VIRAL LOAD-INFLAMATION OF THE LIVER

[KATHYLINUS]

Hi
I just came back from the Dr from the ultra sound and the blood work
Ast-200
Alt-219
Genotype 1
viral load-9590000
alpha-fetoprotein-6.7
I am scheduled for a biopsy May 10th
In the meantime what does the viral load mean? He said I had inflamation (inflammation) of the liver. Should I be worried.
Can you help me I am really stressed.
I have Hep c . I was told today my liver is inflamed. What does this all mean? I also would like to know if I am ever going to be able to have back surgery? I was scheduled for the surgery when this all came out. How much is this going to interfere with my ever getting surgery?
Thanks,
Kathy

[Kevin Pho, MD]

I would consider treatment for hepatitis C.  A viral load is a measure of severity of a viral infection - in this case the hepatitis C.  The liver biopsy is done to assess the amount of damage done to the liver.  

Once the biopsy is performed, you physician would be better able to give you appropriate suggestion for treating your hepatitis.  

Once the hepatitis is appropriately dealt with, there should be no reason why back surgery cannot be pursued.  

These questions should be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Kalio1]

I know it is a shock, but it isnt the end of the world even though it feels like it is! You are smart to get that biopsy, that informations is KEY. This is a slow moving virus. you will need to educate yourself about this disease. Millions of people have it and find out quite by accident. Those enzymes are a sign it is buy at work infaming and therefore harming your liver. What did the doctor recommend? Try not to freak out, everything takes so long with this illness it is lots of hurry up and wait so try to think of other things. The more you learn the better off you will be then make a plan and go on with life. Lots of decisions to be made in how you will deal with your illness, there is a lot of information to absorb. if you are going to treat or not has to be an educated decision. Your geno is the hardest genotype to treat and takes the longest, sorry to say but it can be done, it is a good idea to participate in al decisions and understand what it all means.  Unfortunately you have the additional trama of needing that back surgery, so you are left coping with both the pain and this, I feel for you, stay strong. Glad some results are in. Didnt the doc discuss the back surgery issue with you? FOr me, it helped to bring a list of things to ask the doc so I could get my questions answered when I was there, and you will have a lot of questions. Very important to get those biopsy results, that will help you decide what to do.
You might try the  janis7hepc.com site, they have a lot of information that is helpful. Also if you go to the MedHelp home page and click on Hepatitis there is a forum there where you can talk to other people going through the same thing who are quite knowledgable, they are just patients and it isnt a doctor monitored forum but it can be really helpful.I'd say the back surgery is going to be put on hold like the doc told you unless and until your enzymes are normal and normal range for ALT (SGPT) is 3-42 and normal range for AST(SGOT) 0-43. SO you can see yours are pretty high. That is what is preventing the surgery if I remember correctly. My enzymes stayed high until I started treatment but some people DO have those enzymes level out, there are no definate answers and it makes it frustrating.
Your viral load is "medium" by most charts, viral load tells you how concentrated the virus is in your blood at this time. That number can and does fluctuate and isnt really relevant to you until/unless you start treatment.If you drink at all, staying away from all alcohol might bring them down,and you shoudnt drink with hep c, alcohol accelerates the viral growth. adjust your meds so that you are sure they are all liver friendly. Likely it is the hep c that is doing a number on you so that is what you have to deal with and that is probably what is sending your enzymes so high. It sounds like the surgeon won't do the surgery until this is resolved.
SOme people say a variety of supplements have helped their enzymes and others say they have caused them to go up even more, so be careful of ANY remedy you see on the net and be SURE to run it by your doc before you start any home remedies. The last thing you want to do is make them go higher and there is no evidence they can help the virus, which is what is causing the problems. Hep C can cause liver fibrosis and cirrosis so that is why you need the biopsy to determine if you have liver damage now and to determine the level of damage, it could be you have no damage too.
Remember, our livers are regenerative if they aren't too damaged, there are things you can do to halt the damage and even reverse it if you have some, so try not to worry too much.

[KATHYLINUS]

Hi
Thanks for taking the time to respond. The gastro. Dr. is the one who needs to give me clearance for the back surgery so yes that is correct that the surgeon will not perform the back surgery without the clearance. The gastro Doc wanted me to have the biopsy prior to clearance. I understand all the tests have to be done and I am walking around thanks to the epideral but it will wear off soon and I am unable to have anymore until August. I have been clean from anything and everthing including all pain meds since the end of March. i have been just dealing with the pain for any further liver tests. i had my last ast and alt results where the alt-210 and ast-181 so then when i had the results from this one I was expecting a lower since the former 2 I thought went down because of no meds but then this 3rd test came back higher levels alt-219 ast-200. This really threw me. Why they were higher? i do not drink at all by the way.

I was wondering also why before my biopsy next week the Doc also is sending me for a stomach cat scan. I do not know why or if it has something to do with the virus.

