HCV RNA

[Buba1962]

Having trouble interpreting labs .
HCV viral load PCR iu/ml 506604
HCV viral load RNA 5.70
Those numbers are from July
WBC 2.7
RBC 4.64
HGB 14.8
HCT 43.9
Platelet 61L.  ..these were from March

So if I am reading this correctly  WBC on low side plat.very low not sure what the viral load numbers mean ?

[Sarah1949]

Thank you can-do-man. My doctor, who is the director of clinical hepatology at the medical center in my state, told me the same things you are saying here.

Some people just like to argue and get off on scaring others by obscuring the facts or greatly exaggerating them to their advantage for the sake of winning an argument. Fortunately, I have a decent intellect myself and did enough of my own research to warrant doing treatment myself with Sovaldi and Olysio.

[Dee1956]

Thank you for sharing, I remember when it was called viral or non a non b.

Like you my VL was about 4M after relapsing, then 2 years later right before starting tx again is was 350K

My doctor also said, it can go up and down.

My AST ALT were only slightly elevated but I was just starting in to cirrhosis.

In 1997 I had a friend who treated 3 times with different types of interferon and riba, back then they kept doing the same thing over and over and expecting a different response.  They also did not know back then that it was useless to treat for 48 weeks if you never got to UND.

I am glad we are where we are with newer information, newer research and a better chance to get to SVR and stay there.

Thanks

[bluemetal]

Your being gt4 is a positive factor. Much easier to cure. And the fact that your HCV RNA count (in June-July) was still around 0ne half million iu/mL when starting tx makes it highly likely it wont get into the seriously danger range providing you dont relapse after tx. Ive already posted the refrence links supporting the fact that high viral load can lead to liver cell damage and scarring via its affect on ALT/AST levels. But since there are conflicting studies and medical opinions surrounding this, use logic and common sense where definitive answeres are lacking. Stay the course your on and simply pay close attention to the lab work every month. Because of your genotype a success is practically locked in..

[hrsepwrguy]

What is Fibrosis?

"HCV viral load does not appear to have much effect on fibrosis progression. There is some evidence that HCV genotype 3 may play a role in the formation of steatosis, but the exact mechanism of action is not completely understood."

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Fibrosis.pdf

Fibrosis and Disease Progression in Hepatitis C

"Viral load and genotype do not seem to influence significantly the progression rate"

http://www.hawaii.edu/hivandaids/Fibrosis%20And%20Disease%20Progression%20In%20Hepatitis%20C.pdf

[Buba1962]

Just revisited this post .I am geno type 4

[georgerosie]

My infectious disease doc maintained to me for many years that the only correlation re viral load was regarding how I would respond to treatment.I went from a high of >10 mil, down to less than 800,000 without any significant lifestyle changes.I did jump back up from time to time.When I started the S/O, I was back up to 2,600,000. After 4 wks <15.Got original hep in 1969.I think they called it viral hep.The other kind was infectious hep.Long time ago,I may be misremembering.

[bluemetal]

One last note on HCV RNA count affecting ALT/AST levels: every non-HCV-infected persons ALT/AST levels are normal save for an occasional small rise or drop depending upon diet, meds, etc. Every HCV-infected person on the other hand almost aleays has elevated ALT-AST. Did the HCV cause this perpetual change in ALT-AST levels or is it just coincidence that the levels shot up after exposure to the virus. This being said, most studies have concluded that continuosly elevated ALT/AST causes inflammation, and inflammation is directly linked to liver cell damage and scarring.   Im just keeping it real. Way too much false skepticism and over-optimism leading to false sense of security within the gt 1a population. Hope is good thing, but hope for the best and expect the worse( ie. keep it real).

[bluemetal]

And so... all this tells us is that there are conflicting opinions and diagnosis between medical professionals and therefore leads us full circle to the same conclusion--we must use these pieces of conflicting evidence in conjunction with common sense. For instance, look at the last line by Dr Pearlman: "But HCV viral load does not tell you how fast hepatitus is progressing." Hepatitus IS a virus per se, and if the RNA viral load is x number of copies in any given month, and the next month its higher, than its PROGRESSING. Rate of increase is irrelevant. The fact supported by clinical trials (and logic) is that a person who has 1 billion copies of HCV RNA in his entire bloodstream is MORE likely to not respond to tx than the person who has 1 million. Progression of virus replication therefore is more likely to cause liver cell damage by its sheer number because we know for a fact that it affects ALT and AST levels which in turn inflame the tissue (inflammation IS a direct link to scarring). Hepatituscentral.com is in conflict with Medscape and other sources on this point concerning high levels of HCV RNA and ALT/AST increase. Again, use logic. Who is in greater danger of getting cirrhosis: the patient with 1 billion gt 1a virons, or the patient with 1 million?

