Aa
Hep C Qs Re Treatment/Testing
Due to issues of fidelity with a partner I had over a year ago (we have not had sex for a year) and due to the fact that I have normocytic anemia which may be immune related (I use epogen) I have been having my physician give me an HIV and Hep panel every month just to be on the safe side. I'd planned to stop once I was a year out from that relationship. All tests had come back negative so far(Also, I have been immunized against Hep A & B about three years ago). At any rate, my last test was 6-21-07 and it was also negative for HIV and HepC. On 7-1-07, I was raped. I knew who the assailant was, although he was not someone I was seeing. I also knew him to be an IV drug user. So a few days ago (this past Monday actually) I repeated another HIV and HepC test. Unfortunately, my HepC test came out positive. (Thankfully, the HIV test did not).
The test performed was a high signal-to-cut–off (s/co) ratio. My reading was a 65.1 which is apparently a very strongly positive number for less than two months out from the date of exposure? This is the only possible exposure to HepC that I've had, and remember, I have all of these documented negative tests going back every two or three months for well over a year, probably for two years or so.
Also, I am quite ill. I began to get sick about a month or so ago with nausea, stomach pain and bloating and also just a much smaller amount of urine, which seems very concentrated and much darker in color than usual. I am also very tired suddenly. Initially, I attributed the fatigue to my anemia, but my red blood cell counts are fine. I am trying to get a specialist to see me so that I can get on a combination therapy as I understand that the window for doing this at the beginning acute onset of hepatitis c is fairly narrow, and I am lucky to have known I contracted it so quickly. Unfortunately, all of these gastros and hepatic specialists have waiting lists and it is so difficult to get in without waiting two weeks to a month. You would think they would understand my sense of urgency, but its as though I am talking to a wall. I have been unable to find online information as to why my ration is so high so fast, does anyone else have a clue?
Thanks in advance for any help. Btw, I am close to both Huntsville and Birmingham Alabama. And yes, I have pressed charges, in case anyone was wondering.
The test performed was a high signal-to-cut–off (s/co) ratio. My reading was a 65.1 which is apparently a very strongly positive number for less than two months out from the date of exposure? This is the only possible exposure to HepC that I've had, and remember, I have all of these documented negative tests going back every two or three months for well over a year, probably for two years or so.
Also, I am quite ill. I began to get sick about a month or so ago with nausea, stomach pain and bloating and also just a much smaller amount of urine, which seems very concentrated and much darker in color than usual. I am also very tired suddenly. Initially, I attributed the fatigue to my anemia, but my red blood cell counts are fine. I am trying to get a specialist to see me so that I can get on a combination therapy as I understand that the window for doing this at the beginning acute onset of hepatitis c is fairly narrow, and I am lucky to have known I contracted it so quickly. Unfortunately, all of these gastros and hepatic specialists have waiting lists and it is so difficult to get in without waiting two weeks to a month. You would think they would understand my sense of urgency, but its as though I am talking to a wall. I have been unable to find online information as to why my ration is so high so fast, does anyone else have a clue?
Thanks in advance for any help. Btw, I am close to both Huntsville and Birmingham Alabama. And yes, I have pressed charges, in case anyone was wondering.
Thankfully, I do have great insurance. Unusually good actually. They didn't bat an eye when I was prescribed epo, and a lot of people have difficulty with that unless they have cancer or unless they are on dialysis. I think what I may do is go to the E.R. at Kirkland tomorrow, that's the University of Alabama at Birmingham's teaching hospital. It's where my hematologist is, and actually, I do have a gastro there too who is very good - wasn't planning on using him for this, but I'll bet they could call him in if I went in and maybe he could at least get the ball rolling. God, I hate to sound maudlin, but as it happens, I have FNH too, no big deal, just three smaller tumors in my liver, its just that the gastro guy was following them because I had an iron overdose way back when and they weren't certain what type of tumors I had. It's a completely benign condition so he just follows them once a year or so to make sure they don't get any larger. But that might be the best route to go if I want to really get this started and get the proper testing done all at once.
I don't see why you couldn't go to the ER -- it might speed everything up. Hopefully you have good insurance.
Changes in vision - chest pain - extreme illness not necessarily associated with "FLU" should go to the ER.
Make sure you have insurance - cause ER visits are super expensive.
Meki
Changes in vision - chest pain - extreme illness not necessarily associated with "FLU" should go to the ER.
