administrator has disabled public write access.

To treat or not to treat: Acute HCV mono-infection 2 years 8 months ago #13820

  • sabrecat
  • sabrecat's Avatar
  • Offline
  • Elite Member
  • Posts: 255
  • Thank you received: 719
  • Karma: 9
Price wrote:
Sure but it also depends on what else you're eating.

Thanks Price,

a timely reminder for me as over the now 23 weeks of treatment my new found energy found me eating things I would know to steer clear of - and hence a suspension in weight loss. Now back on the straight and narrow food wise.


Yours


J
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
The administrator has disabled public write access.
Time to create page: 0.130 seconds

Copyright © 2015-2017 FixHepC

Back to Top