Anyway I am a little less stressed today. Thanks for all your help and knowledge.
kath

[KATHYLINUS]

What does genotype 1A mean and how does that effect the liver?
Thks
Kath

[Kalio1]

There are different genotypes of the virus, the most common one in the US is type 1a or 1b. Type 2 or type 3 is supposedly an "easier" virus to kill than type 1. Hep C is a worlwide epidemic and the number one reason for liver transplants in America today.
Your enzymes are rising because the virus is inflaming your liver,the inflammation causes fibrosis and cirrosis, the only way to control them is to stop the virus and the only way to do that is to kill it with treatment. It is great that you arent a drinker but hep c can cause cirrosis all on its own even if you do not drink, unfortunately.
ike the doctor says above, you will have to dea with the hep c before you can do the surgery. You dont want to do it in this situation anyway, it could be ife threatening that is why the surgeon wont touch you, too dangerous to your health. There ARE pain meds you can get that are processed by the kidneys, Vicoprophen is what I use for my back, I have very similar back issues to you. I got hep c during a spinal epidural, scary, eh?
You need to learn about this to ease your fears and also start a list of qquestions to ask the doc. I am just a patient who has educated herself but you must rely on your doctor, you need an open, supportive doc to deal with this. Best is to get one who deals with a ot of Hep C patients because many docs are ignorant about this disease and often give out BAD or incorrect advice ike teling people not to worry about it! It can be a very nasty virus and causes heptoellular cancer in some people, so you have to pay attention to it and deal with it. It can be there a ong time and not cause any trouble in some, in others it rears up and starts casuing problems, like you are having.
Once you get thoe biopsy results you will have a better idea of where you are at, the condition of your liver and make a pan as to how to proceed. This is known as a "silent killer" disease because often you have no symptoms and feel fine and it is silently attacking and damaging your liver and you dont even know it.
It is a lot to absorb and deal with and is very traumatic, try to reaize even if the damage has progressed there are things you can do to repair it and stop the damage. Try not to go crazy thinking this means you are a goner, it doesnt. But it does need to be dealt with and you do need good medical care for this.
Hang in there, try the janis site for good info and explainations about this virus and what to do.
Post again when you get the biopsy results or any time you ned to talk. Try the MedHelp Hepatitis forum for more people to talk to and more info. Until you have your biopsy results, you are in a waiting mode. The waiting is the hardest part!

[Kalio1]

PS. sorry, my L is not cooperating, lots of L's missing in that post.

[KATHYLINUS]

Hi
I was wondering if you knew anything about Milk Thistle. I have heard it is good for the liver. Do you Know?

I was just told by my Gastro Dr. he is clearing me from surgery based on the liver biopsy results from 97 and my recent ultrasound. I am happy about that and I know this is something I need to stay on top of.

Thankyou so much for your quick responses and info. i will check out the sites you suggested.
Thanks
Kath

[Kalio1]

He is? That would scare me, a biopsy from 97 is nearly a decade old and worthless in telling you what is going on now, I can't believe he would do that in light of your enzymes in the 200's, that is far out of normal range. Your high enzymes are a big red flag, those are very high numbers, please get the new biopsy.Normally people with Hep C are suppossed to have biopsies every 3-5 years so you are way overdo as it is. I sure hope the surgeon notices the Gastro did that and didnt get him current info but used a 10 year old biopsy, because if something goes wrong in surgery he will not have current info he needs regarding your health and abiity to take the surgery. If you do get the surgery in spite of the known risks, talk to the surgeon about the risks of doing it with your ALT/AST so far out of whack and using a decade old biopsy.

[BCINDRA]

I WENT TO THE HOSPITAL TODAY TO HAVER MY HIATAL HERNIA FIX AND THE NISSEN FUNDULICATION''''''''''''' AFTER THEY PUT ME ASLEEP THEY TRIED TO MOVE MY LIVER OUT OF THE WAY''' THE DOCTORS SAID EVERYTIME THEY TRIED MY BLOOD PRESSURE DROP VERY VERY LOW AND MY HEART RATE WENT SKY HIGH''''''' THEY ALSO SAID THAT MY LIVER IS ENLARGE'''''' SO WHAT DOES ALL THIS MEAN?? DOES THIS MEAN THEY CANNOT DO MY SURGERY AND WHAT IS MY CHANCES OF THE LIVER ENLARGEMENT BEING CAUSED BY CANCER??  CANCER RUNS IN MY FAMILY AND MY GRANDMOTHER DIED FROM STOMACH CANCER'' I HAVE HAD SEVERE STOMACH PROBLEMS NOT DUE TO DRINKING''''''''I SWELL UP LIKE I AM PREGNANT WHEN I EAT ANYTHING AND MY WEIGHT HAS GONE UP ABOUT 30LBS IN THE LAST 6 MONTHS'''''''' WHAT DOES ALL THIS MEAN?  THANKS BCINDRA