Make sure you have insurance - cause ER visits are super expensive.
Meki
Frankly, my biggest hope is that if I can get treatment quickly and perhaps because I'm actue, I have some chance for a cure. I'm not really that psyched - no offense to anyone else - about having to live with this. I'd rather go with the most intensive therapy I can now, and try to kick it out of my system, if possible. If that doesn't work, I'll deal with that eventuality then and I'll deal with it. For the moment though, I'm just hoping to get into a specialist quickly, and I am going to take everyone's advice and try to have the additional testing run (Tuesday if not Monday, just realized Monday is a holiday) aggh!!!
Oh yes, my mother, who is in a different state, wanted me to ask if there are any dangers in the acute phase. She's worried because I'm in so much pain and because I feel so badly, and wants to know if I should go to the E.R. They can't really do anything though can they?
Oh yes, my mother, who is in a different state, wanted me to ask if there are any dangers in the acute phase. She's worried because I'm in so much pain and because I feel so badly, and wants to know if I should go to the E.R. They can't really do anything though can they?
Acute hep c IS a nasty business. It does resolve in a number of weeks though. Total nausea, unending fatigue, etc. My AS ALT were the 700s and 800s in my acute phase.
Based on the information you’ve provided, odds are you are in the acute stage of HCV. Nobody here is trying to give you false hope; but we do tend to look for bright spots when we can find them. It’s part of this disease, I suppose.
Try not to panic; most of us in here were probably infected 25 to 30 years ago, and generally still ticking. This is disease that a person can become accustomed to; its generally slow moving, and in time most of us come to accept it.
Just the fact that you aren’t ignorant of it will allow you to implement any necessary lifestyle changes, an option that was unavailable to me due to my lack of diagnosis.
All that, coupled with the fact that there are several *very* promising new drugs on the near horizon make this a good time to get infected, if there is such a thing. My deeper concern for you is dealing with the trauma of rape. You are obviously a very intelligent woman to have learned all you have about HCV in this amount of time. Hopefully, you’re capable of recognizing the need to seek counsel if you feel it will benefit you. It doesn’t seem like it right now, but you’ll find a way to manage the Hep C.
I don’t recall experiencing an acute phase of HCV; I hear it’s nasty business, though. Common sense dictates that you stay hydrated, (they tell us to drink half our body weight in ounces of water daily during treatment) and use the ER as necessary if things become intolerable.
You strike me as a very analytical person; this coupled with intelligence will get you through this nightmare.
AST/ALT values are generally shown on a separate liver function test (LFT) or sometimes on a Complete Metabolic Panel. If you are acute, these might be quite high, but I’m not sure if there is any immediate value to having these results. They can be had from a lab within hours if ordered STAT.
This post has already slid to page two status; once relegated to this position, they are rarely read. Feel free to start a new thread when you feel up to it, or the timing is right so we can keep up with things.
Take good care of yourself, and stay in touch—
Bill
Try not to panic; most of us in here were probably infected 25 to 30 years ago, and generally still ticking. This is disease that a person can become accustomed to; its generally slow moving, and in time most of us come to accept it.
Just the fact that you aren’t ignorant of it will allow you to implement any necessary lifestyle changes, an option that was unavailable to me due to my lack of diagnosis.
All that, coupled with the fact that there are several *very* promising new drugs on the near horizon make this a good time to get infected, if there is such a thing. My deeper concern for you is dealing with the trauma of rape. You are obviously a very intelligent woman to have learned all you have about HCV in this amount of time. Hopefully, you’re capable of recognizing the need to seek counsel if you feel it will benefit you. It doesn’t seem like it right now, but you’ll find a way to manage the Hep C.
I don’t recall experiencing an acute phase of HCV; I hear it’s nasty business, though. Common sense dictates that you stay hydrated, (they tell us to drink half our body weight in ounces of water daily during treatment) and use the ER as necessary if things become intolerable.
You strike me as a very analytical person; this coupled with intelligence will get you through this nightmare.
AST/ALT values are generally shown on a separate liver function test (LFT) or sometimes on a Complete Metabolic Panel. If you are acute, these might be quite high, but I’m not sure if there is any immediate value to having these results. They can be had from a lab within hours if ordered STAT.
This post has already slid to page two status; once relegated to this position, they are rarely read. Feel free to start a new thread when you feel up to it, or the timing is right so we can keep up with things.
