I am worried.. VL and Genotype plus no biopsy..

[Ranadil]

Hello everyone..
I am 53 years old female

a Diabetic patient but my Diabetes is controlled very well..

I've platelets problem as well, my platelets are around 80,000 to 100,000.. they keep movin in this.

Due to platelets problems, doctors couldnt do biopsy of my liver.

What are chances of recovery?

My Quantitative PCR shows 5,897,571 IU/ml and Genotype is 3a.

And also tell me at what stage I am? is this Viral Load is so much?

and My other test reports shows that My liver doesnt have anything bad till now By Gods grace..

Its fine .. a mild roughness appeared on it though.

[Ranadil]

One more thing I would like to tell everyone..

My ALT is never more than 80.. It always stood b/w 60 and 80 ..

[copyman]

Ranadil. Relax, having low platelets does not mean you are a stage 4 and have cirrhosis. there would have to be other markers / symptoms to go along with the low platelets. the only way to tell for sure is get a liver biopsy. A CT scan or ultrasound does not tell how much liver damage you have, they can show tumors, etc but not liver damage like fibrosis.
If I was you I would see a Hepatologist (liver specialist) to see exactly what is going on and to put a plan together.
Good luck

[Ranadil]

and also

if God forbid I am at stage 4, than at that point with all conditions written, there are chances of Recovery?

[Ranadil]

I would like to say that Doctors performed CT scan of my intestines and stomach and found it not that damaged.

Plus doesnt the ultrasound of liver shows anything? Plus I would like to tell you that I am not experiencing any prioblem, I dont experience fatigue or anything like that..I am By Gods grace alright but sometimes excess of work causes tireness but I am okay..

My HB level is absolutely fine, but I am worried since I dont know if my liver has cirrosis or not..

and yeah My Platelets are never upto the the standard, they were always less .. They are less since 8 years like they just keep moving in 80,000 to 100,000 but I just diagonosed HCV one year back i.e in 2008.

Now well last year I had a serious Urinary Tract Infection due to which my platelets fell so much.. they fell to 25,000 but after I was treated with UTI, they got well and also doctors tried an injection of Thorombomax.. only one injection due to which in a week or so my platelets went to 200,000..

[mikesimon]

Your platelet count of 80,000 - 100,000 should not preclude a liver biopsy.
There are many sources in support of the fact that < 60,000 in usually the point at which bleeding risk precludes biopsy. Also a slow clotting time (prothrombin time) is a contraindication.

This is from: http://emedicine.medscape.com/article/185230-overview

Contraindications To Liver Biopsy

Contraindications to percutaneous liver biopsy are relatively few, but identifying contraindications is important to avoid the major complications associated with the procedure. Contraindications to liver biopsy include the following:

    * Increased prothrombin time, international normalized ratio (INR) greater than 1.6
    * Thrombocytopenia, platelet count less than 60,000
    * Ascites (transjugular route preferred)
    * Difficult body habitus (transjugular route preferred)
    * Suspected hemangioma
    * Suspected echinococcal infection
    * Uncooperative patient

Mike

[JennyPenny]

Like the others have said, a biopsy is the gold standard for how much damage your liver has sustained. However, with platelets in the range you report, it is likely that you have cirrhosis (Stage 4). I have lived with cirrhosis for the past 18 years and I am still here alive and kicking. With a 3A genotype, you have a decent chance of clearing the virus although the cirrhosis makes it a bit more difficult.

My doctor did my biopsy laprascopically as my platelets were around 80,000 due to treatment.

Good luck.

[copyman]

your PCR # has nothing to do with how much liver damage you have. it really means nothing until you treat then it is monitored to see how well you are responding to the treatment.
You could have a blood test called a fibrosure to rule out cirrhosis. This test is not that accurate for the middle stages but very good at the low end FO-1 and high end F4 Cirrhosis.
Also you could have a trans juglar liver biopsy that is done for people with low platelets.

Being a genotype 3 gives you a very good chance of "cure" if you decide to treat. Also you will only have to treat for 6 months.

Good luck

[newleaf09]

Biopsy is the guaranteed method of assessing damage but there are a few orther methods with some reliability, just not guaranteed.  I think one of those tests is called Fibroscan (?), not sure.  Only the biopsy can truly tell you which stage (1-4) of scarring (fibrosis) exists.  Ultrasounds and the like cannot give a picture of fibrosis.  The platelets are an issue because you cannot treat the disease without interferon, which causes platelet level to drop.  There are some HCV treatment drug trials going on now involving eltrombopag, a drug that causes increased platelet production.  You will find some discussion on this forum about the drug (brand name Promacta).  Low platelets are, unfortunately, a common sign of cirrhosis of the liver, the stage of advanced liver disease where the liver begins to fail.

The VL is not really an issue unless it is low (below a million) , in which case it can indicate a more likely cure.  Your genotype, 3, is among the more easily cured, meaning more likely to cure and treatment for a shorter period.  Good luck.