What’s the news on reactivation of HCV after SVR?


downloadThe VA has stopped testing my husband for any possible HCV viral load because he attained SVR after treatment (in private health care) almost ten years ago.   He’s considered (99%-100%) cured. His private gastroenterologist still tests him. Here’s one definition of SVR:

Sustained virologic response (SVR) is defined as aviremia 24 weeks after completion of antiviral therapy for chronic hepatitis C virus (HCV) infection. In analyses of SVR durability, the incidence of late relapse weeks after completion of antiviral therapy for chronic hepatitis C virus (HCV) infection. In analyses of SVR durability, the incidence of late relapse is extremely low (<1%). 

Can we relax now?  After all, treatment ended with excellent clinical results.  Should the VA spend any more money on these lab tests? Can’t we just deal with the lousy aftereffects of HCV and stop worrying about the virus reactivating?  The answer is NO! Besides the fact that one can be reinfected with a new HCV virus (because there is no immunity to it), it appears HCV can be reactivated if you get sick with other illnesses like cancers and/or HIV.

Here’s one recent (May 30, 2014) headline:

Hepatitis C Reactivation Does Not Worsen Survival Outcomes for HIV+ Patients Diagnosed with Lymphoma 

Two headlines from PubMed:

Reactivation of hepatitis viruses following immunomodulating systemic chemotherapy.

Reactivation of hepatitis B virus and hepatitis C virus in patients with cancer

HIV/HCV research is in a flux.  The VA/DoD/CDC and public health officials are still not transparent when it comes to HCV.   We have to be our own best friends when it comes to testing because as SVR boomers become ill with age-related diseases like cancers, HCV can rear its ugly head again and a worse nightmare begins anew.be-your-own-best-friend1

 

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11 Responses to What’s the news on reactivation of HCV after SVR?

  1. HarryVet says:

    Official Title:A Phase 4, Multicenter, Open Label Study to Investigate the Efficacy and Safety of an All Oral Combination of Sofosbuvir+Ribavirin in Genotype 2 HCV-infected U.S. Veterans With Cirrhosis VALOR-HCV: Veterans Affairs alL Oral Regimen of SOF+RBV in GT2 HCV

    https://clinicaltrials.gov/ct2/show/NCT02128542

    Sponsor: Gilead Sciences
    First received: April 29, 2014
    Last updated: June 9, 2014

    Locations United States various VA Medical Centers only a few are recruiting with more not yet recruiting.

    If you are enrolled in VA health benefits and have HCV GT2 F4 Cirrhosis plus other inclusion criteria listed with no exclusion criteria like Decompensated liver or others listed
    Go to the link and review the Eligibility and location state and city. If you live in or near one of the cities listed and interested, contact your VA HCV provider about getting into this trial

    I am a Vet and currently have the same conditions. I was the only GT2 in the second group of 10 to start tx at my VA medical center (not a trial) Have 2 weeks left in my 12 week tx My only real side effect has been more fatigue

  2. david j murphy says:

    to keidove, please no insult intended. Most of the time the partners get more stress than the vet. My wife nearly had a breakdown pre transplant Best of luck with your battle, sounds like they made some procedural errors in his claim. I am fighting a similar battle with them on two appeals. NOD has been a goldmine in learning how to beat them with their own regs.

  3. hepper74 says:

    Mark: The damage that this disease does to the body is not always the same but the bottom line is that if you have residuals from it, ie DMII, thyroid cancer, neuropathy they are not going to try, at least to my knowledge, going to come back and try to down grade you. But then again who knows for sure what the VA might have up its proverbial sleeve.

  4. Kiedove says:

    Which other cancers did your VA doc want you to get screened for? My husband had his gallbladder out because scans were troubling to private gastro Dr. given his HCV history. This was about a year ago. But no cancer thank God.

  5. david j murphy says:

    To kiedove, are they trying to reduce your husbands bennies as a result of SVR. Also had no idea you were a spouse, thought you were a vet. No insult, just a brain fart on my part

    • Kiedove says:

      Gee, I write like a man! The VA denied him hcv residuals without affording him a C&P exam. We will appeal. He won some other issues. But his VA doc says he doesn’t have DMII. We are going to file a new claim for that even though it’s under control.

      .

  6. mark says:

    On the NEW Treatment, I read the insert, and it says 3 months after treatment,SVR is a success, no studies after that, so what are they saying? Sovaldi, , may be Not a cure? I have been on treatment 2 months and all My problems are getting worse, Toes started to go Num, pounding Heart beat, Very Fatigue, and I am Not on the Bug Juice, just Sovaldi and Ribavirn, I wonder what the long term problems I will have after this 3 time around after all is said and done?

    • Kiedove says:

      Keep us posted on your health. You’re a pioneer so to speak. You may have new problems but your lifespan will be expanded.

      • mark says:

        I will keep everybody posted, Just got back from my normal Doc, and He thinks its all treatment, the good NEWS, Viral load was 3.5 million NOW .15 I did not know they could go that low, ast, 30
        alt 36 lowest in 30 years, so the stuff works, they want me to stay on treatment for 48 weeks, If I took the Bug Juice it would be much shorter, but the IN would Kill me, last time I came up with Major Depression, DM2, and many other problems, this time its 10 pounds of weight loss, chronic fatigue, I will let every one know what else happens, I have been on treatment 7 weeks.

  7. hepper74 says:

    Good information albeit a downer, lol. Since there are several types of cancer related to the HCV then reinfection it is not too far beyond the realm of possibility. The HCV cost me a thyroid but I kicked back and hopeful that it stays out of the system. I actually had a VA doctor advise me to force yearly inspections for several of the related cancers. Blew me away. I have had good results in Denver with the hospital and staff but the RO is ………………….. Loss for words.

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