Take good care of yourself, and stay in touch—
Bill
Also, on the Friday thing. I couldn't even get out of bed to get to the doctor's office. I am exceptionally sick. I am really quite floored by how ill I am. I am going to have to tell the rest of my family who is in town so someone can take me on Tuesday. The specialist is about forty-five minutes away or so.
On the testing, I think the important thing to remember is that I have been tested every two to three months for the entire hepatitis panel for about two years and have always been negative for everything. I have the acutal test results with me here. The last negative test was 6-21-07. Hippygirl, I wish the anemia was giving a false positive but it seems unlikely given that it never has before and I've been on procrit (epogen) x 3 years.
So. I have a negative test on 6-21-07. I'm raped by a known IV DRUG USER on 7-1-07. To make matters worse, my rapist has a best friend, also an IV drug user who is in late stage liver failure from hep c and he has shot up with him. So, my rapist probably has hep c.
Every time I have a hep panel run, I have the hep (4) panel run. On 8-24-07, one month and 24 days after the rape, I had another hep (4) panel and HIV test run. The HIV came out negative as usual. All of the Hep A and Hep B panels came out negative (no surprise, I've had the vaccines). This time, however, for the first time in two years, my hep C panel came out as follows: h (for hight) 61.5 out of a possible range of 0.0 - 0.9. Underneath that, it said that if the test returns a value of 1.0 to 9.9 they recommend another test with PCR or RIBA testing to make certain there isn't a false positive. However, my test was so much higher than that - an s/co ration of 61.5, that the lab didn't even feel another test was warranted.
And to me, it makes sense that it was so high, because I am very ill. I have been so nauseous and in so much abdominal pain, and so exhausted I can barely get out of bed. However, I am going to have my previous primary care physician call in orders for the other tests just so that I will have them for the specialist if I will need them anyway. But I doubt this is a false positive, unfortunately, given the high test value and the way that I feel, along with the risk factor of the person who raped me. Male to female transmission is much easier than the other way around, unfortunately.
My test results don't show ALT values? Must be a different test?
So. I have a negative test on 6-21-07. I'm raped by a known IV DRUG USER on 7-1-07. To make matters worse, my rapist has a best friend, also an IV drug user who is in late stage liver failure from hep c and he has shot up with him. So, my rapist probably has hep c.
Every time I have a hep panel run, I have the hep (4) panel run. On 8-24-07, one month and 24 days after the rape, I had another hep (4) panel and HIV test run. The HIV came out negative as usual. All of the Hep A and Hep B panels came out negative (no surprise, I've had the vaccines). This time, however, for the first time in two years, my hep C panel came out as follows: h (for hight) 61.5 out of a possible range of 0.0 - 0.9. Underneath that, it said that if the test returns a value of 1.0 to 9.9 they recommend another test with PCR or RIBA testing to make certain there isn't a false positive. However, my test was so much higher than that - an s/co ration of 61.5, that the lab didn't even feel another test was warranted.
And to me, it makes sense that it was so high, because I am very ill. I have been so nauseous and in so much abdominal pain, and so exhausted I can barely get out of bed. However, I am going to have my previous primary care physician call in orders for the other tests just so that I will have them for the specialist if I will need them anyway. But I doubt this is a false positive, unfortunately, given the high test value and the way that I feel, along with the risk factor of the person who raped me. Male to female transmission is much easier than the other way around, unfortunately.
My test results don't show ALT values? Must be a different test?
Sorry about what has happened.
First, your case is a little complicated so you do not want to see a Gastro. Only see a liver specialist (hepatologist). Second, there's still a chance you don't have Hepatitis C. The test you took is an antibody test. A sizeable per cent (15-25 or maybe more) of those who have antibodies do not have the virus. The fact that you had what appears to be a symptomatic acute stage (nausea, fatigue, dark urine, etc) stands well for you. It shows your body was trying to fight off the virus and maybe it won.
Alll this goes back to seeing a good liver specialist (hepatologist) who can give you a complete diagnosis and run whatever tests are necessary to help with that diagnosis. Then, if treatment is required, they can do that.
As to seeing a hepatologist quickly, make sure you tell the office that this is an emergency, you may be having an acute attack, and you want to see (or at least speak) to the doctor right away. Be assertive and if they give you blah, blah, blah, -- then ask to speak to a nurse or the office manager.
