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what is signal to cutoff regarding hep c? what does it affect?
my fiancé recently had a reactive (positive) HCV screening. his doctor ordered another set of lab work which only contained the s/co (signal to cut-off ratio).we're not professionals, we're not sure exactly what this refers to, or how the number relates to his illness. his signal to cut-off ratio was 31.90, also had high alt protein levels. waiting to see a liver specialist, but can anyone help us with what any of this means?
i know this lab result site doesn't load the full results, and the doctor said the second work up was to establish the exact the he had before he sent him to a specialist. so i'm guessing he should probably just give the doctor's office a call and see if they will tell him the genotype so we can do some treatment research before his gastro appt. what is standard for gastro doctors? just lots of tests? we have to travel an hour away to see the specialist, will we have to make trips to them for his treatments or will they just transfer the prescriptions and let us do it from our hometown with our family doctor?
From reading your second post it sounds like for some reason he redone the antibody test and both show he is at least positive for the antibodies. When I said, " I am guessing it showed that he had one since he is sending him to a liver doctor". I was meaning that the second test was a PCR and showed he had a viral load but that does not seem to be the case... Nothing to do with genotype. Hang in there.
The HVC RNA panel is looking for the presemce of the actual virus in the blood stream. Showing positive for the antibody only means at one point the patient was exposed to Hep C but about 25% of patients clear the virus on their own the rest go on to be chronic carriers. Those patients will test positive on th eHCV RNA test and have a viral load. The test will also give you the genotype of hep c i.e 1a, 1b, 2a, 2b etc. If my memory serves correct I think there are 16 or so genotypes in all.
A liver doctor is the best one to determine the cause of his elevated ALT test and best course of treatment for possible hep c infection. Treatments vary by genotype, severity of liver damage and prior treatment history.
Fortunatly there have been recent developments in the treatment for hep c much easier, shorter duration, and most importantly much more effective than treatments available prior to December 2013.
The alanine aminotransferase (ALT) test is typically used to detect liver injury. It is often ordered in conjunction with aspartate aminotransferase (AST) or as part of a liver panel to screen for and/or help diagnose liver disease.
AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific to the liver than is AST. Sometimes AST is compared directly to ALT and an AST/ALT ratio is calculated. This ratio may be used to distinguish between different causes of liver damage and to help recognize heart or muscle injury.
ALT values are often compared to the results of other tests such as alkaline phosphatase (ALP), total protein, and bilirubin to help determine which form of liver disease is present.
ALT is often used to monitor the treatment of persons who have liver disease, to see if the treatment is working, and may be ordered either by itself or along with other tests for this purpose.
When is it ordered?
A health practitioner usually orders an ALT test (and several others) to evaluate a person who has signs and symptoms of a liver disorder. Some of these may include:
Weakness, fatigue
Loss of appetite
Nausea, vomiting
Abdominal swelling and/or pain
Jaundice
Dark urine, light-colored stool
Itching (pruritus)
ALT may also be ordered, either by itself or with other tests, for people who are at an increased risk for liver disease since many people with mild liver damage will have no signs or symptoms. Some examples include:
Persons who have a history of known or possible exposure to hepatitis viruses
Those who are heavy drinkers
Individuals whose families have a history of liver disease
Persons who take drugs that might damage the liver
Persons who are overweight and/or have diabetes
In persons with mild symptoms, such as fatigue or loss of energy, ALT may be tested to make sure they do not have chronic liver disease.
When ALT is used to monitor the treatment of persons who have liver disease, it may be ordered on a regular basis during the course of treatment to determine whether the therapy is effective.
Normally, levels of ALT in the blood are low.
Very high levels of ALT (more than 10 times normal) are usually due to acute hepatitis, sometimes due to a viral infection. In acute hepatitis, ALT levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal. Levels of ALT may also be markedly elevated (sometimes over 100 times normal) as a result of exposure to drugs or other substances that are toxic to the liver as well as in conditions that cause decreased blood flow (ischemia) to the liver.
ALT levels are usually not as high in chronic hepatitis, often less than 4 times normal. In this case, ALT levels often vary between normal and slightly increased, so the test may be ordered frequently to see if there is a pattern. Other causes of moderate increases in ALT include obstruction of bile ducts, cirrhosis (usually the result of chronic hepatitis or bile duct obstruction), heart damage, alcohol abuse, and with tumors in the liver.
In most types of liver diseases, the ALT level is higher than AST, and the AST/ALT ratio will be low ( less than 1). There are a few exceptions; the AST/ALT ratio is usually greater than 1 in alcoholic hepatitis, cirrhosis, and with heart or muscle injury and may be greater than 1 for a day or two after onset of acute hepatitis.
from;
http://labtestsonline.org/understanding/analytes/alt/tab/test/
good luck
Lynn
A liver doctor is the best one to determine the cause of his elevated ALT test and best course of treatment for possible hep c infection. Treatments vary by genotype, severity of liver damage and prior treatment history.
Fortunatly there have been recent developments in the treatment for hep c much easier, shorter duration, and most importantly much more effective than treatments available prior to December 2013.