[hrsepwrguy]

Your viral load is the amount of specific viruses that you have, in a given volume of your blood (usually 1 milliliter = 1 cubic centimeter). More precisely, it means that the amount of Hep C genetic material found in your blood corresponds to as many Hep C viruses as the given number says. Therefore the given number denotes "viral equivalents."

There appears to be no significant correlation between HCV RNA levels and ALT values or histological activity in patients untreated by anti-viral therapies (Interferon). Viral load varies between infected individuals but is not a useful prognostic indicator nor does it measure the severity of virus-induced liver disease.

http://www.hepatitiscentral.com/hepatitis-c/what-is-viral-load.html?ssrc=left_sidebar

Why Is Viral Load Important?
Doctors use your viral load to determine how you're responding to treatment. Usually, you will find out your viral load when you start treatment and then repeat the test (usually at three months) as your treatment continues. With at least two viral load results (sometimes along with the results of other blood tests and biopsy), doctors can see how the virus is responding to the drugs. A significantly reduced viral load (a 100-fold decrease in amount of virus) often means that treatment is working. Ideally, treatment should make the virus undetectable.

A viral load test won't tell you about the severity of your liver disease. In other words, a high viral load doesn't necessarily mean you're more sick than someone with a lower viral load. However, viral load can predict how easily you might achieve an undetectable viral level with treatment. Someone who begins treatment with a low viral load will probably have an easier time of getting an undetectable viral level after treatment.

http://hepatitis.about.com/od/diagnosis/a/ViralLoad.htm

[can-do-man]

And this is backed up by countless of top Hep C doctors.
--------------------------------------

Am I Getting Sicker if My Viral Load Is Rising?

Dr. Anania: Not necessarily. With HCV, viral burden in hepatitis C does not necessarily predict the natural history of clinical disease. And therefore, patients need to understand that we use that measurement to help us guide therapy and response to therapy. We use it in conjunction with other types of laboratory data -- liver enzymes, liver biopsies sometimes, and viral genotype. Taken all together, these tests give us a snapshot of what is going on. But viral load numbers themselves do not predict disease.

Dr. Pearlman: Unlike HIV, HCV viral copies do not directly affect a patient's prognosis and how fast disease is progressing in the liver. Remember, we are measuring blood levels, not what is happening in liver cells. HIV viral load does have a lot to do with quicker progression to AIDS. But HCV viral load does not tell you how fast hepatitis is progressing.

http://www.webmd.com/hepatitis/c-hcv-viral-load

I'm out of this one....

[bluemetal]

Be it as it may, "several factors " coming into play  not withstanding, and the article being from 1998, the bottom line hard fact stands to reason just by mere common sense in conjunction with the scientific evidence: the greater majority of relapsers during the past year have been Gt 1a cirrhotic. Logic (again in conjunction with the evidence) tells us that the higher the HCV RNA viral load in this particular virus, the more the likelihood of liver cell damage and further scarring.  The other "factors" may or may not contribute but remain considerably insignificant to the base fact:HCV Gt 1a replicates at a higher rate and is the most difficult to eradicate. Im not being pessimistic nor irrational in scaring anyone. And if Im in error Id rather err on the side of caution than false hope.

[Idyllic]

Errrr not sure how wise it is to leap in to this just would like to point out that first article is dated 1998

and in that Medscape article several factors came into play. Namely, patient ethnicity, sex distribution, alcohol consumption, age at infection, mode of HCV acquisition, serum transaminase levels, histological grade of inflammation, HBV status, HIV co-infection, HCV genotype and viral load.

I just mean it takes a long time reading (and more reading) and integrating all other sources of information in order for the dynamics of all this to fall into place. And I truly do not mean that to sound patronizing so I am honestly sorry in advance if it does.