Also, make sure you get copies of all your previous blood tests,etc, including from your hematologist. And if you can, try and get your hemo (or PCP) to order a viral load test prior to seeing the doctor. One that is readily available is called "Heptimax" from Quest Diagnostics. Just have your doc write the word "Heptimax" on a prescription form (along with proper diagnosis code) and bring it to any Quest Center location (google "quest diagnostics" for locations).
Lastly, when they tested your blood after the rape and around/after your nausea, fatigue, etc -- do you know what your "ALT" and "AST" values were? These are generally quite elevated in the actute stage. If they weren't, it's possible your symptons weren't Hep C related.
Hope it all works out,
-- Jim
First, your case is a little complicated so you do not want to see a Gastro. Only see a liver specialist (hepatologist). Second, there's still a chance you don't have Hepatitis C. The test you took is an antibody test. A sizeable per cent (15-25 or maybe more) of those who have antibodies do not have the virus. The fact that you had what appears to be a symptomatic acute stage (nausea, fatigue, dark urine, etc) stands well for you. It shows your body was trying to fight off the virus and maybe it won.
Alll this goes back to seeing a good liver specialist (hepatologist) who can give you a complete diagnosis and run whatever tests are necessary to help with that diagnosis. Then, if treatment is required, they can do that.
As to seeing a hepatologist quickly, make sure you tell the office that this is an emergency, you may be having an acute attack, and you want to see (or at least speak) to the doctor right away. Be assertive and if they give you blah, blah, blah, -- then ask to speak to a nurse or the office manager.
Also, make sure you get copies of all your previous blood tests,etc, including from your hematologist. And if you can, try and get your hemo (or PCP) to order a viral load test prior to seeing the doctor. One that is readily available is called "Heptimax" from Quest Diagnostics. Just have your doc write the word "Heptimax" on a prescription form (along with proper diagnosis code) and bring it to any Quest Center location (google "quest diagnostics" for locations).
Lastly, when they tested your blood after the rape and around/after your nausea, fatigue, etc -- do you know what your "ALT" and "AST" values were? These are generally quite elevated in the actute stage. If they weren't, it's possible your symptons weren't Hep C related.
Hope it all works out,
-- Jim
alagirl -
First - You're a strong woman to be going through the things that you have recently. I'm not going to give you my condolences - I'm going to give you a high five for being tough, extraordinary and amazing in the light of these experiences!
Second - You might be just going through an acute phase right now. There is a percentage of people who clear during the acute phase. You may be one of them. You are showing all the classic signs of being acute right now, as far as I know.
Third - if you're going to treat - right now is the time to treat.
Fourth - Travel outside of your area - whatever it takes - start calling around - telling them you'll travel to their location and you'll be there in 5 days - can they take you as a walk in.
Or call the local places and let them know you'll be willing to do a walk-in appointment or you will go on a standby list.
Let them know how important it is - let them know you may be going through acute phase - and just tested HCV positive AFTER A RAPE.
Use that information to GUILT them into finding you an open slot.
Get out of your podunk town for this medical stuff.
Get your GP to call ahead and make it happen faster - let him use his weight to have them see you faster.
Hang tough - and good luck!
Meki
First - You're a strong woman to be going through the things that you have recently. I'm not going to give you my condolences - I'm going to give you a high five for being tough, extraordinary and amazing in the light of these experiences!
Second - You might be just going through an acute phase right now. There is a percentage of people who clear during the acute phase. You may be one of them. You are showing all the classic signs of being acute right now, as far as I know.
Third - if you're going to treat - right now is the time to treat.
Fourth - Travel outside of your area - whatever it takes - start calling around - telling them you'll travel to their location and you'll be there in 5 days - can they take you as a walk in.
Or call the local places and let them know you'll be willing to do a walk-in appointment or you will go on a standby list.
Let them know how important it is - let them know you may be going through acute phase - and just tested HCV positive AFTER A RAPE.
Use that information to GUILT them into finding you an open slot.
Get out of your podunk town for this medical stuff.
Get your GP to call ahead and make it happen faster - let him use his weight to have them see you faster.
Hang tough - and good luck!
Meki
Im just wondering if your partner was violent with you, beat you up etc, that is also a form of transmission if there was blood exchanged.
Hi, maybe because you have normocytic anemia, it has given a false positive in your hep c test. This can happen to people that have thyroid problems as well.
I would have another test in a couple of months and if you are hep c positive hopefully whilst you are in the acute stage you may clear it on your own.
I would have another test in a couple of months and if you are hep c positive hopefully whilst you are in the acute stage you may clear it on your own.
