TOPIC:

Serg wrote:

"I can be positive with TTW or hepatitis G viruses by PCR test, for example. But this does not mean that i have a "disease", because such viruses will not cause symptoms for me (like cirrhosis). Analogically, if HCV will not cause symptoms for me - what is the reason to define such situation as a "disease"? Of course, for such proportion of patients, who will develop cirrhosis/extrahepatic manifestations during lifetime - HCV is a disease. But many infected people will not develop symptoms."


The circular logic of this argument is counterproductive.

Serg, If you don't believe you have a disease, may I ask what benefit or purpose there is to your participation here?

Your argument seems to be that the only rationale for treatment, or credible indicator of 'disease' would be if one is actually dying of cirrhosis - which is exactly the operative assumption of Big Phama and Big Insurance for denying treatment to Hep C patients until one is by their definition "sick enough".

Frankly, if I were Big Pharma/Big Insurance, your argument would be precisely the one I would be making.

virus C (GBV-C), formerly known as hepatitis G virus (HGV) and also known as HPgV is a virus in the Flaviviridae family and a member of the Pegivirus genus,[1] is known to infect humans, but is not known to cause human disease

en.m.wikipedia.org/wiki/GB_virus_C

It appears that HGV is a benign blood borne virus, at any one time our bodies are host to zillions of such viral/bacterial/fungal life forms. The fact that it has (had) a name similar to several diseases does not make it one.

Serg

"Analogically, if HCV will may not cause noticeable symptoms for me - what is the reason to define such situation as a "disease"?"

I have amended your statement/question above to reflect the reality that while chronic HCV is a slow acting disease that doesn't always cause obvious damage, it is still having some sort of impact on the body. LFTs within nominal range that drop on treatment is evidence of that.

Errr....Google says that TTW is a computer game that can get infected with the SHuer3 virus??? (Take one subscription to Norton annually. )

Serg, If you don't believe you have a disease, may I ask what benefit or purpose there is to your participation here?

fitz, I have F4 (cirrhosis) - hence, i definitely have a disease.

Your argument seems to be that the only rationale for treatment, or credible indicator of 'disease' would be if one is actually dying of cirrhosis - which is exactly the operative assumption of Big Phama and Big Insurance for denying treatment to Hep C patients until one is by their definition "sick enough".

No, i dont think this way. If treatment is "prophylaxis" of cirrhosis/extrahepatic manifestations - people should have full rights to prevent cirrhosis/extrahepatic manifestations - whether they are sick or not.

Rather, semantics of "hcv is a disease in every infected", "everyone must undergo treatment", and "achieve a cure" may be promoted by Big Pharma for maximizing their profit. If we can convince infected people that they are all "sick" - it is much simple to sell him medication with huge prices, than sell prophylactic drugs to healthy people.

Gaj wrote: Errr....Google says that TTW is a computer game that can get infected with the SHuer3 virus??? (Take one subscription to Norton annually. )

Oh, i am sorry for error - of course, TTV virus, not TTW.

Gaj wrote: LFTs within nominal range that drop on treatment is evidence of that.

If i correctly understand, LFTs and PCR are signs, not symptoms. A quote about such things (really, i dont agree with all statements of this relatively old article):

let us consider the difference between signs and symptoms. Signs are typically abnormal blood tests; these are the tests that doctors order to monitor patients. Some signs measure the degree of inflammation (such as enzymes called aminotransferases, known by patients as “ALT” or “AST”). While the ALT or AST test is often called a “liver function test”, it really does not measure any function that the liver performs, but simply assesses the presence of liver cell damage. It is more appropriately denoted as a “liver enzyme test”. The other test (sign) that we need to consider is the one that measures the number of hepatitis C particles that are present in the blood (known as “viral load” or “viral titer”). Traditionally, the success of treatment has been measured by the absence of detectable viral particles in the blood at least six months after the therapy has been stopped. This prolonged clearance of virus from the blood stream is known as a “sustained viral response” or SVR.
Symptoms are the things that affect the quality and quantity of life; it is the development of symptoms that concerns patients. Symptoms of liver failure include internal bleeding from dilated veins (called varices), excessive fluid accumulation in the legs (called edema) and abdomen (called ascites), and slowing down of thinking with confusion and even coma (called hepatic encephalopathy). Another symptomatic complication of cirrhosis is the development of hepatocellular carcinoma.
The point is that if only the enzyme tests remain abnormal, and symptoms of liver failure never occur, there is no clinical “dis-ease”. Treatment is irrelevant because it is impossible to make an asymptomatic patient feel better and, at the time of treatment, patients do not have symptoms of end-stage liver disease.

(www.news-medical.net/health/Hepatitis-C-...d-possible-harm.aspx)

Serg wrote:

Serg, If you don't believe you have a disease, may I ask what benefit or purpose there is to your participation here?

fitz, I have F4 (cirrhosis) - hence, i definitely have a disease.

Rather, semantics of "hcv is a disease in every infected", "everyone must undergo treatment", and "achieve a cure" may be promoted by Big Pharma for maximizing their profit. If we can convince infected people that they are all "sick" - it is much simple to sell him medication with huge prices, than sell prophylactic drugs to healthy people.

Thanks to all involved for moving on with the discussion.

Content redacted.

Getting treated for HCV is a vey individual decision / choice, no matter if it is with DAAs, IF+RIB or any other mixture of substances one may identify as possible cure.

So, it is up to everyone to decide in what extent they want to research it and make the own opinion.

Me personally I am curious to know how the fibrosis may be reduced without treatment .

Gaj wrote: Both the studies you list in the above quote are from 2004 and well prior to the development of modern DAAs such as Sofosbuvir, Ledipasvir, Daclatasvir, etc, etc. If you are going to cite studies to try to support your claims about the modern DAAs you need to provide more current information.

Here's a current one....

HCV RNA Persists in Liver Explants of Most Patients Awaiting Liver Transplantation Treated With an Interferon-Free Regimen.

www.ncbi.nlm.nih.gov/m/pubmed/27373513/#

P.

Serg, I also think that you need to take into consideration whether you treated and failed treatment previously because studies have shown that may impact their health in the future.

P.

fitz, I did not wrote that "Big Pharma dispenses treatment to everyone", please do not ascribe to me such thoughts. I will skip some your "ad hominem" arguments, but i agree that these discussed things about "semantics" may seems like some "offtopic" there... And, anyway, we cannot change current "semantic" in this area.

Best wishes,
Serg

Price wrote: Serg, I also think that you need to take into consideration whether you treated and failed treatment previously because studies have shown that may impact their health in the future.

Yes, of course.

Thanks Price, very new article.

Although not able to access the full article yet, I see that 85% of them went on to acheive SVR after they had their liver transplant so presumably they became undetected? I wonder if having a compromised immune system prior to transplant was preventing them from clearing the stragglers that the DAAs hadn't affected?

Full article is available via sci-hub: dx.doi.org.sci-hub.cc/10.1053/j.gastro.2016.06.025