The alanine aminotransferase (ALT) test is typically used to detect liver injury. It is often ordered in conjunction with aspartate aminotransferase (AST) or as part of a liver panel to screen for and/or help diagnose liver disease.
AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific to the liver than is AST. Sometimes AST is compared directly to ALT and an AST/ALT ratio is calculated. This ratio may be used to distinguish between different causes of liver damage and to help recognize heart or muscle injury.
ALT values are often compared to the results of other tests such as alkaline phosphatase (ALP), total protein, and bilirubin to help determine which form of liver disease is present.
ALT is often used to monitor the treatment of persons who have liver disease, to see if the treatment is working, and may be ordered either by itself or along with other tests for this purpose.
When is it ordered?
A health practitioner usually orders an ALT test (and several others) to evaluate a person who has signs and symptoms of a liver disorder. Some of these may include:
Weakness, fatigue
Loss of appetite
Nausea, vomiting
Abdominal swelling and/or pain
Jaundice
Dark urine, light-colored stool
Itching (pruritus)
ALT may also be ordered, either by itself or with other tests, for people who are at an increased risk for liver disease since many people with mild liver damage will have no signs or symptoms. Some examples include:
Persons who have a history of known or possible exposure to hepatitis viruses
Those who are heavy drinkers
Individuals whose families have a history of liver disease
Persons who take drugs that might damage the liver
Persons who are overweight and/or have diabetes
In persons with mild symptoms, such as fatigue or loss of energy, ALT may be tested to make sure they do not have chronic liver disease.
When ALT is used to monitor the treatment of persons who have liver disease, it may be ordered on a regular basis during the course of treatment to determine whether the therapy is effective.
Normally, levels of ALT in the blood are low.
Very high levels of ALT (more than 10 times normal) are usually due to acute hepatitis, sometimes due to a viral infection. In acute hepatitis, ALT levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal. Levels of ALT may also be markedly elevated (sometimes over 100 times normal) as a result of exposure to drugs or other substances that are toxic to the liver as well as in conditions that cause decreased blood flow (ischemia) to the liver.
ALT levels are usually not as high in chronic hepatitis, often less than 4 times normal. In this case, ALT levels often vary between normal and slightly increased, so the test may be ordered frequently to see if there is a pattern. Other causes of moderate increases in ALT include obstruction of bile ducts, cirrhosis (usually the result of chronic hepatitis or bile duct obstruction), heart damage, alcohol abuse, and with tumors in the liver.
In most types of liver diseases, the ALT level is higher than AST, and the AST/ALT ratio will be low ( less than 1). There are a few exceptions; the AST/ALT ratio is usually greater than 1 in alcoholic hepatitis, cirrhosis, and with heart or muscle injury and may be greater than 1 for a day or two after onset of acute hepatitis.
from;
http://labtestsonline.org/understanding/analytes/alt/tab/test/
good luck
Lynn
also, the alt protein levels showed high, normal range being 9-46 units, and his test coming back at 69 units. I read that this is released into your blood stream after liver damage, is this high level also from the hep c?
I am having problems just posting his lab results up here, for some reason the pdf won't let me copy out of it.
his first general lab work-up showed the general hepatitis panel, showing hepatitis C as reactive, below that it shows signal to cut-off as 31.90, with the normal unit of <1.00 beside it.
the next lab order was named hepatitis c antibody, which also says the same thing. it's an online site called myquest diagnostics, so I don't think they put in depth reports up so that way people don't try to self treat.. not so sure.
he has already set him up with a gastro specialist, but hasn't called to say anything about the second work up. was the secondwork up to determine which genotype he was or what was the second test actually for? the rna pcr panel, what exactly is that?
also, you said if a liver doctor is needed it sounds like type 1, is that more severe? we're new to all this, trying not to stress but be prepared.
thanks so much for your help!!
his first general lab work-up showed the general hepatitis panel, showing hepatitis C as reactive, below that it shows signal to cut-off as 31.90, with the normal unit of <1.00 beside it.
the next lab order was named hepatitis c antibody, which also says the same thing. it's an online site called myquest diagnostics, so I don't think they put in depth reports up so that way people don't try to self treat.. not so sure.
he has already set him up with a gastro specialist, but hasn't called to say anything about the second work up. was the secondwork up to determine which genotype he was or what was the second test actually for? the rna pcr panel, what exactly is that?
also, you said if a liver doctor is needed it sounds like type 1, is that more severe? we're new to all this, trying not to stress but be prepared.
thanks so much for your help!!
Since his doctor has ordered two tests the first one would have been a antibody test to which he was positive. The second test would be to confirm a viral load and would have been a RNA PCR. I am guessing it showed that he had one since he is sending him to a liver doctor.
Posting the numbers and how it was worded would be a big help and take the guessing out. If he does have Hep C try not to get to upset. Treating this virus has never been better and cure rates never higher. Best to both of you and welcome to the forum.
Posting the numbers and how it was worded would be a big help and take the guessing out. If he does have Hep C try not to get to upset. Treating this virus has never been better and cure rates never higher. Best to both of you and welcome to the forum.
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