I already have a hematologist, but I'm not as worried about the anemia as you might expect. I've managed my anemia very successfully on epogen for the past three years. My counts are a little higher than they should be right now in fact because after the rape, I didn't leave the house to get blood levels as I should have (normally, I do an anemia b with retic. count every two weeks to see where I'm at) and I was just administering epo during that time when I felt tired - NOT a good way to handle things. I had actually piggy backed the HCV and HIV tests onto my anemia b profile when I finally went back to get on my regular every two week testing (this was a few days ago), and this is how I found out my HCV was positive. (My last HCV test was 6-21 and was negative, I was raped on 7-1. No other possible exposures.)
At any rate, my position regarding the anemia and the combo treatment is that I already am a successful epogen patient so I know I can successfully adjust my epogen levels to make up for any hemolysis caused by the antiviral drug in the treatment. Epogen works very well for me and there is nothing wrong with my bone marrow. Also, I've had the test done already to ensure that I have no antibodies to artificial epo. So in my view, I'm already ahead of the game in this area - I can adjust for anemia more quickly because I don't have to get permission from insurance, doctors etc for epo, I just have to adjust levels on a med I already use if hemolysis occurs. My anemia, by the way, is not hemolytic in nature. I have a normocytic anemia that appears to be the result of my body's inability to manufacture epo appropriately. My kidneys are fine, my body just seems to have some difficulty understanding when its time to make epo or, alternately, it may be suppressing natural epo production somehow, but that seems unlikely. Ultimately, nobody knows what is really causing the problem but since epogen works so well and my kidneys are fine, it seems a little academic.
At any rate, my position regarding the anemia and the combo treatment is that I already am a successful epogen patient so I know I can successfully adjust my epogen levels to make up for any hemolysis caused by the antiviral drug in the treatment. Epogen works very well for me and there is nothing wrong with my bone marrow. Also, I've had the test done already to ensure that I have no antibodies to artificial epo. So in my view, I'm already ahead of the game in this area - I can adjust for anemia more quickly because I don't have to get permission from insurance, doctors etc for epo, I just have to adjust levels on a med I already use if hemolysis occurs. My anemia, by the way, is not hemolytic in nature. I have a normocytic anemia that appears to be the result of my body's inability to manufacture epo appropriately. My kidneys are fine, my body just seems to have some difficulty understanding when its time to make epo or, alternately, it may be suppressing natural epo production somehow, but that seems unlikely. Ultimately, nobody knows what is really causing the problem but since epogen works so well and my kidneys are fine, it seems a little academic.
I'm very sorry for your situation. It's so very rare that you should get HepC this way on top of everything (and I know from experience how hard it is to be violated by someone you know - I think it happens WAY more than anybody realizes) but at least you found out right away so you can try to get rid of it before it has the chance to really take hold of you.
Thank God you are a smart person and did all the right things by getting tested.
Regular old primary care doctors really don't know squat about Hep C (even though many of them think they do, they do not) and you are MUCH better off going to a GI. Bill 1954 is right hand cuff yourself in there, do whatever you have to do. Believe me unfortunately we've all seen how uncaring some of the people in the medical field are and he's right it's just a JOB to many of them.
To others (like Dr. Ira Jacobson mentionned above) it is a CALLING and they have more caring in them somehow, more compassion well it amazes me. He has a GREAT phycians assistant there I wish I could remember his name because I'm sure even if Dr. J was busy this guy would talk to you.
You have nothing to lose and everything to gain by reaching out to them.
This forum here is full of the most kind and caring people I've EVER come across in my life. Keep asking whatever questions you have because honestly...the knowledge in here has doubled what some of the doctors I've met have had. It's like they read out of an old text book and think that is "treatment" - well it's not. so ask away - everyone is here to help you as hard as we can.
Good luck,
Thank God you are a smart person and did all the right things by getting tested.
Regular old primary care doctors really don't know squat about Hep C (even though many of them think they do, they do not) and you are MUCH better off going to a GI. Bill 1954 is right hand cuff yourself in there, do whatever you have to do. Believe me unfortunately we've all seen how uncaring some of the people in the medical field are and he's right it's just a JOB to many of them.
To others (like Dr. Ira Jacobson mentionned above) it is a CALLING and they have more caring in them somehow, more compassion well it amazes me. He has a GREAT phycians assistant there I wish I could remember his name because I'm sure even if Dr. J was busy this guy would talk to you.