[bluemetal]

Your initial question had to do with the meaning of viral load. Others jumped in and confused the issue with their misinterpretation. Genotype (1a) and high viral load DOES in fact contribute toward liver scarring and cirrhosis as I stated before. But you dont have to take my word for it. See: http://www.unboundmedicine.com/harrietlane/ub/citation/9840128/Factors_associated_with_severity_and_disease_progression_in_chronic_hepatitus_C      Also see: Medscape: Predicting Prrogression to Cirrhosis in Chronic HCV Infection.    HCV RNA viral load over 800000 iu/mL is high. This level of HCV RNA in combination with Gt 1a can and will lead to cirrhosis if left untreated, and if  cirrhosis isb already present, can worsen it.  Take care and good luck.

[can-do-man]

Hi pooh. Wondered where you've been, hadn't seen you around here. His post was so ridiculous I didn't even respond back to him. One needs to learn the facts before they come here scaring people. Hope your doing well.

[pooh55811]

I agree with everything you said about the viral load, Can-Do-Man. Thanks for setting the record straight and keeping the facts accurate.

[bluemetal]

sorry pal but your the one who is in error. I researched this very thoroughly and know im correct on   HCV RNA quantives. My material comes directly from the science techs and their confirmed data. Look carefully at my above posts then go to your serach bar and type in. You must understand mathematics to understand how to use the conversion table.

[can-do-man]

I'm not sure where you are coming up with this crap but ones viral load has nothing to do with liver damage and sure does not indicate cirrhosis or leading to decompensated liver. I am cirrhotic and my viral load was all over the map before I became SVR. At one time it was 10 million and then has low as 800,000. Ones viral load really only matters when one starts treatment. Although some studies have shown in the past a better outcome with those with a lower starting viral load. BTW both of these peoples viral load is not that high...

[can-do-man]

Slotgirl your viral load is only 596,000 which is not that high. But your viral load doesn't really matter at this point until you start treatment as it can change weekly even daily. Your HGB is high for being a female and your SGOT and SGPT is higher then the normal range. I don't know about Poorphria PCT but that could be the reason your HGB is high. Hopefully the ones here that have that problem can help answer that.

[slotgirl]

So you went through the treatment how bad was it? It took 9 months? Were you sick the whole time? Could you work?

[slotgirl]

You seem to have a very good grasp on what these numbers mean. MY numbers are very close to Bubbas but I also have Poorphria PCT from the hep C. These are my initial numbers maybe you can help interoperate mine as you did for Bubba
Anti -HCV Strong reactive
HCV RNA detected 596,000IU/ml plasma Log = 5.78
RT PCR method 15IUml or lower
WBC 6.20 My Ferrtian is 512 very high
RBC 5.40   SGOT 153
HGB17.5 SGPT 243 both of those way out of range
HCT51.

[Buba1962]

Thanks ,I started tx on Monday,peg sovaldi and RIBA. If you don't mind telling me ,why did you have to stop tx ? Hope your next one will be easier on you

[bluemetal]

In keeping it real in laymans terms: My viral load prior to tx was (in round figures) 177,000 per mililiter which is 177,000,000 per liter which, according to the COBAS Ampliprep/COBAS TagMan test conversion chart is 88,000,000. There are roughly 5.5 liters of blood in a 150 lb person. 5.5 x 88,000,000= 4,840,000,000 (4.8 billion copies in the entire bloodstream. This is typical for a cirrhotic with HCV forv 35 years. Anything over 5 log (1 to the 5th power) which is 100,000 iu/mL is considered "clinically significant", in the red flag zone. Should you be worried? Yes and no. Viral load is not a certain indicator of just how healthy or sick a person is. A billion copies of the virus, however, swimming through ones blood stream cant be a good thing. Its time for tx ASAP. Ill be going for roiund 2  in Oct, hopefully.

[bluemetal]

A high viral load is considered to be anything higher than 800,000 iu/L (2 million copies  or more of virus in the entire bloodstream). 800,000 iu/L is 800,000 standard units of virus per liter of blood. The actual number of virus copies may be higher or lower. Ex: a viral load of 50-100 copies per mililiter is equivillant to 25-50 iu/mL. My own HCV RNA Quantitive results just came back: UNDETECTED. This was 2 weeks after my last dose of Sovaldi-Olysio which I only took for 22 days before terminating tx. Im a gt 1a  F-4 cirrhosis (compensated). The likelihood of the virus reappearing is almost certain. Previous HCV RNA Quant test results before tx on S-O combo: 5/22/2014 --- 177042 iu/mL.  10/22/2013--105256 iu/mL.

[Buba1962]

Thanks