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17 September 2018 at 10:32 am #28554
I have a question that I was gonna ask Dr. James at my appointment but I think it may be relevant to other patients so I’ve decided to ask here. I hope it’s relevant.
On the last day before my last pill I was opening a box and cut myself by accident and I’ve bleed.
I’m not worried about that, but I’ve remembered that I’m really clumsy opening boxes and this was not the first time I’ve cut myself by accident with the same knife.
Right after that my thought was: “Oh great! The last thing I need is to recontaminate myself with the same virus”.
Here’s my question: We know that the hepatitis c virus stays active outside the body for a while. I’ve read a study that the virus was still active up to six weeks on room temperature.
The official guidelines states that patients with hepatitis c shouldn’t share toothbrushes, nail cutters or anything that may be in contact with blood.
If we are now virus free (at least I hope I am), shouldn’t we get rid of this stuff to avoid being contaminated again with traces of our “old blood” containing the virus?
I know people don’t get immune from hepatitis c after they get rid of the virus, but this still applies to the same virus or genotype?
Does that make sense? I hope this question is useful.
17 September 2018 at 12:07 pm #28555Hi John,
There is already a thread on this:
https://fixhepc.com/forum/end-of-treatment-eot/1130-possible-reinfection-route.html#19133
The general consensus seems to be self-reinfection is unlikely, but of course be sensible.
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).17 September 2018 at 2:08 pm #28556Hi John,
As you mention the virus can live for up 2 six weeks outside the body, but for you incident there is no risk because of the timing.
Even if you had cut yourself 6 weeks ago with the same knife your blood would have had no virus and thus there is no chance you could have reinfected either yourself or anyone else.
Undetected = Uninfectious
YMMV
17 September 2018 at 8:28 pm #28557I had no idea that there was an exact topic on this exact same subject and I’ve searched before I posted. Sorry about that.
When my viral load became undetectable, I threw away everything that might have traces of blood on it like razors and toothbrushes but it didn’t occurred to me the knife I open boxes and cut myself from time to time that’s actually a retractable switchblade. What was I thinking? Now it’s gone as well.
So my thinking was correct. If the knife had blood before the 6 weeks when I was detectable the virus would be gone by now and after that that would be no virus to contaminate the blade. Phew…
I think more doctors should mention to their patients the necessity of throwing away personal use stuff, especially woman with all those nail clippers.
Looking foward to out appointment Doctor James. Just waiting for the test results.
Thanks again!
18 September 2018 at 4:17 pm #28558Hi John,
The previous thread was from over 2 years ago, but the search page only offers to search over the last year of posts be default.
It’s a bit of a pity because back then there were lots of good posts from people who were learning about generics and how to access them for the first time. But I suppose it might be too much of a burden for the fixHepC web server to always search over everything, since there are now over 26,000 posts.
BTW, here is another one:
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).19 September 2018 at 9:20 am #28568Hello John and Vororo,
I’ve changed the default to search all of the posts, rather than just the last years.
There is a lot of gold in them there ye olde threads!
YMMV
21 September 2018 at 4:50 pm #28572So, Dr. James (and anyone else with knowledge of the subject):
Louis Pasteur barely missed the guillotine because of his heresy which evolved into modern day immunology. Much like the small pox and polio antibodies that are in my body, so are HCV antibodies generated from the 40 years that the virus was active in my body.
Under basic principles of immunology, does SVR not mean that I am immune from further HCV infection? Or, is this virus different from the many other bugs for which I have been innoculated?
Tiger Fan
1970’s-Bad behavior as a teenager.
2001- Insurance Company denies coverage due to HCV positive
2002- Another HCV positive reading and referral to liver doctor.
2003-Commence Interferon Combination treatment. VL 205,088 after 3 months. Doctor says stop.
2007-VL 1,045,320.
2017-VL 3,121,174.
2.5.18-Commenced generic Epclusa.
3.7.18- VL Undetected!
3.13.18-US Abdomen Complete scan reflects Normal echogenicity with no mass detected. No dilated intrahepatic biliary ducts”.21 September 2018 at 5:34 pm #28573Hi Tigerfan, I believe that anyone cured from Hepatitis C can get re-infected unfortunately, it’s not like Small Pox. I don’t know why a cured patient doesn’t gain immunity, maybe Dr James will shed some light.
Making the world a better place – one patient at a time.
21 September 2018 at 11:53 pm #28574Hi TigerFan, Mar,
Well, Dr James is the real Medical Doctor here, but maybe I can save him some time (he will surely correct me if I am wrong).
When you get infected with HCV, the body recognises the virus as “foreign” and the immune system quickly develops antibodies against it (so an antibody test will reveal the presence of virus, but not how much of it).