You have nothing to lose and everything to gain by reaching out to them.
This forum here is full of the most kind and caring people I've EVER come across in my life. Keep asking whatever questions you have because honestly...the knowledge in here has doubled what some of the doctors I've met have had. It's like they read out of an old text book and think that is "treatment" - well it's not. so ask away - everyone is here to help you as hard as we can.
Good luck,
Bring a pair of handcuffs and chain yourself to the reception desk at the GI doc :o). Be as proactive as it takes; this is their job, but your life. I see from another post that you’re aware of the fact that the combo treatment generally affects hemoglobin levels. With pre-existing anemia going in to treatment, that might be somewhat problematic. We’ve had other forum members that have successfully treated with thalassemia minor, a hereditary blood condition. Others have not been so lucky. You might ask the specialist if he’s comfortable with managing this; an option is to bring a hematologist into the midst. One thing at a time, though; get a good diagnosis first.
Best of luck tomorrow, and keep us up to speed if you get a chance—
Bill
Best of luck tomorrow, and keep us up to speed if you get a chance—
Bill
I just switched to this new primary care doc because my old doc closed his office. He does still have his license though (the old doc), so if I cannot get in as a work-in at the specialist's office either tomorrow, or the first of next week, I will have my old primary care doctor call those particular lab tests in to the local hospital and I'll go there and take them
I understand your primary doctor’s reluctance to *interpret* the results of a PCR test. However, this test generally requires 7 to 10 days to process. It will be necessary to run this test regardless; I’d definitely press to have this performed ASAP. Have your doctor order a Quest Diagnostics “Heptimax”, along with a genotype test. The Heptimax is considered to be very sensitive (down to <5 IU/mL), and will give you quantitative results (i.e. expressed in numerical value, rather than pos/neg). The genotype test is an additional test that will define the “strain” of HCV you have. Again, both of these tests will be needed; but get the clock ticking.
Please stay in touch with the forum and let us know how things proceed. This is a good, caring group here- you found an excellent place for support.
Bill
Please stay in touch with the forum and let us know how things proceed. This is a good, caring group here- you found an excellent place for support.
Bill
Thank you everyone for your helpful advice,
Bill - I've read about the PCR, however, after referring me to the gastro guy today, my primary care physician announced that he would not do further testing himself, he wanted to leave it to the "specialist." I wanted to go ahead and do the gamut of further testing, with genotype testing and liver enzymes today, so that when I finally SEE the specialist, he'll have all of the documentation he needs to start me on the medication protocol. My primary care physician was having none of that.
Soooo... tomorrow, I am going to go and sit in the waiting room of the specialist with my little medical chart and see if he will feel sorry for me since I've driven for forty-five minutes, and squeeze me in. Otherwise, I have to wait until the 17th (because that's the date I'm really supposed to see him). And I won't be able to work feeling this lousy physically and also, just worrying about things emotionally, if I have to wait until the 17th. I am WAY too neurotic for that. If I really am unable to see a specialist until the 17th though, I am going to take your advice and try to prevail upon my primary care physician to at least repeat the first test to guard against any possibility that it was a false positive.
Bill - I've read about the PCR, however, after referring me to the gastro guy today, my primary care physician announced that he would not do further testing himself, he wanted to leave it to the "specialist." I wanted to go ahead and do the gamut of further testing, with genotype testing and liver enzymes today, so that when I finally SEE the specialist, he'll have all of the documentation he needs to start me on the medication protocol. My primary care physician was having none of that.
Soooo... tomorrow, I am going to go and sit in the waiting room of the specialist with my little medical chart and see if he will feel sorry for me since I've driven for forty-five minutes, and squeeze me in. Otherwise, I have to wait until the 17th (because that's the date I'm really supposed to see him). And I won't be able to work feeling this lousy physically and also, just worrying about things emotionally, if I have to wait until the 17th. I am WAY too neurotic for that. If I really am unable to see a specialist until the 17th though, I am going to take your advice and try to prevail upon my primary care physician to at least repeat the first test to guard against any possibility that it was a false positive.
wow, that IS a podunk town.
Of course, it's optimal to start tx in the first 30 days but often an acute doesn't present in that window.
60 days is optimal too and sometimes folks STILL haven't presented in that time. My window was right at 2 months for diagnosis.
Gish, my hep doc likes to start tx at 90 days but says anything within six months is still a wonderful window. do you have a viral load yet?
