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Post treatment questions: can I drink alcohol, can I be reinfected after clearing virus?

Dear Dr. Chung:

I have 7 weeks remaining out of 48 weeks on Rebetron therapy. I achieved complete response after 12 weeks and this was still the case at 24 weeks. I have good predictors of success, including genotype 3a, biopsy stage 1 grade 1, low-moderate viral load before treatment, alcohol free approx 1 year before treatment. Although non type-1 genotypes are sometimes treated for 24 weeks only, my physician recommended a full 48 weeks of treatment to maximize the potential for success. He is very optimistic for my chances for sustained response. I would value your opinion on some questions about post treatment conditions:

1. If a person achieves sustained response to Rebetron treatment, what is the risk of reinfection?

     Answer from Dr. Chung --The risk of reinfection is the same as for anyone without HCV, that is, past infection does not protect you from future infection. thus, all risk exposures should be curbed.

2. Can a person be reinfected after successful treatment, or is the risk of reinfection less, or greater, than it would be for a person who has never been infected?

     Answer from Dr. Chung -- See above.

3. What are the transmission\contagion risks from a person who has had active HCV and subseqently achieved sustained response to treatment? Assuming complete response, Is it still possible o transmit HCV to another person, post-treatment?

     Answer from Dr. Chung -- It is almost certainly nonexistent, as there is no detectable viremia.

4. Is there any data on sexual transmission and exposure through environmental contact with items such as razors, nail clippers, etc?

     Answer from Dr. Chung -- In those who are sustained responders, again the sexualm household and casual exposure risk is virtually nonexistent.

5. After sustained response, is occasional light social drinking considered hazardous, or does it affect the likelihood of a long term relapse in any way?

     Answer from Dr. Chung -- This depends on the degree of damage on your original liver biopsy. if there was cirrhosis or advanced fibrosis, I would strongly argue against resuming drinking. Thanks very much for your time. RC


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