But the antibodies are just the first stage in a cascade of responses which should eventually kill the infection before the infection kills you. For HCV, This all works correctly in about 1 out of 4 cases.
The problem is that, unlike many other kinds of infection, for the other 3 out of 4 cases it turns out that the HCV virus is able to hide or “lie low” for long enough that the rest of the immune system calms down before the virus is completely destroyed. But a part of the immune system stays activated, which is why we usually have only a few millions of virus per unit of blood instead of virus goo coming out of our ears, and also why some people have strange but unexplainable symptoms like skin problems etc.
So this all means that if you are re-infected with HCV, you are still stuck with the same half-functional immune response and so you will remain infected until the next treatment.
I am not sure how different genotypes come into the picture here. It must depend on which part of the viral surface that the antibody physically recognises. Probably it will be the exterior viron surface, and so the genotype of the hidden payload inside will not come into play.
Anyway, as far as I know, why this all happens with HCV and not other viruses remains a mystery. In life we are all potentially exposed to several hundred viral pathogens on a daily basis, but we successfully kill most of then stone dead in a few days.
On the other hand there are some anti-HCV vaccines in the development pipeline, so maybe in the near future it will be eventually possible to innoculate against it.
ps. sorry for long answer!
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).22 September 2018 at 9:59 am #28576Vororo is 100% correct.
When you are infected you deploy an immune response. As always this is the production of HCV Antibodies, unfortunately, these antibodies only clear the infection in 25% of patients, and the rest go on the have chronic HCV, despite having antibodies to the disease.
This is the main reason an effective vaccine is unlikely – as a group our innate immune response to HCV is poor and most of us produce weak antibodies that are simply not up to the job.
Getting on to reinfection – the DAAs clear the virus you currently have but, as soon as you stop taking them, they wash out of your system within a week (in terms of being at effective levels) and 6 months in terms of leaving even a single molecule.
So although you will still have antibodies to HCV that is all you have, and we know yours are not good enough to clear an infection so… If you are exposed to HCV again, chance are you will be infected again.
So be good. If you can’t be good be careful!
YMMV
22 September 2018 at 8:34 pm #28577Thanks to all for the responses, which is what I expected–the nature of the HCV virus is something different than bugs for which inoculation is traditionally effective.
(The motive for my question was purely academic— I had no intention of revisiting behaviors which are high risk for contracting the virus on the naïve belief that I was immune).
1970’s-Bad behavior as a teenager.
2001- Insurance Company denies coverage due to HCV positive
2002- Another HCV positive reading and referral to liver doctor.
2003-Commence Interferon Combination treatment. VL 205,088 after 3 months. Doctor says stop.
2007-VL 1,045,320.
2017-VL 3,121,174.
2.5.18-Commenced generic Epclusa.
3.7.18- VL Undetected!
3.13.18-US Abdomen Complete scan reflects Normal echogenicity with no mass detected. No dilated intrahepatic biliary ducts”.23 September 2018 at 7:13 am #28578Wow! I’ve learned a lot with this topic. My question was useful after all!
I’ve threw away everything that could infect me. I’m still mad about the knife accident and had an allergic reaction for some reason 48 hours later, that’s usually a reaction I get when I’m gonna get sick with some virus, like when I got chicken pox when I was little or a flu, so I’m worried. How could I do this at the last pill day?
But at the same time, if the medicine is still effective for a week, perhaps I was protected from a possible infection by the medication?
If I’ve got reinfected, would treatment be the same or would the medication change?
I know he chances of reinfection in my case are almost none because of time frame, but since we’re discussing this subject, I think it would be a good time to ask a couple more questions to learn more about it, so I can make sure I won’t ever get this again.
I don’t know if most people here know how they’ve got infected but I don’t have the slightest clue. No drugs. No blood transfusion. Nothing. This is why I want to learn the most I can.
23 September 2018 at 9:43 am #28579Hi John,
I’ve written you a whole article on it.
https://fixhepc.com/blog/item/114-why-me-why-do-i-have-hepatitis-c.html
YMMV
23 September 2018 at 6:21 pm #28580And there’s absolute no relation between viral load and time of infection? Why some people have 800.000 and other like me had 3.5 million and others much more?
23 September 2018 at 8:34 pm #28581Hello John Smith, I think this thread specifically about the viral load subject may give you good insights https://fixhepc.com/support-forum/fixhepc-admin/1930-viral-load.html#26797
The take away is that viral loads have no impact on cure rates, and strange as it may seem, a high viral load may translate into less damage to the liver.
Making the world a better place – one patient at a time.
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