I started tx at 4 months and one week. Within two weeks of tx i was undetectable. my worse viral load was 42,000 at eight weeks post exposure, down to 192 and then up to 4000 the day before treatment started. believe me, these are tiny viral loads.
the one thing you need to do prior to thinking about treating is get a viral load.
i have to agree on the efficacy of this acute window, Lord knows I wouldn't have treated this early if it wasn't worth it from the benefit standpoint.
get that viral load immediately. PCR or TMA.
Deb
PS: I know someone who was infected under extreme similar circumstances but i haven't heard from her lately so i'm hoping she's gone on with her life happily after clearing.
Of course, it's optimal to start tx in the first 30 days but often an acute doesn't present in that window.
60 days is optimal too and sometimes folks STILL haven't presented in that time. My window was right at 2 months for diagnosis.
Gish, my hep doc likes to start tx at 90 days but says anything within six months is still a wonderful window. do you have a viral load yet?
I started tx at 4 months and one week. Within two weeks of tx i was undetectable. my worse viral load was 42,000 at eight weeks post exposure, down to 192 and then up to 4000 the day before treatment started. believe me, these are tiny viral loads.
the one thing you need to do prior to thinking about treating is get a viral load.
i have to agree on the efficacy of this acute window, Lord knows I wouldn't have treated this early if it wasn't worth it from the benefit standpoint.
get that viral load immediately. PCR or TMA.
Deb
PS: I know someone who was infected under extreme similar circumstances but i haven't heard from her lately so i'm hoping she's gone on with her life happily after clearing.
Be sure to request hard copies of all labs, correspondence, etc. that you generate from here on out; they will help you remain informed as well as additionally benefit you if this case goes to trial. Medical privacy laws vary from state to state; make sure that your doctors cc you on the lab orders.
Again, I’m sorry to hear of this attack,
Bill
Again, I’m sorry to hear of this attack,
Bill
I’m saddened by your story. I wish there was something I could say to make things better; all we can do sometimes is continue to move forward.
I’m in California, and not familiar with LA Hepatology. I’m assuming that you’re currently being cared for by your primary care physician. Although the antibody test you were given has a high s c/o score, it still only tests for antibodies.
INSIST on a Nucleic Acid Test; this will be generically known as HCV RNA PCR, or possibly bDNA, TMA testing. These test results are extremely accurate for the presence of active HCV virus; without positive PCR results, you really can’t be properly diagnosed with HCV. The PCR results will need to be *carefully* analyzed by a qualified and experienced medical doctor due to your possible acute status; there may be some fluctuation in viral load because of this.
I’d advise you to e-mail several top-notch Hepatologists for their opinion, even if they are out of your area. They may be able to guide you. Several come to mind:
Dr Robert Gish, California Pacific Medical Center, San Francisco
Dr Douglas Dietrich, NYC
Dr Ira Jacobson, NYC
Dr Mitchell Shiffman, Duke University, NC ?
Here is Dr Gish’s telephone: (415) 600-1020
Others here will hopefully chime in with the other doc’s contact numbers.
Your right regarding a limited time to deal with this as a possible acute case- make the best you can of it.
Again, sorry this occurred—
Take care,
Bill
I’m in California, and not familiar with LA Hepatology. I’m assuming that you’re currently being cared for by your primary care physician. Although the antibody test you were given has a high s c/o score, it still only tests for antibodies.
INSIST on a Nucleic Acid Test; this will be generically known as HCV RNA PCR, or possibly bDNA, TMA testing. These test results are extremely accurate for the presence of active HCV virus; without positive PCR results, you really can’t be properly diagnosed with HCV. The PCR results will need to be *carefully* analyzed by a qualified and experienced medical doctor due to your possible acute status; there may be some fluctuation in viral load because of this.
I’d advise you to e-mail several top-notch Hepatologists for their opinion, even if they are out of your area. They may be able to guide you. Several come to mind:
Dr Robert Gish, California Pacific Medical Center, San Francisco
Dr Douglas Dietrich, NYC
Dr Ira Jacobson, NYC
Dr Mitchell Shiffman, Duke University, NC ?
Here is Dr Gish’s telephone: (415) 600-1020
Others here will hopefully chime in with the other doc’s contact numbers.
Your right regarding a limited time to deal with this as a possible acute case- make the best you can of it.
Again, sorry this occurred—
Take care,
Bill
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